A nurse is collecting data from a client who is 18 hr postpartum. The nurse notes that the client is in the "taking-in phase" of maternal adjustment. Which of the following manifestations should the nurse expect?
Tolerates physical discomforts
Performs self-care independently
Begins reconnecting with their partner
Is eager to review the birth experience
The Correct Answer is D
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason:
Wipe any excess medication from the inner canthus outward. When administering ophthalmic ointment to a child, it's essential to apply the medication gently and accurately. To prevent the spread of infection and ensure proper absorption, the nurse should instruct the guardian to wipe any excess medication from the inner canthus (the inner corner of the eye) outward. This technique helps to prevent contamination of the medication tube and minimizes the risk of introducing bacteria into the eye.
Choice B Reason:
Placing an occlusive dressing on the affected eye is not necessary for treating acute bacterial conjunctivitis.
Choice C Reason:
Instructing the guardian to apply erythromycin ophthalmic ointment is incorrect because the child has been prescribed bacitracin ophthalmic ointment.
Choice D Reason:
Massaging the eyelid is not necessary and can be uncomfortable for the child. It's important to apply the medication gently and not to massage the eyelid.
Correct Answer is C
Explanation
A) Coiling the tubing on the bed above the collection bag is incorrect because it can cause urine to flow back into the bladder, increasing the risk of infection and compromising the effectiveness of the drainage system. The tubing should be kept below the level of the bladder to ensure proper drainage.
B) Instructing the client to hold the drainage bag at waist height when ambulating is incorrect because the drainage bag should always be kept below the level of the bladder to prevent urine from flowing back into the bladder, which could lead to a urinary tract infection (UTI).
C) Securing the tubing with adhesive tape to the lower abdomen is correct because it helps prevent accidental pulling or tugging on the catheter, which could cause discomfort or dislodgement. Properly securing the tubing also helps maintain a continuous flow of urine and reduces the risk of infection.
D) Collecting a sterile specimen from the urinary drainage bag is incorrect because urine in the drainage bag is not considered sterile. If a sterile specimen is needed, it should be obtained by cleaning the catheter's sampling port with an antiseptic solution and withdrawing urine directly from the port using a sterile syringe.
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