A nurse is planning care for a client who is scheduled to have a paracentesis. Which of the following actions should the nurse include in the plan of care?

Position the client over an overbed table prior to the procedure.

Instruct the client to empty her bladder prior to the procedure.

Administer 1 L dextrose 5% in water IV bolus prior to the procedure.

Initiate NPO status 4 hr prior to the procedure.

Answer and Explanation

The Correct Answer is B

A.   Positioning the client over an overbed table is not appropriate for a paracentesis procedure and may interfere with the procedure.
B.   Emptying the bladder before the procedure helps to reduce the risk of accidental bladder puncture during paracentesis.
C.   Administering IV fluids prior to the procedure is not typically indicated for a paracentesis, unless specifically ordered by the provider for hydration purposes.
D.   NPO status is not typically required before a paracentesis procedure unless otherwise specified by the provider.

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Correct Answer is C

Explanation

A. Chorioamnionitis, an infection of the fetal membranes, can lead to fetal tachycardia and no bradycardia
B. Fetal anemia might present with tachycardia rather than bradycardia.

C. Maternal hypoglycemia can cause fetal bradycardia since when a mother experiences hypoglycemia, it can result in inadequate blood glucose levels that are crucial for both her and the fetus. This condition can impair the oxygen and nutrient delivery to the fetus, as the mother's body prioritizes her own metabolic needs. Consequently, the fetal heart rate may slow down as a response to the stress of reduced energy supply.
D. Maternal fever is associated with fetal tachycardia rather than bradycardia.

A. A client who has Clostridium difficile and a temperature of 38.6° C (101.5° F) B. A client who has a complete femur fracture and reports a pain level of 7 on a scale from 0 to 10 C. A client who has left shoulder pain and S-T elevation on a 12-lead ECG D. A client who has orthostatic hypotension and 4+ pitting edema in the lower extremities

Correct Answer is C

Explanation

A. While a temperature elevation in a client with Clostridium difficile requires assessment, it is not as urgent as potential cardiac ischemia.
B. Pain assessment in a client with a femur fracture is important but does not take priority over potential cardiac issues.
C. Left shoulder pain with S-T elevation on an ECG can indicate myocardial infarction (MI), a life-threatening condition requiring immediate assessment and intervention.
D. Orthostatic hypotension and pitting edema, while concerning, do not indicate an acute, life-threatening condition that requires immediate assessment in this scenario.

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A nurse is planning care for a client who is scheduled to have a paracentesis. Which of the following actions should the nurse include in the plan of care?

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