A nurse is planning care for a client who sustained a major burn over 20% of the body. Which of the following interventions should the nurse include to support the client's nutritional requirements?

Schedule meals at 6-hr intervals.

Maintain calorie intake at 1,500 per day.

Keep a calorie count for foods and beverages.

Provide a low-protein, high-carbohydrate diet.

Answer and Explanation

The Correct Answer is C

A. Scheduling meals at 6-hour intervals is inadequate as clients with major burns require frequent, high-calorie intake.

B. A calorie intake of 1,500 per day is insufficient for burn clients, who require significantly higher caloric intake to support healing.

C. Keeping a calorie count helps ensure the client is meeting their increased nutritional needs for wound healing and recovery.

D. A high-protein, high-carbohydrate diet is necessary, not a low-protein diet, to support tissue repair and metabolic demands.

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Correct Answer is ["A","E"]

Explanation

A. Assist the provider with inserting a fetal scalp electrode (FSE) and intrauterine pressure catheter (IUCP): This action is not the priority in the context of the client's current clinical status, particularly with the risk of placental abruption and severe bleeding. Fetal monitoring via scalp electrode and IUCP is typically reserved for stable clients, and invasive monitoring should be avoided in a potentially unstable situation.

B. Obtain serial H&H and clotting studies: The client is presenting with significant vaginal bleeding, low hemoglobin (8.1 g/dL at 0930, decreased to 7.5 g/dL at 1005), and low hematocrit levels (24% at 0930, dropping to 21% at 1005). Serial hemoglobin and hematocrit levels will help monitor ongoing blood loss and guide decisions regarding further interventions, such as transfusion. Clotting studies, including the prothrombin time and PTT, are necessary to assess the client's coagulation status and potential for disseminated intravascular coagulation (DIC), which can be associated with placental abruption or severe bleeding.

C. Administer misoprostol 600 mg rectally: Misoprostol is used to manage postpartum hemorrhage or to induce labor, but it is not indicated in the acute management of this client's condition. The client is 38 weeks gestation and presenting with signs of potential placental abruption, not requiring the use of misoprostol at this time.

D. Place the client in a supine position: The client should not be placed in a supine position, as this may exacerbate hypotension due to the supine hypotension syndrome, particularly if the uterus is compressing the inferior vena cava. The client would benefit more from positioning that promotes circulation, such as lying on the left side.

E. Prepare to transfuse 2 units of packed RBCs: The client is showing signs of hypovolemic shock with progressively declining blood pressure (from 95/62 mm Hg to 85/48 mm Hg), elevated heart rate (from 104/min to 128/min), and worsening hematocrit and hemoglobin. Blood transfusion is likely necessary to restore circulating volume, improve oxygen delivery, and address the ongoing blood loss.

A. Flush the NG tube with 5 mL water. B. Add medication directly to enteral feeding. C. Use a syringe to allow the medications to flow by gravity. D. Dissolve the medications together.

Correct Answer is C

Explanation

A. The NG tube should be flushed with 15-30 mL of water before and after medication administration, not 5 mL.

B. Medications should not be added directly to enteral feeding as it may alter the medication's effectiveness or cause tube clogging.

C. Using a syringe to allow medications to flow by gravity reduces the risk of pressure-related complications and ensures safe administration.

D. Medications should be dissolved separately to prevent interactions or clogging.

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A nurse is planning care for a client who sustained a major burn over 20% of the body. Which of the following interventions should the nurse include to support the client's nutritional requirements?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client. Exhibits Select the 2 actions that the nurse should take.

Correct Answer is ["A","E"]

Explanation

A nurse is preparing to administer three medications to a client who is receiving continuous enteral feeding through an NG tube. Which of the following actions is appropriate for the nurse to take?

Correct Answer is C

Explanation

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