A nurse is positioning a client for a cesarean birth. To prevent a compromise in placental blood flow during the intraoperative period, which of the following actions should the nurse take?

Insert a pillow under the client's knees.

Assist the client into the lithotomy position,

Place a wedge under one of the client's hips.

Position the client in reverse Trendelenburg.

Answer and Explanation

The Correct Answer is C

A) Insert a pillow under the client's knees: While placing a pillow under the knees may promote comfort, it can lead to increased pressure on the lower back and may not effectively address potential compression of the vena cava, which is crucial in maintaining optimal placental blood flow during surgery.

B) Assist the client into the lithotomy position: The lithotomy position can increase pressure on the abdominal vessels, potentially compromising blood flow to the placenta. This position should be used cautiously, especially in clients with concerns regarding blood flow.

C) Place a wedge under one of the client's hips: This action is appropriate as it helps to displace the uterus laterally, reducing pressure on the inferior vena cava. This maneuver improves venous return and maintains placental perfusion, which is critical during cesarean delivery.

D) Position the client in reverse Trendelenburg: Although this position elevates the upper body, it does not specifically address the potential for vena cava compression caused by the weight of the uterus. It is less effective than placing a wedge under the hips in terms of preserving placental blood flow.

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Correct Answer is B

Explanation

A) Ketorolac: Ketorolac is a potent nonsteroidal anti-inflammatory drug (NSAID) often used for severe pain. However, it can cause gastrointestinal irritation and bleeding, which poses a significant risk for a client with a history of peptic ulcers. Therefore, administering ketorolac would not be advisable in this situation.

B) Acetaminophen: Acetaminophen is an analgesic that does not have the gastrointestinal side effects associated with NSAIDs. It is a safer option for clients with a history of peptic ulcers, as it does not irritate the stomach lining and can effectively relieve headache pain without exacerbating ulcer-related complications.

C) Aspirin: Aspirin is another NSAID that can increase the risk of gastrointestinal bleeding, especially in individuals with a history of peptic ulcers. While it is effective for pain relief, its anticoagulant properties and irritation potential make it an unsuitable choice for this client.

D) Ibuprofen: Like other NSAIDs, ibuprofen can cause gastrointestinal issues, including irritation and bleeding. Given the client’s history of peptic ulcers, using ibuprofen could lead to exacerbation of the condition and should be avoided in favor of safer alternatives for pain management.

A. Provide chilled formula. B. Administer feedings at a slower rate. C. Discard the open can of formula after 36 hr. D. Flush the tube with 10 mL of water after feedings.

Correct Answer is B

Explanation

A. Provide chilled formula: Chilled formula can be less palatable and may cause gastrointestinal discomfort, potentially worsening diarrhea. Room temperature or slightly warmed formula is generally recommended for enteral feedings to enhance tolerance and digestion.

B. Administer feedings at a slower rate: Slowing the rate of enteral feedings can help reduce gastrointestinal irritation and improve absorption, which may be particularly beneficial for a client experiencing diarrhea. This approach allows the intestines more time to process the nutrients, potentially alleviating symptoms.

C. Discard the open can of formula after 36 hr: While proper storage is important, many enteral formulas can be stored for up to 48 hours once opened. The key is to ensure the formula is stored correctly to prevent bacterial growth, but the 36-hour guideline may not be strictly necessary in all cases.

D. Flush the tube with 10 mL of water after feedings: Flushing the tube is a good practice to maintain tube patency, but the volume may not be adequate depending on the tube size and the specific protocol. Adequate flushing is essential, but it does not directly address the issue of diarrhea, which is the priority concern in this scenario.

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A nurse is positioning a client for a cesarean birth. To prevent a compromise in placental blood flow during the intraoperative period, which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who reports a headache and has a history of a peptic ulcer. Which of the following medications should the nurse administer?

Correct Answer is B

Explanation

A nurse is caring for a client who has diarrhea and is receiving intermittent enteral feedings. Which of the following actions should the nurse take?

Correct Answer is B

Explanation

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