A nurse is reviewing the prescriptions for a client who is pregnant and is taking digoxin.
Which of the following actions should the nurse take to best evaluate the client's medication adherence?

Determine the client's apical pulse rate.

Ask the client if they are taking the medication as prescribed.

Assess the client's kidney function.

Check the client's serum medication level.

Answer and Explanation

The Correct Answer is B

Rationale:

A. Determining the client's apical pulse rate is important for monitoring the effects of digoxin therapy but does not directly assess medication adherence.

B. Asking the client if they are taking the medication as prescribed is a direct way to evaluate medication adherence. Open communication with the client can provide valuable insight into their medication-taking behavior.

C. Assessing the client's kidney function is important for monitoring the effects of digoxin therapy but does not directly assess medication adherence.

D. Checking the client's serum medication level can provide information about medication concentration but may not necessarily indicate adherence, as the level could be within the therapeutic range even if the client is not taking the medication as prescribed.

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Correct Answer is ["C","G","H"]

Explanation

A. Peripheral edema 2+ bilateral lower extremities - Peripheral edema is common postpartum and does not typically require immediate follow-up unless it is associated with other concerning signs or symptoms.
B. Blood pressure 136/6 mm Hg - The blood pressure provided appears to be incorrect, as the diastolic pressure is unusually low. However, given the options provided, blood pressure is not explicitly mentioned in the scenario as a critical factor requiring immediate follow-up.
C. Lateral deviation of the uterus - Lateral deviation of the uterus suggests uterine atony, a potential complication of postpartum hemorrhage, requiring immediate follow-up and intervention to prevent further complications.
D. Pain rating of 3 on a scale of 0 to 10 - While increased pain should be addressed, it does not necessarily indicate an emergency situation requiring immediate follow-up compared to other findings such as uterine deviation or excessive bleeding.
E. Deep tendon reflexes 1+ - This finding is within normal limits and does not require immediate follow-up.
F. Breasts soft - Soft breasts are expected in the postpartum period and do not typically require immediate follow-up unless associated with other concerning signs or symptoms.

G. Large amount of lochia rubra - A large amount of bright red lochia could indicate postpartum hemorrhage, necessitating immediate follow-up and intervention to prevent further complications.
H. Uterine tone soft - Soft uterine tone suggests uterine atony, which is a potential complication requiring immediate follow-up and intervention to prevent excessive bleeding.

A. Instruct the client that an autopsy should be performed within 24 hr. B. Inform the client that the law requires them to name the fetus. C. Provide the client with photos of the fetus. D. Limit the amount of time the fetus is in the client's room.

Correct Answer is C

Explanation

A. While an autopsy can be an option for determining the cause of stillbirth, it is not a requirement, and the decision should be made by the parents. This statement may add undue pressure on the client.

B. There is no legal requirement for parents to name a stillborn fetus. This can be a sensitive topic, and it is essential to respect the parents' wishes and feelings in this regard.

C. Providing the client with photos of the fetus can help the parents in their grieving process, allowing them to create memories and acknowledge their loss. This action can offer emotional support and validation of their experience.

D. Limiting the time the fetus is in the client's room may not consider the parents' need for closure and the opportunity to say goodbye. Encouraging the family to spend time with their stillborn child can be an important aspect of the grieving process.

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A nurse is reviewing the prescriptions for a client who is pregnant and is taking digoxin.Which of the following actions should the nurse take to best evaluate the client's medication adherence?

Nursing Test Bank

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A nurse is reviewing the prescriptions for a client who is pregnant and is taking digoxin.
Which of the following actions should the nurse take to best evaluate the client's medication adherence?