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A nurse reviews the provider prescriptions and reassesses the client.
Exhibits
The nurse is continuing to care for the client. Which of the following actions should the nurse take? Select all that apply.

Initiate contact precautions.

Inform the client she will need to formula feed her newborn until she has received antibiotics for 24 hr.

Monitor the height and tone of the client's fundus.

Request a prescription for terbutaline from the provider.

Obtain a culture specimen of the lochia from the client's perineal pad using a sterile swab,

Encourage the client to maintain a semi-Fowler's position to enhance uterine drainage.

Instruct the client to wash her hands before and after changing her perineal pad.

Answer and Explanation

Correct Answer : C,E,F,G

Rationale:

A. Initiate contact precautions: Endometritis is not typically caused by a pathogen requiring contact precautions (like MRSA or C. difficile). Standard precautions are sufficient unless otherwise indicated.

B. Inform the client she will need to formula feed her newborn until she has received antibiotics for 24 hr: The prescribed antibiotics (e.g., clindamycin) are generally considered safe for breastfeeding, and lactation should be encouraged unless specifically contraindicated.

C. Monitor the height and tone of the client's fundus: Fundal tenderness, foul-smelling lochia, and fever are signs of endometritis. Ongoing fundal assessment is important to evaluate uterine involution and identify potential complications like subinvolution or abscess formation.

D. Request a prescription for terbutaline from the provider: Terbutaline is a tocolytic used to relax the uterus in cases of hyperstimulation during labor not for treating uterine infection or postpartum discomfort.

E. Obtain a culture specimen of the lochia from the client's perineal pad using a sterile swab: Culturing lochia helps identify the causative organism of the uterine infection and guide antibiotic therapy. This is a standard step in suspected endometritis cases.

F. Encourage the client to maintain a semi-Fowler's position to enhance uterine drainage: Positioning the client with the head elevated allows for better lochia drainage, preventing accumulation that could worsen infection or discomfort.

G. Instruct the client to wash her hands before and after changing her perineal pad: Good perineal hygiene helps prevent the spread of infection and supports recovery, especially in the context of suspected endometritis.

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Correct Answer is ["A","B","C"]

Explanation

Rationale:

A. Maternal diabetes: Infants born to diabetic mothers are at increased risk for hypoglycemia due to elevated insulin levels stimulated by maternal hyperglycemia. After birth, the abrupt loss of maternal glucose can lead to a rapid drop in the infant’s blood sugar.

B. Prematurity: Premature infants have limited glycogen stores and immature metabolic systems, making them more susceptible to hypoglycemia. Their inability to effectively regulate glucose levels increases their risk after birth.

C. Hypothermia: Cold stress increases metabolic demands and glucose consumption. As the infant uses more energy to maintain body temperature, blood glucose levels can drop rapidly if not closely monitored and managed.

D. Thrombocytopenia: Low platelet counts may indicate other underlying conditions but are not directly associated with hypoglycemia. It is more relevant to clotting and bleeding risks rather than glucose regulation.

E. Anemia: Anemia affects oxygen-carrying capacity but does not have a direct link to blood glucose control. While it may indicate other health issues, it is not a recognized independent risk factor for neonatal hypoglycemia.

A. "Placement of the catheter is confirmed by a CT scan." B. "You will be under general anesthesia for this procedure." C. "The provider will wear a mask while performing the procedure." D. "Your head will be elevated as high as possible while the catheter is inserted."

Correct Answer is C

Explanation

Rationale:

A. "Placement of the catheter is confirmed by a CT scan.": Catheter placement is typically confirmed by a chest X-ray, not a CT scan, to verify correct positioning and rule out complications such as pneumothorax. CT imaging is not routine for this purpose.

B. "You will be under general anesthesia for this procedure.": Placement of a nontunneled percutaneous central line is usually done under local anesthesia with possible mild sedation. General anesthesia is not required for this relatively short and minimally invasive procedure.

C. "The provider will wear a mask while performing the procedure.": A mask, along with sterile gloves, gown, and drape, is worn to maintain sterile technique and reduce the risk of catheter-related bloodstream infections. This is standard protocol during central line insertion.

D. "Your head will be elevated as high as possible while the catheter is inserted.": The client is usually placed in the Trendelenburg position (head down) during catheter insertion to distend neck veins and reduce the risk of air embolism—not in a high head-elevated position.

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A nurse reviews the provider prescriptions and reassesses the client.Exhibits The nurse is continuing to care for the client. Which of the following actions should the nurse take? Select all that apply.

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A nurse reviews the provider prescriptions and reassesses the client.
Exhibits
The nurse is continuing to care for the client. Which of the following actions should the nurse take? Select all that apply.