A pregnant woman is getting ready for a chorionic villus sampling procedure at 10 weeks.

The nurse has been educating her about the procedure.

Which of the following statements, if made by the client, would indicate that the teaching has been effective?

Choice A rationale:

Joining a support group can be beneficial. I can provide some recommendations.

Support groups offer a safe and supportive environment where couples can share their experiences, feelings, and coping strategies with others who understand what they are going through. This can be incredibly helpful in reducing isolation, normalizing their emotions, and promoting a sense of hope. Support groups can also provide valuable information and resources about infertility, treatment options, and coping strategies. Additionally, they can help couples develop a sense of community and belonging, which can be especially important during a challenging time.

I can provide some recommendations for support groups in your area. This demonstrates the nurse's willingness to help the couple find the resources they need and underscores the value of support groups in managing infertility.

Choice B rationale:

Share your situation with friends and family so they can provide support.

While sharing with friends and family can be helpful for some couples, it's important to recognize that not everyone may be able to provide the kind of support that is needed. Some friends and family members may not understand the challenges of infertility or may offer unsolicited advice, which can be hurtful. Additionally, couples may not feel comfortable sharing such personal information with their loved ones. It's important to respect the couple's privacy and preferences in this regard.

Choice C rationale:

Start adoption proceedings immediately as it can be challenging to adopt an infant.

This response is not appropriate as it does not address the couple's immediate concern, which is how to maintain their emotional balance while dealing with infertility. It also assumes that the couple is interested in adoption, which may not be the case. While adoption can be a wonderful option for some families, it's a major decision that requires careful consideration and should not be rushed into.

Choice D rationale:

Speak only with other friends who are dealing with infertility as they can provide the most help.

While connecting with others who are experiencing infertility can be helpful, it's important not to isolate oneself from other sources of support. Friends and family who are not dealing with infertility can still offer valuable support, understanding, and companionship. It's important to have a variety of supportive relationships in one's life.

The correct answers are B, C, E, and F.

Rationale for each choice:

1. Albuterol

Mechanism of action: Albuterol is a beta-2 agonist that stimulates beta-2 receptors in the cell membranes of skeletal muscle, liver, and adipose tissue. This stimulation causes an increase in intracellular cyclic AMP (cAMP), which activates protein kinase A (PKA). PKA then phosphorylates a number of proteins, including the sodium-potassium ATPase pump. This pump is responsible for transporting potassium ions into cells and out of the bloodstream. By increasing the activity of this pump, albuterol can help to lower serum potassium levels.

Onset of action: Albuterol has a rapid onset of action, typically within 30 minutes.

Duration of action: The duration of action of albuterol is relatively short, usually 4-6 hours.

Dosage: The dosage of albuterol for hyperkalemia is typically 10-20 mg nebulized every 4-6 hours.

Additional considerations: Albuterol can cause tachycardia and tremors. It should be used cautiously in patients with heart disease or hyperthyroidism.

1. Kayexalate

Mechanism of action: Kayexalate is a cation exchange resin that binds to potassium ions in the gastrointestinal tract. This prevents the potassium from being absorbed into the bloodstream.

Onset of action: Kayexalate has a relatively slow onset of action, usually 1-2 hours.

Duration of action: The duration of action of Kayexalate is relatively long, usually 4-6 hours.

Dosage: The dosage of Kayexalate for hyperkalemia is typically 15-30 grams orally or rectally every 6 hours.

Additional considerations: Kayexalate can cause constipation and hypocalcemia. It should be used cautiously in patients with bowel obstruction or kidney disease.

1. Insulin & dextrose

Mechanism of action: Insulin promotes the movement of potassium into cells, thus lowering serum potassium levels. Dextrose is given along with insulin to prevent hypoglycemia.

Onset of action: Insulin has a rapid onset of action, typically within 30 minutes.

Duration of action: The duration of action of insulin is relatively short, usually 4-6 hours.

Dosage: The dosage of insulin for hyperkalemia is typically 10 units of regular insulin IV push, followed by an infusion of 5-10 units per hour. The dosage of dextrose is typically 50 grams IV push, followed by an infusion of 10% dextrose at 100 mL/hour.

Additional considerations: Insulin can cause hypoglycemia. It should be used cautiously in patients with diabetes mellitus.