A provider orders IV pain medication for your pregnant client, who is now requesting pain medication due to kidney stones.

The order is Hydromorphone 1.5 mg IV push every 4 hours as needed for pain.

The only available concentration in the pyxis is 4 mg per 1 mL. How many milliliters should the nurse administer? Round to the tenths place.

Choice A rationale

Dismissing a client's concerns, regardless of whether they are a normal finding, can invalidate their feelings and damage the therapeutic relationship. This approach fails to address the client's psychosocial needs, potentially leading to increased stress, anxiety, and non-adherence to care recommendations. Nursing practice emphasizes holistic care, which includes acknowledging and addressing emotional distress to promote psychological well-being. This intervention is not therapeutic or supportive.

Choice B rationale

While it's true that some women's bodies do recover postpartum, explaining this without first addressing the client's current concerns can be dismissive. The client's present body image distress is the immediate issue. Providing information about future outcomes without validating their current feelings can seem unfeeling and may not provide the immediate support needed. The focus should be on the now, not just on a future possibility.

Choice C rationale

Stretch marks, or striae gravidarum, are a result of the stretching of the dermis, the middle layer of skin, due to rapid growth during pregnancy. The integrity of the skin's connective tissue, specifically collagen and elastin fibers, is compromised. Topical lotions are largely ineffective in preventing their formation as the changes occur at a deeper dermal level. Lotions may help with skin hydration and itching, but they do not prevent stretch marks.

Choice D rationale

Acknowledging a client's concerns validates their feelings and establishes a trusting nurse-client relationship. By encouraging sharing, the nurse creates a safe space for the client to express their emotions. This therapeutic communication technique promotes emotional well-being and allows the nurse to assess the severity of the concern and provide individualized, empathetic support. It addresses the psychosocial aspect of care.

Choice E rationale

Referring a client for counseling is an appropriate intervention when their body image concerns are significant, persistent, or causing distress beyond the scope of a typical nursing conversation. Counseling can provide professional support and coping strategies. This intervention demonstrates an understanding that psychosocial issues may require specialized care, and it empowers the client to seek help from a qualified mental health professional. It is a key nursing intervention. *.

Choice A rationale

While follow-up serologic testing is an important part of managing syphilis, it is not the initial priority. The most immediate and critical intervention is to treat the infection to prevent vertical transmission to the fetus, which can lead to severe congenital syphilis. Without immediate treatment, the fetus is at high risk for serious complications.

Choice B rationale

The priority in managing a pregnant patient with syphilis is to ensure she and her partner receive appropriate treatment with penicillin. This is the only therapy proven effective in treating maternal infection and preventing congenital syphilis. The prompt treatment of both partners is crucial to prevent reinfection and protect the fetus from serious complications like stillbirth or congenital abnormalities.

Choice C rationale

While patient education is crucial, informing the patient about the risks of congenital syphilis is a secondary step to the primary intervention of administering treatment. The immediate priority is to initiate the therapy that will mitigate the risk and protect the fetus from harm. Without treatment, knowledge of the risk is insufficient to prevent the adverse outcomes.

Choice D rationale

Educating the patient on safe sexual practices is a vital component of comprehensive care to prevent future STIs. However, in the context of an active infection during pregnancy, the immediate priority is to treat the existing condition with penicillin to prevent congenital syphilis, which poses the greatest immediate threat to the fetus.