During her prenatal exam at 26-weeks gestation, a client expresses feeling faint while lying supine on the examination table.
Which action should the practical nurse (PN) implement?
Elevate the head of the examination table.
Assist the client to a lateral position.
Place the examination table in Trendelenburg.
Step out of the room to notify the healthcare provider (HCP).
The Correct Answer is B
Choice A rationale
Elevating the head of the examination table would not effectively alleviate supine hypotensive syndrome. This condition occurs due to compression of the vena cava by the gravid uterus, reducing venous return to the heart. While elevating the head might provide some comfort, it does not directly address the underlying circulatory compromise.
Choice B rationale
Assisting the client to a lateral position, particularly the left lateral position, is the most effective intervention. This maneuver displaces the gravid uterus off the inferior vena cava, increasing venous return to the heart, thereby improving cardiac output and uteroplacental perfusion, which alleviates symptoms of faintness and dizziness.
Choice C rationale
Placing the examination table in Trendelenburg position involves lowering the head and raising the foot of the bed. This position would further exacerbate vena caval compression in a pregnant client, potentially worsening supine hypotensive syndrome and increasing the risk of aspiration, making it an contraindicated intervention.
Choice D rationale
Stepping out of the room to notify the healthcare provider (HCP) before addressing the immediate physiological distress is inappropriate. The PN should first implement immediate interventions to stabilize the client's condition, such as repositioning, and then promptly inform the HCP about the event and the interventions performed.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["0.3"]
Explanation
Step 1 is to convert the child's weight from pounds to kilograms. 66 pounds ÷ 2.2 pounds/kg = 30 kg.
Step 2 is to calculate the total dose in milligrams. 0.01 mg/kg × 30 kg = 0.3 mg.
Step 3 is to calculate the volume to administer in milliliters. 0.3 mg ÷ (1 mg/mL) = 0.3 mL.
Correct Answer is D
Explanation
Choice A rationale
Collecting a urine specimen for electrolytes and protein would not directly address the client's acute symptoms of restlessness and apprehension. While important for general assessment, these lab parameters are not the primary indicators of fetal distress or immediate maternal physiological deterioration in this context. Normal electrolyte ranges: sodium 135-145 mEq/L, potassium 3.5-5.0 mEq/L. Protein in urine is usually negative.
Choice B rationale
Moving the client into a dorsal recumbent position can actually exacerbate vena caval compression in a laboring client at 42-weeks gestation, potentially leading to supine hypotensive syndrome, which would worsen rather than alleviate restlessness and apprehension due to decreased cardiac output and uteroplacental perfusion.
Choice C rationale
Encouraging the client to push with the next contraction is inappropriate given her symptoms of restlessness and apprehension. These symptoms could indicate evolving complications, such as hypoxemia or even early stages of hypovolemic shock, requiring immediate assessment of vital signs and fetal well-being before encouraging active labor efforts.
Choice D rationale
Providing information about the baby's status can help alleviate the client's apprehension, especially if her symptoms are related to anxiety about the labor process or fetal well-being, which is common in intrapartum fever. Scientific rationale supports addressing psychological distress to improve coping mechanisms.
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