Exhibits

Click to highlight the findings that indicate an improvement in the client’s condition.

Nurses Notes

2230:

Contractions occurring every 2.5 to 3 minutes, lasting 60 to 70 seconds. Epidural placed by anesthesiologist. Client rates pain with contractions as a 3 on a scale of 0 to 10. FHR 150/min with moderate variability. Accelerations present, no decelerations noted.

Vital Signs

2230:

Temperature 38° C (100.4° F)

Heart rate 88/min

Respiratory rate 16/min

Blood pressure 122/80 mm Hg

Oxygen saturation 98% on room air

A. Projection:Projection involves attributing one's own unacceptable thoughts or feelings to someone else. For example, a person who overeats might accuse others of having poor self-control, rather than acknowledging their own behavior.

B. Sublimation:Sublimation is a mature defense mechanism in which unacceptable impulses or urges are redirected into socially acceptable or constructive activities. In this case, turning the urge to overeat into productive presentations about nutrition is a clear example.

C. Introjection:Introjection is the unconscious adoption of another person’s ideas, values, or behaviors as one’s own. It does not explain the client’s channeling of impulses into positive action, which is better described by sublimation.

D. Dissociation:Dissociation involves a disconnection from thoughts, feelings, memories, or sense of identity. It is often seen in trauma-related disorders, not in purposeful, constructive activities like giving presentations.

A. Chicken pox: Chicken pox (varicella) typically presents with a vesicular rash starting on the trunk and spreading to the face and extremities. It does not cause bluish-white spots on the buccal mucosa and rarely appears without skin lesions.

B. Roseola: Roseola (sixth disease) is characterized by a high fever followed by a sudden rose-colored rash as the fever subsides. It does not cause lesions in the mouth such as Koplik spots, which are associated with measles.

C. Measles: Bluish-white spots on the buccal mucosa, known as Koplik spots, are a hallmark sign of measles and often appear before the characteristic maculopapular rash. This early sign helps identify the disease even when no other symptoms are present.

D. Erythema infectiosum: Also known as fifth disease, this condition usually presents with a "slapped cheek" facial rash followed by a lacy rash on the body. It does not produce oral lesions like the buccal mucosa spots seen in measles.