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Exhibits

Click to highlight the findings that indicate improvement in the client's condition. To deselect a finding, click on the finding again.

Assessment

Findings

Nurses' Notes

Client rates lower back pain a 0 on a scale from 0 to 10. No reports of vaginal discharge.

Membranes intact

No uterine contractions noted.

FHR baseline 138, minimal variability.

No further reports of burning with urination.

Laboratory Results

WBC 12,000/mm2 (5,000 to 10,000/mm3)

Platelet count 188,000/mm3 (150,000 to 400,000/mm3)

Vital Signs

Temperature 37.1° C (98.7° F)

Blood pressure 120/78 mm Hg

Client rates lower back pain a 0 on a scale from 0 to 10. No reports of vaginal discharge.

No uterine contractions noted.

No further reports of burning with urination.

WBC 12,000/mm2 (5,000 to 10,000/mm3)

Temperature 37.1° C (98.7° F)

Membranes intact

FHR baseline 138, minimal variability.

Platelet count 188,000/mm3 (150,000 to 400,000/mm3)

Blood pressure 120/78 mm Hg

Answer and Explanation

The Correct Answer is ["A","B","C","D","E"]

Client rates lower back pain as 0 on a scale from 0 to 10:

On Day 1, the client reported lower back pain, which could be associated with uterine contractions or other complications. By Day 2, the pain has resolved completely, with the client reporting a pain level of 0/10. This is a clear sign of improvement in her condition, especially since pain is often a key indicator of progress in antepartum care.

No reports of vaginal discharge:

On Day 1, the client reported pinkish vaginal discharge, which can be indicative of preterm labor or other complications. By Day 2, the absence of vaginal discharge suggests that the situation has improved, and the risk of preterm labor may be decreasing.

No uterine contractions noted:

On Day 1, the client had uterine contractions occurring every 8 minutes, which could be indicative of early labor or preterm labor. By Day 2, the absence of uterine contractions is a positive sign that the client is no longer experiencing early labor signs. This indicates that the situation is improving.

No further reports of burning with urination:

On Day 1, the client reported burning with urination, which was indicative of a urinary tract infection (UTI). On Day 2, the client no longer reports this symptom, suggesting that the urinary symptoms have resolved, and the infection may be improving, especially in light of ongoing treatment (e.g., antibiotics).

Laboratory Results Indicating Improvement:

WBC count 12,000/mm³ (Day 2) vs. 16,000/mm³ (Day 1):

The WBC count has decreased from 16,000/mm³ on Day 1 (which indicated infection or inflammation) to 12,000/mm³ on Day 2. Although the WBC count is still slightly elevated above the normal range (5,000-10,000/mm³), the decrease in WBC count suggests that the client's body is responding to treatment, and the infection or inflammation may be resolving.

Vital Signs Indicating Improvement:

Temperature 37.1° C (98.7°F) (Day 2) vs. 38.4° C (101.1°F) (Day 1):

The client’s fever has resolved, with a temperature decrease from 38.4°C (101.1°F) on Day 1 to 37.1°C (98.7°F) on Day 2. Fever is a common sign of infection, and the reduction in temperature suggests that the infection (likely a urinary tract infection) is being controlled and is improving.

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Correct Answer is C

Explanation

A. While discussing measures is important, identifying factors contributing to infections should be done first.
B. Staff training is crucial, but identifying the root causes should precede it to ensure the training is focused on the specific problems identified.
C. Identifying precipitating factors is the most immediate and practical step in addressing the issue, as it allows for targeted interventions.
D. Revising the policy may be necessary but should be based on the findings from identifying the root causes.

A. Perform the procedure prior to meals. B. Hold hand flat to perform percussions on the child. C. Perform the procedure twice each day. D. Administer a bronchodilator after the procedure.

Correct Answer is B

Explanation

A. Postural drainage should ideally be done after meals to reduce the risk of vomiting.
B. Holding the hand flat during percussions helps distribute the force evenly and prevents injury to the
child’s ribcage.
C. The procedure may need to be performed more than twice daily, depending on the child's condition.
D. A bronchodilator is typically administered before the procedure, not after, to help open the airways and improve the effectiveness of drainage.

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