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Exhibits

Drag words from the choices below to fill in each blank in the following sentence.

The nurse should anticipate a provider's prescription for a(n)

and.
Answer and Explanation

The Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"C"}

Rationale for Correct Choices:

  • Intravenous antibiotic: The client exhibits signs of postpartum infection, most consistent with endometritis—elevated WBC count, low-grade fever, uterine tenderness, foul-smelling lochia, and a history of prolonged rupture of membranes and cesarean delivery. IV antibiotics are the first-line treatment to control uterine infection and prevent sepsis.
  • Increase in daily fluid intake: Maintaining adequate hydration is essential to support tissue perfusion and aid in the clearance of infection. Fever and elevated WBCs increase metabolic demands, so increased fluid intake can help mitigate dehydration and support antibiotic therapy.

Rationale for Incorrect Choices:

  • Kleihauer-Betke test: This test detects fetal-to-maternal hemorrhage, typically used after trauma or suspected placental abruption. It is not indicated in cases of suspected postpartum infection.
  • Intrauterine tamponade balloon: This intervention is used for managing postpartum hemorrhage due to uterine atony or trauma, not infection. The client’s bleeding is moderate and not indicative of uncontrolled hemorrhage.
  • Tocolytic medication: Tocolytics are used to suppress premature labor and have no role in postpartum care, especially in the presence of infection, where uterine relaxation could worsen outcomes.


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Related Questions

Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"A"}

Explanation

Rationale for Correct Options:

  • Preeclampsia is a hypertensive disorder of pregnancy that typically occurs after 20 weeks of gestation. This client has elevated blood pressure (156/96 mm Hg), proteinuria (25 mg/dL), hyperreflexia, headache, right upper quadrant pain, and facial edema—all hallmark signs of preeclampsia.
  • Urinalysis shows elevated protein, which is a diagnostic criterion for preeclampsia. Proteinuria is a result of kidney involvement due to endothelial damage from hypertension indicating kidney involvement due to the systemic vascular changes in preeclampsia.

Rationale for Incorrect Options:

  • Chorioamnionitis typically presents with maternal fever, uterine tenderness, foul-smelling amniotic fluid, and fetal tachycardia. This client is afebrile and has no signs of intrauterine infection.
  • Preterm labor is indicated by cervical changes and regular uterine contractions, neither of which are present. The fetal monitor shows no contractions, and there are no reports of vaginal drainage or pressure.
  • Serum WBC count is mildly elevated at 12,500/mm³, which can be normal in pregnancy and does not indicate infection or inflammation in this context.
  • Fundal assessment: The fundal height of 29 cm at 30 weeks is within the normal range (+/- 2 cm), so it does not evidence a particular risk.

Correct Answer is D

Explanation

A. “I should assess the client's skin integrity every 8 hours while in mechanical restraints.”: Skin integrity should be assessed much more frequently, typically every 1 to 2 hours, to prevent pressure injuries and ensure circulation is not impaired.
B. “I should expect the provider to evaluate the client within 4 hours of restraint application.”: Provider evaluation is required sooner, generally within 1 hour of restraint application, to ensure the necessity and appropriateness of restraints.
C. “I should ask the provider to write a prescription for mechanical restraints as needed.”: Restraints require a specific, time-limited provider order; PRN (as needed) orders are not appropriate because continuous assessment is necessary to determine ongoing need.
D. “I should visually monitor the client continuously when in mechanical restraints.”: Continuous visual monitoring is essential to ensure the client’s safety, prevent injury, and assess for any distress while restraints are in place.

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