Exhibits

For each assessment finding, click to indicate whether findings from this client's assessment are generally associated with mastitis, endometritis, or could be a sign of both conditions. Each row must have only one response option selected.

A. Turn off the suction on the nasogastric tube. The client has been experiencing continuous nasogastric (NG) suction, which can lead to fluid and electrolyte imbalances. The client's low blood pressure (86/64 mm Hg), leg cramping, and fatigue suggest volume depletion and possible electrolyte loss. Discontinuing NG suction will help prevent further fluid loss and electrolyte depletion.
B. Bolus calcium. The client’s calcium levels (9.2 mg/dL and 9.1 mg/dL) are within normal range (8.5–10.2 mg/dL). Since there is no indication of hypocalcemia, a calcium bolus is not necessary.
C. Increase the intravenous fluid rate. The client’s low blood pressure, tachycardia (96 bpm), and signs of fatigue suggest hypovolemia, likely due to fluid losses from NG suction and inadequate IV fluid replacement. Increasing IV fluid rate can help restore circulatory volume and improve perfusion.
D. Add potassium to the intravenous fluids. The client’s potassium level has dropped from 3.8 mEq/L to 3.5 mEq/L, which is at the lower limit of normal (3.5–5.0 mEq/L). Prolonged NG suctioning can cause hypokalemia, leading to muscle cramps, weakness, and fatigue. Adding potassium to IV fluids can prevent further decline and correct the deficiency.
E. Administer a diuretic. The client is already hypovolemic due to NG losses, as evidenced by low blood pressure and tachycardia. A diuretic would further exacerbate volume depletion, making it an inappropriate intervention.
F. Flush the central line with 3% sodium chloride. The client's sodium levels are normal (139–142 mEq/L), so a hypertonic saline flush (3% NaCl) is not needed. This type of fluid is typically used for severe hyponatremia, which is not present in this case.
G. Decrease the percentage of sodium in the intravenous fluids. The client is receiving Dextrose 5% in 0.9% sodium chloride, which provides isotonic hydration. Since the sodium level is within normal limits and the client is hypovolemic, reducing sodium concentration in IV fluids is not necessary.

A. Determine if the child can administer the insulin. While older children with type 1 diabetes can learn to self-administer insulin, a newly diagnosed 10-year-old may not yet have the skills or confidence to manage injections independently. The primary caregiver should first learn the procedure to ensure proper insulin administration.
B. Ask if the father can help with the injections. While involving another caregiver can be helpful, the mother, as a primary caregiver, needs to learn how to administer insulin. Avoiding the task entirely could compromise the child’s diabetes management, so supporting the mother in overcoming her fear is the priority.
C. Assess the mother's parenting skills. A fear of needles does not indicate poor parenting skills. Many people have needle-related anxiety, and the nurse should focus on providing support and education rather than questioning the mother’s ability to care for her child.
D. Encourage the mother to handle the needles. Helping the mother gradually become comfortable with insulin syringes through guided handling, demonstration, and practice can reduce her fear and build confidence. The nurse can use hands-on teaching techniques, such as allowing the mother to practice with an orange before injecting her child, to ease anxiety and ensure she can perform the procedure effectively.