Exhibits

The nurse is reviewing the chart.

Select the condition from the choices below to fill in each blank in the following sentence.

Based on the client's history and physical, the nurse notes that this postpartum client is most at risk for developing 

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Rationale

A. Measuring vital signs, including respiratory rate, heart rate, blood pressure, and oxygen saturation, is important to assess the client's overall status and to determine the severity of the dyspnea. Vital signs provide essential information to guide further interventions. While important, this action may not directly alleviate the client's immediate distress from dyspnea.

B. Placing the client in a high Fowler's position (sitting upright with the head of the bed elevated to 90 degrees) helps to maximize chest expansion and improve lung ventilation. This position can relieve dyspnea by reducing pressure on the diaphragm and improving lung compliance. It is a simple and effective intervention for clients experiencing respiratory distress.

C. While deep breathing exercises are beneficial for promoting lung expansion and improving respiratory function, they may not be appropriate as the first action when the client is already dyspneic. The priority

should be to position the client to alleviate immediate breathing difficulty before initiating exercises that require active participation.

D. Auscultating breath sounds is important for assessing lung function and detecting any abnormalities such as adventitious sounds (e.g., crackles, wheezes). However, this action is secondary to placing the client in a high Fowler's position to relieve dyspnea. Auscultation can be performed after the client's breathing has stabilized.

Rationale

A. Iodinated contrast dye is commonly used in IVP procedures. Clients with a known allergy to iodine or shellfish may be at increased risk of an allergic reaction to the contrast dye. It is crucial to notify the healthcare provider so that appropriate pre-medication or alternative imaging options can be considered to minimize the risk of an allergic reaction.

B. While some procedures may require a urinary catheter, it is not routinely necessary for an IVP. Urinary catheters are generally used when precise urinary output measurement is required or when there are concerns about bladder function during and after the procedure. There is no specific indication for routine urinary catheterization before an IVP.

C. Drinking plenty of fluids before an IVP helps to ensure adequate hydration and can help flush the contrast dye from the body more quickly after the procedure. This can help reduce the risk of contrast dye-related complications such as nephrotoxicity and contrast-induced nephropathy.

D. After an IVP, there is no requirement for the client to keep their legs straight for an extended period. Typically, clients are observed for a brief period after the procedure to monitor for any immediate adverse reactions, but they are not required to keep their legs straight or remain immobile for an extended duration.