Exhibits

Which other treatment(s) might be helpful for this client? Select all that apply.

Phototherapy

Administration of lithium

Consciousness raising

Cognitive behavioral therapy

Electroconvulsive therapy

Animal therapy

Answer and Explanation

Correct Answer : A,C,D,F

A.   Phototherapy involves exposure to specific wavelengths of light to help regulate mood and alleviate symptoms of depression, anxiety, or sleep disorders. It can be particularly beneficial in a hospital setting where natural light exposure may be limited, potentially aiding in mood stabilization and improving sleep patterns.
B.   Lithium is a mood stabilizer commonly used to treat bipolar disorder. While the client's symptoms and presentation do not immediately suggest bipolar disorder, lithium could be considered if there are indications of mood instability or severe emotional dysregulation that are not adequately controlled by other medications.
C.   Consciousness raising refers to increasing awareness and understanding of one's thoughts, emotions, and behaviors. In the context of therapy, it can help the client process traumatic experiences, gain insight into their reactions, and develop coping strategies. This approach can be integrated into various forms of psychotherapy.
D.   CBT is a structured form of psychotherapy that focuses on identifying and modifying dysfunctional thought patterns and behaviors. It has been shown to be effective in treating anxiety, depression, PTSD, and other trauma-related disorders by helping individuals challenge negative thoughts and develop healthier coping mechanisms.
E.   ECT involves passing electrical currents through the brain to intentionally trigger a brief seizure. It is primarily used for severe depression or other mental illnesses that have not responded to other treatments. Given the client's presentation and the availability of less invasive treatments, ECT would generally not be considered unless her condition worsens significantly and other therapies are ineffective or contraindicated.
F.   Animal therapy involves interacting with animals, such as therapy dogs or horses, to improve mood, reduce stress, and provide emotional support. This type of therapy can be beneficial for individuals experiencing trauma or emotional distress, offering comfort and companionship.

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Correct Answer is C

Explanation

Rationale

A. In heart failure exacerbation, decreased cardiac output can lead to poor peripheral perfusion, potentially manifesting as weak or diminished pedal pulses. However, in the context of acute symptoms such as palpitations or chest discomfort, assessing the rhythm and rate of central pulses (like the apical pulse) may be more immediate and informative.

B. Capillary refill time assesses peripheral perfusion and can indicate circulatory status. Prolonged capillary refill (>2 seconds) may indicate poor perfusion, which could occur in heart failure exacerbation due to reduced cardiac output. It is a valuable assessment, but in this scenario, focusing on more central aspects such as the heart rhythm is typically more immediate.

C. Assessing the rhythm of the apical pulse is crucial in this scenario. The client's sensation of "flopping" in the chest suggests palpitations or irregular heartbeats, which could indicate arrhythmias such as atrial fibrillation or other dysrhythmias.

D. Skin elasticity primarily assesses hydration status and may provide information about overall skin integrity but is less directly related to the acute symptoms described by the client. While important in general assessments, it does not directly address the urgent need to assess for arrhythmias or irregular heartbeats.

A. Notify primary healthcare provider B. Count saturated pads per hour C. Administer 2 units of packed red blood cells (PRBC) D. Administer 0.2 mg methylergonovine IM E. Insert straight catheter F. Alert the emergency response team G. Increase the IV fluid to maximum rate H. Weigh all bloody materials I. Massage fundus until firm

Correct Answer is ["A","B","D","F","G","I"]

Explanation

A.Notify primary healthcare provider
The client's vital signs indicate signs of potential hypovolemic shock (low blood pressure, tachycardia, fever), and the saturated pad and sheets suggest ongoing significant bleeding. Notifying the primary healthcare provider is crucial to obtain further orders and potentially escalate care.
B. Count saturated pads per hour
Counting saturated pads per hour provides a quantitative assessment of blood loss and helps monitor the effectiveness of interventions aimed at reducing bleeding. This ongoing assessment guides further management decisions.
C. Administer 2 units of packed red blood cells (PRBC)

While blood loss is significant, initiating a blood transfusion is not typically an immediate first-line intervention unless the client shows signs of severe hemorrhagic shock or ongoing bleeding that cannot be controlled by other measures.
D. Administer 0.2 mg methylergonovine IM
Methylergonovine is a medication used to promote uterine contraction and control postpartum hemorrhage. Given the boggy fundus and significant bleeding, administering methylergonovine IM helps to contract the uterus and reduce bleeding.
E. Insert straight catheter
While maintaining accurate fluid balance is important, inserting a straight catheter is not an immediate priority compared to addressing active hemorrhage and stabilizing the client's condition.
F. Alert the emergency response team
The client's condition, with a boggy fundus, saturated pads, and ongoing bleeding, indicates a need for urgent intervention beyond routine measures. Alerting the emergency response team ensures prompt assistance and resources for managing potential hemorrhagic shock.
G. Increase the IV fluid to maximum rate
Increasing IV fluid administration helps to restore circulating volume and stabilize the client's blood pressure. This is essential in managing hypovolemia resulting from significant postpartum hemorrhage.
H. Weigh all bloody materials
Weighing all bloody materials is a method to estimate blood loss but is not as urgent as direct interventions aimed at stopping bleeding and stabilizing the client.
I. Massage fundus until firm
Massaging the fundus helps to stimulate uterine contractions, which can help control bleeding by compressing blood vessels at the placental site. A boggy fundus indicates poor uterine tone, and firming it up is crucial to prevent further hemorrhage.

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Exhibits Which other treatment(s) might be helpful for this client? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with a recent exacerbation of heart failure reports to the nurse feeling uncomfortable and anxious, with a sensation of the flopping in the chest. While waiting for an electrocardiogram (ECG), which assessment is most important for the nurse to obtain?

Correct Answer is C

Explanation

Exhibits Based on the assessment data, the nurse recognizes the need to intervene immediately. Select the 5 priority interventions that the nurse should initiate based on the most recent assessment.

Correct Answer is ["A","B","D","F","G","I"]

Explanation

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Exhibits

Which other treatment(s) might be helpful for this client? Select all that apply.