The client is at risk for developing which of the following 2 complications?

Select 2 complications the client is at risk for developing.

Sepsis

Placenta previa

Disseminated intravascular coagulation

Preeclampsia

Preterm prelabor rupture of membranes (PROM)

Seizures

Answer and Explanation

Correct Answer : A,E

A.   Sepsis
Sepsis is a systemic infection that can occur during pregnancy, particularly if there is an infection such as chorioamnionitis (infection of the amniotic sac) or endometritis (infection of the uterine lining). The client's fever (38.4°C) could be indicative of infection, which is a risk factor for sepsis.
B.   Placenta Previa
Placenta previa occurs when the placenta implants in the lower part of the uterus, covering the cervix. This can cause vaginal bleeding and may lead to complications during labor. However, this is not related to the client's current symptoms.
C.   Disseminated Intravascular Coagulation (DIC)
DIC is a serious condition that can occur due to pregnancy complications like abruptio placentae, infection, or severe preeclampsia. However, the client’s symptoms do not indicate bleeding, bruising, or other signs of DIC. The client's blood pressure (130/78) is normal, and there are no indications of placental abruption.
D.   Preeclampsia
Preeclampsia is characterized by hypertension and proteinuria. The client’s blood pressure (130/78) is normal, and there are no signs of significant swelling or other symptoms commonly associated with preeclampsia.
E.   Preterm Premature Rupture of Membranes (PPROM)
PPROM is the rupture of the membranes (amniotic sac) before 37 weeks gestation, leading to the risk of infection, preterm labor, and other complications. While the client’s membranes are intact at this time, preterm labor at 33 weeks is a risk factor for PPROM.
F.   Seizures
Seizures in pregnancy are most commonly seen in conditions like eclampsia, which is a complication of preeclampsia. However, the client does not have the signs of preeclampsia (high blood pressure, proteinuria, edema) that typically lead to eclampsia.

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Correct Answer is D

Explanation

A. The number of sponges used during the procedure is not necessary for the hand-off report unless the nurse is specifically asked or there is a concern for retained sponges.
B. The client's status as a board member is irrelevant to their medical care and should not be included in the hand-off report.
C. Intubation without complications is important to report but is not as critical as information about blood loss, which directly impacts the client's recovery.
D. Reporting the estimated blood loss is important for the receiving nurse to know as it can affect the client’s hemodynamic status and monitoring postoperatively.

A. "How long have you been hearing the voices?" B. "I realize the voices are real to you, but I don't hear anything." C. "What are the voices telling you?" D. "Have you taken your medication today?"

Correct Answer is C

Explanation

A. While it is important to assess the duration of symptoms, it is more important to understand the content and context of the voices to determine potential risks.
B. Acknowledging that the voices are real to the client, while not hearing them, shows empathy and avoids invalidating the client's experience.
C. Understanding what the voices are saying helps assess the potential for harm and allows for appropriate intervention.
D. While checking on medication adherence is important, it does not address the immediate concern of what the voices may be telling the client.

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