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The nurse has reviewed the Nurses' Notes and Provider Prescriptions at 1100 and Diagnostic Results on Day 3.

The nurse is preparing the client for surgery. Which of the following actions should the nurse take. Select all that apply.

Assist with administration of AB positive blood products if needed.

Prepare client for insertion of 18-gauge peripheral IV prior to surgery.

Administer Rh, D immune globin prior to surgery.

Obtain a complete blood count.

Explain the surgical procedure to the client.

Remind client to be NPO prior to surgery.

Verify consent form is signed by the client.

Answer and Explanation

Correct Answer : B,C,D,F,G

Prepare client for insertion of 18-gauge peripheral IV prior to surgery: A large-bore IV catheter, such as an 18-gauge, is necessary before surgery to ensure rapid administration of fluids, medications, or blood products if needed during the procedure. It is a measure to support hemodynamic stability during anesthesia and surgery.
Administer Rh, D immune globin prior to surgery: The client's blood type is B negative. Because an ectopic pregnancy involves fetal tissue, and there's a potential for fetal-maternal blood mixing during the surgery, administering Rh(D) immune globulin (RhoGAM) is crucial to prevent Rh sensitization in Rh-negative women who may be carrying an Rh-positive fetus. This is typically given within 72 hours of a potential sensitizing event.
Obtain a complete blood count: A CBC is critical to assess hemoglobin, hematocrit, and platelet levels before surgery. This helps the healthcare team anticipate the risk of bleeding and determine if transfusions might be necessary during or after the laparoscopic procedure.
Explain the surgical procedure to the client: Explaining the surgical procedure is the provider's responsibility, not the nurse's role. The nurse can reinforce teaching and answer basic questions but should not be the primary person explaining the procedure or obtaining informed consent.
Remind client to be NPO prior to surgery: Maintaining NPO status is essential to reduce the risk of aspiration during anesthesia. The client should avoid eating or drinking for a specified time before surgery, following the facility's preoperative protocol.
Verify consent form is signed by the client: Verifying that the informed consent form is properly signed is a crucial nursing responsibility before surgery. It ensures legal compliance and confirms that the client has been informed about the procedure, risks, and alternatives.

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Correct Answer is C

Explanation

A. Place the client on bedrest: While limiting the client’s activity is important to reduce oxygen demand, it is not the first priority. Immediate actions should focus on improving oxygenation and reducing respiratory distress.

B. Obtain the client's ABG levels: Although obtaining arterial blood gases provides valuable information about oxygenation and acid-base balance, it does not address the immediate need to relieve the client's breathing difficulty and hypoxia.

C. Elevate the head of the client's bed: Elevating the head of the bed promotes lung expansion and improves oxygenation, making it the first action to reduce dyspnea and ease the client’s breathing. It is a simple, quick intervention that can stabilize the client while further assessments are conducted.

D. Prepare the client for a ventilation-perfusion scan: A V/Q scan may be indicated to diagnose conditions like pulmonary embolism, but it is a diagnostic step that follows stabilization. Immediate efforts must first focus on ensuring adequate oxygenation and respiratory support.

A. “I may notice an increase in the firmness of my breasts.” B. "My estrogen levels will elevate” C. "I may experience more vaginal dryness." D. "I may become cold more often."

Correct Answer is C

Explanation

A. “I may notice an increase in the firmness of my breasts.”: During menopause, breasts typically become less firm and more fatty due to decreased estrogen levels. Loss of glandular tissue and changes in connective tissue elasticity cause breasts to feel softer, not firmer.

B. "My estrogen levels will elevate”: Estrogen levels decline significantly during menopause, not elevate. This hormonal decrease leads to many of the physical and emotional symptoms associated with menopause, including hot flashes, vaginal dryness, and bone density loss.

C. "I may experience more vaginal dryness.": Vaginal dryness is a common and expected symptom during menopause due to the reduction in estrogen. Lower estrogen levels cause thinning and decreased lubrication of the vaginal tissues, often resulting in discomfort during intercourse and increased risk of irritation or infection.

D. "I may become cold more often.": Clients undergoing menopause typically experience hot flashes and night sweats, not an increased tendency to feel cold. Hot flashes are sudden sensations of heat and are one of the most recognized and frequent symptoms of menopausal transition.

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The nurse has reviewed the Nurses' Notes and Provider Prescriptions at 1100 and Diagnostic Results on Day 3. The nurse is preparing the client for surgery. Which of the following actions should the nurse take. Select all that apply.

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