The nurse is caring for a client in labor who has refused epidural anesthesia. An order was placed for Stadol 3mg IV Q4h PRN pain. The drug is supplied 2 mg per ml. How much of the medication should the nurse give?

0.75ml

15ml

1.5 ml

0.9ml

Answer and Explanation

The Correct Answer is C

A.   0.75 mL would provide only 1.5 mg, which is half the prescribed dose
B.   15 mL would provide 30 mg, which is ten times the prescribed dose and could be dangerously toxic
C.   1.5 mL is correct and delivers exactly 3 mg of Stadol, matching the provider's order. To calculate the correct volume to administer, use the formula: Dose to give= ordered dose/concentration= 3/2= 1.5ml
D.   0.9 mL would give 1.8 mg, which is below the ordered dose.

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Correct Answer is A

Explanation

A. Request the client to empty her bladder is the correct action. A fundus that is firm but deviated to the left and higher than expected (U+1) suggests that the bladder is full. A full bladder can displace the uterus, causing it to become misaligned and elevated. Asking the client to empty her bladder is often the first step to address this situation before proceeding with further assessment or intervention.

B. Follow PRN order to insert a straight urinary catheterization might be appropriate if the client is unable to empty her bladder voluntarily, but it is typically a last resort. Before resorting to catheterization, encourage the client to try to void first.

C. Start an IV and add 20 units Pitocin would be indicated if there were signs of uterine atony or hemorrhage. However, in this case, the issue seems related to bladder distention rather than uterine atony, so starting Pitocin is not the appropriate immediate response.

D. Massage fundus until it descends below the level of the umbilicus would be done if the fundus were boggy or soft, indicating uterine atony. However, in this case, the fundus is described as firm, so massaging is not necessary. The priority is addressing the bladder distention.

A. two fingerbreadths above the umbilicus B. two fingerbreadths below the umbilicus C. at the level of the umbilicus D. four fingerbreadths below the umbilicus

Correct Answer is C

Explanation

A. Two fingerbreadths above the umbilicus would be abnormal and may indicate uterine distension due to retained placental fragments or a full bladder, especially this long after delivery.

B. Two fingerbreadths below the umbilicus is typically expected 24 hours or more after delivery, not at 12 hours postpartum.

C. At the level of the umbilicus is normal and expected at about 12 hours postpartum. After delivery, the uterus rises slightly and is generally found at or near the umbilicus before it begins to descend (involute) by about 1 fingerbreadth per day.

D. Four fingerbreadths below the umbilicus would be expected several days postpartum, not within the first 12 hours.

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The nurse is caring for a client in labor who has refused epidural anesthesia. An order was placed for Stadol 3mg IV Q4h PRN pain. The drug is supplied 2 mg per ml. How much of the medication should the nurse give?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

During a routine postpartum assessment following a normal vaginal delivery, the nurse notes the fundus is firm, but the level has changed from U-1 to U+1 and deviated to the left. Which action would be appropriate before continuing the assessment?

Correct Answer is A

Explanation

A primipara client gave birth vaginally to a healthy newborn girl 12 hours ago. The nurse palpates the client's fundus. Which finding would the nurse identify as expected?

Correct Answer is C

Explanation

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