The practical nurse (PN) is assisting the registered nurse (RN) in caring for a client with placenta previa who is at 31-weeks gestation.
Which method should the PN use to most accurately estimate blood loss?

Choice A rationale

While suctioning with a bulb syringe may be indicated for secretions, in an active choking episode with a foreign body obstruction, it is not the immediate first action. Back-blows are more effective at dislodging the obstructing object by increasing intrathoracic pressure and creating an artificial cough.

Choice B rationale

Monitoring respirations for 15 seconds is a delay in critical intervention for an infant actively choking. An infant who is choking requires immediate, active intervention to clear the airway and restore effective breathing, as prolonged airway obstruction can quickly lead to hypoxia and cardiac arrest.

Choice C rationale

In a choking infant, the immediate and most effective first action is to perform three back-blows. This maneuver utilizes gravity and rapid increases in intrathoracic pressure to dislodge the foreign object from the airway, aiming to clear the obstruction quickly and restore ventilation.

Choice D rationale

Stopping the feeding and sitting the infant upright might be appropriate if the infant is merely gagging or coughing, but for active choking, this action alone is insufficient to dislodge an aspirated object. Active intervention like back-blows is required to overcome the obstruction.

Choice A rationale

Protecting the myelomeningocele surgical incision from fecal contamination is paramount to prevent infection, as the defect is often located in the lumbosacral area. Fecal matter contains a high concentration of microorganisms, and any contamination could lead to serious central nervous system infections like meningitis.

Choice B rationale

The statement that the dressing will help dry the sutures for ease of removal is incorrect. Occlusive dressings are designed to maintain a moist wound environment, which promotes optimal wound healing and reduces scar formation, rather than drying sutures for removal.

Choice C rationale

Rapidly removing tape from the edges of the dressing is an incorrect technique. This can cause skin trauma, including stripping or tearing, especially in infants whose skin is delicate. Tape should be removed slowly and parallel to the skin to minimize epidermal injury.

Choice D rationale

The statement that the dressing should be dampened periodically to keep the skin incision moist is generally incorrect for surgical incisions once an occlusive dressing is applied. The occlusive dressing itself maintains a moist environment underneath, and external dampening could introduce pathogens and compromise the sterile field.