Nokea
A postpartum multiparous client diagnosed with endometritis is to receive intravenous antibiotic therapy with ampicillin sodium (Polycillin). Before administering this drug, the nurse must do which of the following?
- A. Ask the client if she has any drug allergies.
- B. Assess the client's pulse rate.
- C. Place the client in a side-lying position.
- D. Check the client's perineal pad.
Correct Answer: A
Rationale: Checking for drug allergies is critical before administering ampicillin to prevent allergic reactions.
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When developing the teaching plan for a primigravid client at 30 weeks' gestation diagnosed with mild preeclampsia who is being treated at home, which of the following would the nurse identify as the most appropriate client-centered goal?
- A. Return visit to the prenatal clinic in approximately 4 weeks.
- B. Decreased edema after 1 week of a low-protein, low-fiber diet.
- C. Bed rest on the left side during the day, with bathroom privileges.
- D. Immediate reporting of adverse reactions to magnesium sulfate therapy.
Correct Answer: C
Rationale: Bed rest on the left side enhances placental perfusion and reduces blood pressure.
A multigravid client admitted to the labor area is scheduled for a cesarean delivery under spinal anesthesia. After instructions by the anesthesiologist, the nurse determines that the client has understood the instructions when she says which of the following?
- A. The medication will be administered while I am in a side-lying position.'
- B. The anesthetic may cause a severe headache which is treatable.'
- C. My blood pressure may increase if I lie down too soon after the injection.'
- D. I can expect immediate anesthesia that can be reversed very easily.'
Correct Answer: B
Rationale: Spinal anesthesia carries a risk of post-dural puncture headache, which is treatable (e.g., with a blood patch). The side-lying position is for epidural, not spinal, anesthesia; blood pressure typically decreases; and spinal anesthesia is not easily reversed.
A multigravida in active labor is 7 cm dilated. The fetal heart rate baseline is 130 bpm with moderate variability. The client begins to have variable decelerations to 100 to 110 bpm. What should the nurse do next?
- A. Perform a vaginal examination.
- B. Notify the physician of the decelerations.
- C. Reposition the client and continue to evaluate the tracing.
- D. Administer oxygen via mask at 2 L/minute.
Correct Answer: C
Rationale: Variable decelerations suggest possible cord compression. Repositioning the client (e.g., to a side-lying position) can relieve pressure on the cord, and continued monitoring assesses the effectiveness. Vaginal examination, notification, or oxygen may follow if the issue persists.
A primigravid client in active labor has had no anesthesia. The client's cervix is 7 cm dilated, and she is starting to feel considerable discomfort during the first 10 cm to the client's sacral client is a left side-lying position. The nurse should encourage which of the following?
- A. Rapid, shallow chest breathing.
- B. Deep chest breathing.
- C. Rapid pant-blow breathing.
- D. Slow abdominal breathing.
Correct Answer: D
Rationale: Slow abdominal breathing promotes relaxation and oxygenation, helping manage discomfort in active labor without anesthesia. Rapid or shallow breathing may lead to hyperventilation, and deep chest breathing is less effective for pain control.
The nurse is preparing to administer terbutaline(Brethine) to a multigravid client in preterm labor. Before administering this drug intravenously, the nurse should determine the results of the following?
- A. Hematocrit.
- B. Weight gain.
- C. Urinary output.
- D. Heart rate.
Correct Answer: D
Rationale: Heart rate should be monitored due to terbutaline's potential to cause tachycardia.