Ethical Issues in Maternal Newborn Nursing

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The nurse is assessing a 64-year-old female patient. The patient states that she is able to reduce the risk of urinary tract infections (UTIs) by drinking a quart of cranberry juice a day. Which health condition, if present in this patient, contraindicates the use of cranberry juice?

  • A. Hypertension, managed with lisinopril
  • B. Diabetes type 1, managed with insulin
  • C. Atrial fibrillation, managed with warfarin
  • D. COPD, managed with inhaled steroids
Correct Answer: C

Rationale: Cranberry juice has the potential to interact with warfarin, a common blood thinner prescribed for conditions such as atrial fibrillation. Cranberry juice contains components that can inhibit the metabolism of warfarin in the body, leading to an increased risk of bleeding. Therefore, patients taking warfarin should avoid or limit their intake of cranberry juice to prevent potential negative interactions. In this case, the patient's use of warfarin to manage atrial fibrillation contraindicates the consumption of cranberry juice in large quantities. It is essential to consult a healthcare provider before making any changes to the diet, especially when taking medications that may interact with certain foods or beverages.

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The nurse is assessing a 42-year-old patient who presents to the gynecology office with complaints of pelvic pressure, backaches, menorrhagia, and urinary frequency. The health care provider has diagnosed the patient with leiomyoma of the uterus. What are the treatment options for this condition? Select all that apply.

  • A. Routine pelvic examinations to assess rate of disease process
  • B. Oral contraceptives to control the bleeding and pain
  • C. Myomectomy for women who desire pregnancy
  • D. Hysterectomy for women who do not desire pregnancy
Correct Answer: B

Rationale: - Oral contraceptives are a common treatment option for leiomyoma of the uterus to help control the bleeding and pain associated with the condition.

Clients treated for syphilis with penicillin may experience a Jarisch-Herxheimer reaction. Which clinical presentation would be unlikely if a client is experiencing this reaction?

  • A. Vomiting and diarrhea
  • B. Headache, myalgias, and arthralgia
  • C. Preterm labor
  • D. Jarisch-Herxheimer in the first 24 hours after treatment
Correct Answer: A

Rationale: The Jarisch-Herxheimer reaction is characterized by fever, headache, and muscle pain, not vomiting and diarrhea.

What is a patient statement that indicates effective teaching after a new diagnosis of nonlactational mastitis?

  • A. “I will avoid wearing a bra until I feel better.”
  • B. “I should take steps to stop smoking cigarettes.”
  • C. “Applying an ice pack to my breasts can help reduce pain.”
  • D. “I should take the prescribed antibiotics until I feel better.”
Correct Answer: D

Rationale: The statement "I should take the prescribed antibiotics until I feel better" indicates effective teaching after a new diagnosis of nonlactational mastitis. Nonlactational mastitis is commonly treated with antibiotics to help clear up the infection. It is crucial for the patient to follow the prescribed antibiotic regimen as directed by their healthcare provider to ensure the infection is fully treated and to prevent it from worsening or recurring. Compliance with the antibiotic treatment plan is essential for successful management of nonlactational mastitis.

Which response by the nurse is the most therapeutic when the patient states, “I’m so afraid to N R I G B.C M U S N T O have a cesarean birth”?

  • A. “Everything will be OK.”
  • B. “Don’t worry about it. It will be over soon.”
  • C. “What concerns you most about a cesarean birth?”
  • D. “The physician will be in later and you can talk to him.”
Correct Answer: C

Rationale: The most therapeutic response by the nurse when the patient expresses fear about having a cesarean birth is to offer an open-ended question that explores the patient's concerns further. By asking, "What concerns you most about a cesarean birth?" the nurse acknowledges the patient's fears, encourages communication, and allows the patient to express her feelings and fears in more detail. This response shows empathy and enables the nurse to better address the specific worries and anxieties the patient may have about the procedure. The other options do not effectively address the patient's fears and do not promote therapeutic communication.

A 48-year-old woman has just had a hysterectomy for endometrial cancer. Which statement alerts the nurse that further teaching is needed?

  • A. I can't wait to go on the cruise that I have planned for this summer.
  • B. I know that the surgery saved my life, but I will miss having sexual intercourse with my husband.
  • C. I have asked my daughter to come and stay with me next week after I am discharged from the hospital.
  • D. Well, I don't have to worry about getting pregnant anymore.
Correct Answer: B

Rationale: Stating that she will miss having sexual intercourse with her husband indicates that further teaching is needed for this client regarding sexual activities after a hysterectomy. Although intercourse may be initially uncomfortable, the use of water-soluble lubricants, relaxation exercises, and changes in position may be helpful.

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