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Two days after delivery, a postpartum client prepares for discharge. What should the nurse teach her about lochia flow?
- A. Lochia does change color but goes from lochia rubra (bright red) on days 1-3, to lochia serosa (pinkish brown) on days 4-9, to lochia alba (creamy white) days 10-21.
- B. Numerous clots are abnormal and should be reported to the physician.
- C. Saturation of the perineal pad is considered abnormal and may indicate postpartum hemorrhage.
- D. Lochia normally lasts for about 21 days, and changes from a bright red, to pinkish brown, to creamy white.
Correct Answer: D
Rationale: The correct answer is D. Lochia normally lasts for about 21 days, and changes from a bright red, to pinkish brown, to creamy white. This is accurate information regarding the typical progression of lochia flow postpartum. Lochia rubra is the initial discharge, followed by lochia serosa, and finally, lochia alba. This teaching is important for the client to understand what to expect in terms of postpartum bleeding.
Choice A is incorrect as it inaccurately describes the color changes of lochia. Choice B is incorrect because the presence of numerous clots is common in the immediate postpartum period and not necessarily abnormal. Choice C is incorrect as perineal pad saturation is expected initially, and significant saturation may not always indicate hemorrhage.
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A nurse is caring for a client who is 36 weeks of gestation and has a prescription for an amniocentesis. For which of the following reasons should the nurse prepare the client for an ultrasound?
- A. To estimate fetal weight
- B. To locate a pocket of fluid
- C. To determine multiparity
- D. To pre-screen for fetal anomalies
Correct Answer: B
Rationale: The correct answer is B: To locate a pocket of fluid. Before performing an amniocentesis procedure, it is essential to locate a pocket of amniotic fluid to ensure the safety of the fetus during the procedure. This is crucial to avoid accidentally puncturing the fetus or placenta. An ultrasound helps in visualizing the amniotic fluid pocket and guiding the needle insertion accurately.
Incorrect Choices:
A: To estimate fetal weight - Estimating fetal weight is not a primary reason for preparing the client for an ultrasound before amniocentesis.
C: To determine multiparity - Multiparity (number of pregnancies) does not directly impact the need for an ultrasound before an amniocentesis.
D: To pre-screen for fetal anomalies - While ultrasounds can detect anomalies, the primary purpose before an amniocentesis is to locate the amniotic fluid pocket, not screen for anomalies.
During an outpatient clinic visit, a 13-year-old client is diagnosed with infectious mononucleosis. The nurse should expect which of the following to be included in the client's plan of care?
- A. Take acetaminophen (Tylenol) with codeine as prescribed for pain.
- B. Encourage gargling with warm water to alleviate pain.
- C. Start a short course of ampicillin.
- D. Encourage social activity to prevent depression.
Correct Answer: B
Rationale: The correct answer is B: Encourage gargling with warm water to alleviate pain. Gargling with warm water can help soothe a sore throat, a common symptom of infectious mononucleosis. Acetaminophen with codeine (A) is not typically recommended for mononucleosis pain management in children due to the risk of respiratory depression. Starting a short course of ampicillin (C) is contraindicated in mononucleosis as it can cause a rash. Encouraging social activity (D) may not be appropriate as the client may need rest to recover.
A new client's pregnancy is confirmed at 10 weeks gestation. Her history reveals that her first two pregnancies ended in spontaneous abortion at 12 and 20 weeks. She has a 4-year-old and a set of 1-year-old twins. How should the nurse record the client's current gravida and para status?
- A. Gravida 2, para 3
- B. Gravida 4, para 2
- C. Gravida 5, para 2
- D. Gravida 5, para 4
Correct Answer: C
Rationale: The correct answer is C: Gravida 5, para 2. Gravida refers to the total number of pregnancies, including the current one. The client is currently pregnant (1), had two spontaneous abortions (2), a 4-year-old (3), and a set of 1-year-old twins (4-5). Para refers to the number of viable births (past the age of viability). The client has a 4-year-old and a set of 1-year-old twins, totaling 2 live births. Therefore, the correct status is Gravida 5, para 2.
Choice A (Gravida 2, para 3) is incorrect because it does not account for the client's current pregnancy and the twins. Choice B (Gravida 4, para 2) is incorrect as it overlooks the client's previous spontaneous abortions. Choice D (Gravida 5, para 4) is incorrect as it includes all
A client delivered two days ago and is suspected of having postpartum 'blues.' Which symptoms confirm the diagnosis?
- A. Uncontrollable crying and insecurity
- B. Depression and suicidal thoughts
- C. Sense of the inability to care for the family and extreme anxiety
- D. Nausea and vomiting
Correct Answer: A
Rationale: The correct answer is A because uncontrollable crying and insecurity are classic symptoms of postpartum blues, also known as baby blues. This condition is characterized by mood swings, tearfulness, and feelings of vulnerability. Choices B, C, and D are incorrect as they suggest more severe symptoms associated with postpartum depression or other mental health disorders, which require immediate intervention. Nausea and vomiting (choice D) are not typically associated with postpartum blues. It is essential to differentiate between postpartum blues and more serious conditions to provide appropriate support and treatment to the client.
A nurse is caring for a 7-month-old infant with acute bronchiolitis. The infant has a persistent, dry, hacking cough that worsens at night, tachypnea, and weakness. Which of the following actions should the nurse implement?
- A. Administer prescribed cough suppressants as needed.
- B. Place the child on droplet precautions.
- C. Administer antibiotics and corticosteroids as prescribed.
- D. Provide intravenous fluids as prescribed.
Correct Answer: D
Rationale: IV fluids ensure hydration and dilute secretions, which is crucial in bronchiolitis.