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Ati Proctored Maternal Newborn Latest Version 2
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Ati Proctored Maternal Newborn Latest Version 2| Questions and Solutions | Rated A+
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Ati Proctored Maternal Newborn Latest Version 2| Questions a nd Solutions | Rated A+ A nurse is providing discharge teaching to a client who is postpar tum. For which of the following manifestations should the nurse instruct the client to monitor and report to the provider? Correct Answer: A. Persistent abdominal striae B. Temperature 37.8° C (100° F) C. Brownish -red discharge on day 5 Answer: Unilateral breast pain A. Persistent abdominal striae Persistent abdominal striae are caused by the separation of the underlying connective tissue and are an expected postpartum finding. B. Tempera ture 37.8° C (100° F) The nurse should instruct the client to report a temperature of 38° C (100.4° F) or higher because it could be an indication of infection. Sudden onset of chills, fever, malaise, body aches, headaches, and unilateral breast pain can be indications of mastitis, an infection of the breast tissue. The nurse should instruct the client to report this manifestation to the provider. C. Brownish -red discharge on day 5 Brownish -red discharge is an expected manifestation during days 3 to 10. The client should report a large amount of lochia and large clots to the provider. A nurse is reviewing the medical record at 1800 for a client who is at 34 weeks of gestation. Based on the chart findings and documentation, the nursing plan of care should include which of the following actions? Exhibit 1: Diagnostic Results Lecithin/sphingomyelin (L/S) ratio 1.4:1Phosphatidylglycerol (PG) absentABO -Rh B-negati ve Exhibit 2: Medication Administration Record lOMoARcPSD|227893 81 Terbutaline 0.25 mg SQ every hr PRN contractionsRho(D) immune globulin 300 mcg IM onceNalbuphine 10 mg IV every 3 hr PRN pain Exhibit 3: Progress Report 1655 - Amniocentesis completed, tocotransducer and external fetal monitor applied1700 - Fetal heart rate 130/min with moderate variabilityUterine contractions q 5 to 8 min lasting 30 to 60 sec durationUterine contractions palpated at 1+ intensityClient reports uterine contraction pain of 2 on a scale of 0 to 10 Correct Answer: A. Administer terbutaline. B. Discuss possible genetic anomalies with the client. C. Administer nalbuphine. lOMoARcPSD|227893 81 D. Discontinue external fetal monitoring. Answer: Administer terbutaline. A. Administer terbutaline. The nurse should administer terbutaline to stop contractions because the laboratory results indicate that the fetus's lungs are not mature enough for birth. B. Discuss possible genetic anomalies with the client. There is no indication of genetic anomalies based on the results of the amniocentesis. C. Administer nalbuphine. Nalbuphine is an analgesic used for moderate to sever e pain. A report of 2 on a scale of 0 to 10 is mild pain. D. Discontinue external fetal monitoring. The nurse should not discontinue external fetal monitoring. Because the client is exhibiting manifestations of preterm labor, fetal well -being and contraction patterns should be continuously monitored to continue toThe benefits of buying summaries with Stuvia:
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