A pregnant client is in a motor vehicle crash and needs surgery to repair a fractured lower leg. What special precautions will this client need during and after the surgery? Select all that apply
1. Prepare for intubation.
2. Insert a nasogastric tube.
3. Maintain on strict bed rest.
4. Insert an indwelling urinary catheter.
5. Apply sequential compression devices (SCDs).
1, 2, 4, 5
Explanation:
1. Pregnancy causes increased secretions of the respiratory tract and engorgement of the nasal mucous membrane, often making breathing through the nose difficult. Consequently, pregnant women often need an endotracheal tube to maintain an airway during surgery.
2. The decreased intestinal motility and delayed gastric emptying that occur in pregnancy increase the risk of vomiting when anesthetics are given and during the postoperative period. A nasogastric tube may be recommended before major surgery.
3. Exercises in bed should be encouraged along with early ambulation after surgery.
4. An indwelling urinary catheter prevents bladder distention, decreases risk of injury to the bladder, and permits monitoring of output.
5. SCDs during and after surgery help prevent venous stasis and the development of thrombophlebitis.
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