K.W. is an 18-year-old woman who comes to Planned Parenthood for a pregnancy test because a condom broke during intercourse the night before. Her last menstrual period (LMP) was 13 days ago and was normal. She always has a monthly menstrual cycle. She is extremely nervous about pregnancy because she is beginning college on a scholarship soon. She states there have been no other acts of unprotected intercourse since her LMP and declines a gynecologic examination.
As the nurse working in the clinic, should you run a pregnancy test?
A pregnancy test will not be positive for a conception that occurred only the previous evening. A pregnancy
test detects human chorionic gonadotropin (HCG); a serum HCG test can detect a pregnancy as soon as
8 days postconception. A urine pregnancy test can detect as little as 25 mIU of HCG, which can be detected as
soon as 10 to 14 days postconception. A pregnancy test could be performed to rule out previous pregnancy.
This is optional if the patient is a reliable historian and has had a normal period in the past 30 days.
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With regard to eventual discharge of the high risk newborn or transfer to a different facil-ity, nurses and families should be aware that:
a. Infants will stay in the neonatal intensive care unit (NICU) until they are ready to go home. b. Once discharged to home, the high risk infant should be treated like any healthy term newborn. c. Parents of high risk infants need special support and detailed contact information. d. If a high risk infant and mother need transfer to a specialized regional center, it is better to wait until after birth and the infant is stabilized.
The nurse is admitting a patient who has been taking minoxidil (Loniten) to treat hypertension. Prior to beginning therapy with this medication, the patient had a blood pressure of 170/95 mm Hg and a heart rate of 72 beats per minute
The nurse assesses the patient and notes a blood pressure of 130/72 mm Hg and a heart rate of 78 beats per minute, and also notes a 2.2-kg weight gain since the previous hospitalization and edema of the hands and feet. The nurse will contact the provider to discuss which intervention? a. Adding hydrochlorothiazide to help increase urine output b. Adding metoprolol (Lopressor) to help decrease the heart rate c. Increasing the dose of minoxidil to lower the blood pressure d. Restricting fluids to help with weight reduction
A patient is preparing to be discharged to home with hospice. She is on a morphine patient-controlled analgesia (PCA) in the hospital
She is concerned as to whether she can stay on her morphine PCA at home even when she is not able to give herself boluses. What would be the appropriate response of the clinician? a. "We are unable to prescribe a PCA for use at home. If you are comfortable on the PCA you should remain in the hospital." b. "It would be possible for your nurse or another trained family member to activate the dosing button when you are unable to do so." c. "A PCA is not an appropriate method of pain medication delivery once you are unable to use the dosing button. I will switch you to another form of pain control." d. "You should not be concerned about your pain management at home. It will be taken care of for you."
An individual was killed during a store robbery 2 weeks earlier. The widowed spouse, who has schizoaffective disorder, cries spontaneously when talking about the death. Which is the nurse's most therapeutic comment?
a. "I'm worried about how much you're crying. Your grief over your spouse's death has gone on too long." b. "The unexpected death of your spouse must be so painful. I'm glad you're able to talk to me about your feelings." c. "This loss is harder to accept because of your mental illness. Let's refer you to the partial hospitalization program." d. "Your crying shows me you aren't coping well. I made an appointment for you to see the psychiatrist for medication adjustment."