The perinatal nurse has assessed Neela, who has a twin pregnancy, and made the following determinations: blood pressure = 136/80; pulse rate = 84; fetal heart rates (FHRs) are between 138–146 bpm and 132–138 bpm; uterine contractions occur every
5–6 minutes, duration = 45 seconds, moderate strength. Neela's birth plan describes her wish to be involved in all decision-making throughout her labor and birth as well as her partner's wish to say a prayer in each infant's ear as soon after birth as possible (he is a Muslim). The perinatal nurse's appropriate actions would include a discussion with Neela and her partner about:
A) The need for Neela to have an intravenous infusion administered throughout labor
B) The emergent care the infants will require after birth that will not allow the time to pray
C) The need for epidural analgesia during labor because of Neela's multiple gestation
D) The gestational abilities of the twins at birth, the progress of Neela's labor and the nurse's ability to advocate for prayers if possible
D
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The nurse is preparing a client for discharge who has had an artificial valve placement and will be taking an oral anticoagulant. The nurse instructs the client to:
A) "Use only electric toothbrushes." B) "Avoid taking acetaminophen (Tylenol) while on the medication." C) "Take your pulse every day at the same time." D) "Wear a Medic-Alert bracelet indicating your medication."
The nurse assesses the arm of a patient with an arteriovenous fistula for the presence of which finding?
1. A bruit upon auscultation 2. A thrill upon auscultation 3. A bruit upon palpation 4. A thrill upon inspection
In which situation would an emergency room nurse be justified in proceeding without obtaining consent, verbal or otherwise?
a. An unconscious, profusely bleeding victim is brought in by ambulance. b. A 13-year-old child is brought to the emergency room after suffering a frac-tured arm while at school. c. A construction worker comes into the emergency room to have a boil lanced. d. A 15-year-old high-school girl comes in for treatment of psoriasis.
The urologist discusses possible treatment options with A.B. Identify three treatment options
for prostate cancer. Watchful waiting: This involves simply monitoring A.B.'s condition and intervening if symptoms become troublesome. Brachytherapy: Radioactive seeds are implanted in the prostate (these people have irritative voiding symptoms [frequency] for months after the procedure), or external beam radiation can be used. Hormone therapy: A PSA is drawn and medications are given based on PSA levels. In some patients, medications are given to shrink the tumor before surgery. Chemotherapy: Systemic cytotoxic chemotherapy might be done for patients whose cancer has metastasized.