The nurse is assessing a woman who is 26 weeks' pregnant and is brought to the ER with complaints of vaginal bleeding with severe abdominal pain. What complication would the nurse suspect?
A) Placenta previa
B) Placental abruption
C) Preterm labor
D) Pregnancy induced hypertension
B
Feedback:
Bleeding with severe abdominal pain is a sign of placental abruption, or premature separation of the placenta. Painless vaginal bleeding may be a sign of placenta previa, a condition in which the placenta lies partly over the cervical opening. Preterm labor is characterized by backache, pelvic/abdominal cramping, rhythmic pelvic pressure, diarrhea, change in vaginal discharge, vaginal spotting, leaking fluid, and malaise. Signs of pregnancy-induced hypertension include severe headache, visual changes, sudden edema or swelling, and epigastric pain.
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1. Accept fetal heart rate as normal. 2. Notify the primary RN. 3. Have the client lie on the right side to increase fetal blood supply. 4. Have the client lie on her back with the head of the bed elevated.
The nurse provides discharge teaching to a client with laryngitis. Which client statement indicates an understanding of the instruction?
1. "I should massage my throat to stimulate the vocal cords." 2. "I can speak as much as I want as long as it is not painful." 3. "I can whisper but not speak in a regular voice." 4. "I should rest my voice by not speaking."
Why should the nurse avoid maintaining clients on simple IV solutions such as dextrose in water longer than 1 to 2 days?
A) Dextrose in water is nutritionally and calorically inadequate. B) Dextrose in water has high potential for severe adverse effects. C) Dextrose in water is not as effective as complex solutions. D) Dextrose in water carries a high risk of getting contaminated.
A nurse notices frequent artifact on the ECG monitor for a client whose leads are connected by cable to a console at the bedside. The nurse examines the client to determine the cause. Which of the following items is unlikely to be responsible for the artifact?
A. Frequent movement of the client B. Tightly secured cable connections C. Leads applied over hairy areas D. Leads applied to the limbs