A client who has high blood pressure is having difficulty following their treatment plan. Which of the following factors should the nurse recognize as being the greatest barrier to the client's ability to be compliant?
Dietary salt restriction
Absence of symptoms
Addition of a new medication
A detailed plan of care
The Correct Answer is B
Rationale:
A. Dietary salt restriction is challenging but is a specific intervention that can be managed with education and support.
B. The absence of symptoms can significantly hinder compliance because clients may not perceive the need to adhere to a treatment plan if they do not feel unwell. This perception can lead to underestimating the importance of managing their blood pressure.
C. The addition of a new medication may pose some challenges, but clients often adapt to new medications with proper guidance.
D. A detailed plan of care can enhance understanding and compliance, making it less likely to be a barrier compared to the lack of symptomatic cues indicating a need for treatment.
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Correct Answer is D
Explanation
Rationale:
A. Early decelerations are typically benign and often associated with head compression, not necessitating an emergency cesarean birth.
B. A knee-chest position is generally used for variable decelerations but is not indicated for early decelerations.
C. Continuous internal monitoring may be necessary in certain situations, but in the case of early decelerations, it is not an immediate intervention.
D. Early decelerations usually require continued monitoring without immediate intervention as they typically resolve spontaneously with contractions.
Correct Answer is C
Explanation
Rationale:
A. Withholding the next dose of warfarin may not be necessary at this point, as the INR is elevated but not critically high. Monitoring is essential, but vitamin K administration is indicated if the INR exceeds therapeutic levels significantly.
B. Withholding the heparin infusion is not appropriate since the aPTT is critically elevated, indicating that the client is at risk for bleeding. Heparin should be adjusted, but not entirely withheld without further evaluation.
C. Preparing to administer vitamin K is appropriate because the INR is elevated (1.8), indicating an increased risk for bleeding. Vitamin K is used to reverse the effects of warfarin.
D. Preparing to administer alteplase (a thrombolytic) is unnecessary and inappropriate in this situation, as the client is already receiving anticoagulation therapy with heparin and warfarin.