A nurse in a provider's office is assessing an adolescent who has been taking ibuprofen for 6 months to treat juvenile idiopathic arthritis. Which of the following questions should the nurse ask to assess for an adverse effect of this medication?
"Have you experienced a dry cough?"
"Have you noticed an increase in urine output?"
"Have you experienced muscle stiffness?"
"Have you had any stomach pain or bloody stools?"
The Correct Answer is D
Rationale:
A. A dry cough is not a common adverse effect associated with ibuprofen and is more related to respiratory issues.
B. An increase in urine output is not a typical adverse effect of ibuprofen; rather, it may indicate a different condition.
C. Muscle stiffness is a symptom of juvenile idiopathic arthritis itself and not specifically an adverse effect of ibuprofen.
D. Asking about stomach pain or bloody stools is crucial as ibuprofen can cause gastrointestinal irritation, ulcers, or bleeding, which are serious adverse effects of long-term use.
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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 ["A","C","D","E"]
Explanation
Rationale:
A. Administering methylergonovine maleate is appropriate if the uterus is boggy, as it helps to promote uterine contractions and prevent postpartum hemorrhage.
B. Massaging a firm fundus is incorrect; instead, the nurse should massage a boggy (soft) fundus to encourage it to contract.
C. Documenting fundal height is essential to monitor the uterine involution and ensure the uterus is returning to its pre-pregnancy size.
D. Observing the lochia during palpation of the fundus is important to assess for any abnormal bleeding or clots, which may indicate complications.
E. Determining whether the fundus is midline is necessary to assess for displacement, which can affect uterine tone and bleeding.