A nurse is administering a miconazole vaginal suppository to a client who has vaginal candidiasis. Which of the following actions should the nurse take?
Insert the suppository 5 cm.
Apply petroleum jelly to the suppository.
Assist the client into a prone position.
Insert the suppository along the posterior vaginal wall.
The Correct Answer is D
Choice A rationale
Inserting the suppository 5 cm is generally insufficient for proper placement. The suppository needs to be placed further along the vaginal canal to be effective.
Choice B rationale
Applying petroleum jelly to the suppository is not recommended because it can interfere with the absorption and effectiveness of the medication.
Choice C rationale
Assisting the client into a prone position is not appropriate for inserting a vaginal suppository. The client should be in a lithotomy or supine position with legs bent.
Choice D rationale
Inserting the suppository along the posterior vaginal wall ensures proper placement and maximizes the effectiveness of the medication by allowing it to dissolve and be absorbed where it is needed.
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Correct Answer is D
Explanation
Choice A rationale
This statement is incorrect because after a cesarean birth, clients are usually started on clear liquids and then gradually progress to regular food as tolerated. Swallowing safety is related to anesthesia recovery, not cesarean birth recovery.
Choice B rationale
This statement is incorrect because the client does not need to stay flat on their back for 24 hours. Early ambulation is encouraged to prevent complications such as deep vein thrombosis and promote recovery.
Choice C rationale
This statement is incorrect because the urinary catheter is typically removed within 24 hours after surgery to reduce the risk of urinary tract infections and encourage normal bladder function.
Choice D rationale
This statement is correct because after a cesarean birth, the nurse will frequently assess the uterus for firmness and massage it as needed to prevent postpartum hemorrhage.
Correct Answer is B
Explanation
Choice A rationale
Ensuring the client has a full bladder before the procedure is incorrect. A full bladder can cause discomfort during the pelvic examination and may obscure the pelvic organs, making the examination more challenging for the provider.
Choice B rationale
Instructing the client to bear down when the speculum is inserted is correct. Bearing down helps relax the pelvic muscles, making it easier to insert the speculum and perform the examination with minimal discomfort.
Choice C rationale
Encouraging the client to take rapid, shallow breaths during the procedure is incorrect. This can increase anxiety and tension in the pelvic muscles, making the examination more uncomfortable.
Choice D rationale
Applying povidone-iodine to the provider's fingers prior to bimanual examination is incorrect. The standard procedure involves using gloves and lubricant to prevent infection and ensure patient comfort, not povidone-iodine.