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A nurse is assisting with the care of a client who is in labor and has an epidural infusion for pain management.The client’s blood pressure is 80/40 mm Hg. Which of the following actions should the nurse take?

A.

Place the client in knee-chest position.

B.

Administer methylergonovine IM.

C.

Give a bolus of lactated Ringer’s.

D.

Assist the client to empty her bladder.

Answer and Explanation

The Correct Answer is C

Choice A rationale

 

Placing the client in the knee-chest position is not appropriate for managing hypotension caused by an epidural infusion. This position does not effectively improve blood pressure.

 

Choice B rationale

 

Administering methylergonovine IM is not appropriate for managing hypotension caused by an epidural infusion. Methylergonovine is used to manage postpartum hemorrhage, not hypotension.

 

Choice C rationale

 

Giving a bolus of lactated Ringer’s is the appropriate action to manage hypotension caused by an epidural infusion. This helps to increase blood volume and improve blood pressure.

 

Choice D rationale

 

Assisting the client to empty her bladder is important, but it is not the immediate priority in managing hypotension caused by an epidural infusion.


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View Related questions

Correct Answer is D

Explanation

Choice A rationale

Home palliative services are typically provided for patients with terminal illnesses or those requiring end-of-life care. A molar pregnancy, while serious, does not usually necessitate palliative care. Instead, the focus is on monitoring and follow-up to ensure complete removal of molar tissue and to detect any potential complications, such as gestational trophoblastic neoplasia.

Choice B rationale

Amniocentesis is a procedure used to diagnose chromosomal abnormalities and fetal infections, typically performed during the second trimester of pregnancy. It is not relevant for a patient recovering from a molar pregnancy, as there is no viable fetus involved.

Choice C rationale

Chemotherapy may be required if there is evidence of persistent gestational trophoblastic disease or choriocarcinoma, but it is not an immediate requirement for all patients recovering from a molar pregnancy. The need for chemotherapy would be determined based on follow-up hCG levels and other diagnostic tests.

Choice D rationale

Attending a support group is an important aspect of emotional and psychological recovery after a molar pregnancy. Support groups provide a space for patients to share their experiences, receive emotional support, and gain information about their condition and recovery process.

Correct Answer is A

Explanation

Choice A rationale

Oral contraceptives decrease the risk for endometrial cancer by regulating the menstrual cycle and reducing the frequency of ovulation, which lowers the exposure of the endometrium to estrogen.

Choice B rationale

Combined estrogen-progestin contraceptive pills typically shorten and lighten menstrual periods, rather than causing longer periods.

Choice C rationale

Medroxyprogesterone acetate injections are administered every three months, not once per month.

Choice D rationale

Diaphragms need to be replaced every 1-2 years, not every 4 years, to ensure proper fit and effectiveness.

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