A nurse is caring for a client who experienced a cesarean birth due to dysfunctional labor. The client states that she is disappointed that she did not have a natural childbirth. Which of the following responses should the nurse make?
Maybe next time you can have a vaginal delivery.
It sounds like you are feeling sad that things didn’t go as planned.
At least you know you have a healthy baby.
You can resume sensations sooner than if you had delivered vaginally.
The Correct Answer is B
Choice A reason:
Saying “Maybe next time you can have a vaginal delivery” is not supportive and may minimize the client’s current feelings of disappointment. It is important to acknowledge and validate the client’s emotions rather than focusing on future possibilities.
Choice B reason:
This response, “It sounds like you are feeling sad that things didn’t go as planned,” is empathetic and validates the client’s feelings. It shows that the nurse is listening and understands the client’s disappointment, which is crucial for emotional support.
Choice C reason:
While it is true that having a healthy baby is important, saying “At least you know you have a healthy baby” can come across as dismissive of the client’s feelings. It is essential to address the client’s emotions directly rather than shifting the focus.
Choice D reason:
Telling the client “You can resume sensations sooner than if you had delivered vaginally” is not relevant to the client’s expressed feelings of disappointment about not having a natural childbirth. This response does not address the emotional aspect of the client’s experience.
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Correct Answer is A
Explanation
Choice A: Unlike Chickenpox, the Vesicles of Smallpox Are More Abundant on the Face
This statement indicates an understanding of the teaching. Smallpox lesions are indeed more abundant on the face and extremities compared to chickenpox, which tends to have a more central distribution on the trunk. Smallpox lesions are also typically more uniform in their stage of development, whereas chickenpox lesions can appear in various stages of healing simultaneously.
Choice B: Smallpox Lesions Appear in Various Stages of Healing
This statement is incorrect. Unlike chickenpox, where lesions can be in different stages of healing at the same time, smallpox lesions generally progress through the same stages simultaneously. This uniformity in lesion development is a distinguishing feature of smallpox.
Choice C: Vaccination Against Smallpox Provides Lifelong Immunity
This statement is partially correct but needs clarification. The smallpox vaccine provides long-lasting immunity, but it may not be lifelong. Immunity can wane over time, and booster vaccinations may be necessary for continued protection.
Choice D: There Are Rare, Occasional Occurrences of Smallpox
This statement is incorrect. Smallpox was declared eradicated in 1980 by the World Health Organization (WHO). There have been no naturally occurring cases of smallpox since then. The only known stocks of the virus are kept in secure laboratories for research purposes.
Correct Answer is C
Explanation
Choice A: Apply Bilateral Wrist Restraints
Applying bilateral wrist restraints can be necessary in some cases to prevent the child from touching or interfering with the surgical site. However, restraints should be used as a last resort and only when absolutely necessary. They can cause distress and discomfort to the child and should be monitored closely to prevent any complications.
Choice B: Administer Opioids for Pain
Administering opioids for pain management is a common practice post-surgery to ensure the child is comfortable. However, opioids should be used cautiously due to the risk of side effects and potential for dependency. Non-opioid pain management strategies, such as acetaminophen or ibuprofen, are often preferred unless the pain is severe.
Choice C: Implement a Soft Diet
Implementing a soft diet is crucial for a child who is 24 hours postoperative following a cleft palate repair. The surgical site in the mouth is still healing, and a soft diet helps prevent any damage or irritation to the area. Soft foods are easier to swallow and less likely to cause pain or disrupt the healing process. Examples of soft foods include mashed potatoes, yogurt, and pureed fruits.
Choice D: Offer Fluids Through a Straw
Offering fluids through a straw is not recommended for a child who has undergone cleft palate repair. The suction created by using a straw can put pressure on the surgical site and potentially cause complications. Instead, fluids should be offered using a cup or a spoon to minimize any risk to the healing palate.
