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 reason:
Metoprolol is a beta-blocker commonly used to treat high blood pressure (hypertension). One of its primary therapeutic effects is the reduction of blood pressure. By blocking beta-adrenergic receptors, metoprolol decreases the heart rate and the force of contraction, leading to lower blood pressure.
Choice B reason:
While metoprolol can help manage certain types of dysrhythmias by slowing the heart rate and stabilizing the heart’s rhythm, the primary therapeutic effect for which it is most commonly prescribed is the reduction of blood pressure.
Choice C reason:
Increased urine output is not a direct therapeutic effect of metoprolol. This effect is more commonly associated with diuretics, which are often used in conjunction with beta-blockers to manage hypertension and heart failure.
Choice D reason:
Decreased pulse is a potential effect of metoprolol, as it slows the heart rate. However, this is not the primary therapeutic goal. The main therapeutic effect is the reduction of blood pressure.
Correct Answer is A
Explanation
Choice A: Wrap the stump with an elastic bandage in a figure-eight configuration
Wrapping the stump with an elastic bandage in a figure-eight configuration is a standard practice in postoperative care for below-the-knee amputations. This method helps to shape and shrink the residual limb, preparing it for a prosthesis fitting. The figure-eight wrap provides even compression, which helps to reduce swelling and promote proper healing. It also helps to prevent the formation of edema and ensures that the residual limb maintains a conical shape, which is ideal for fitting a prosthetic socket.
Choice B: Remove the elastic bandage and re-wrap the stump once per day
While it is important to regularly check and adjust the bandage, removing and re-wrapping the stump only once per day may not be sufficient. The bandage should be checked more frequently to ensure it remains properly positioned and provides consistent compression. In some cases, it may need to be adjusted multiple times a day to maintain the desired level of compression and to prevent any issues such as slippage or uneven pressure.
Choice C: Perform passive range of motion exercises once daily
Performing passive range of motion exercises is beneficial for maintaining joint flexibility and preventing contractures. However, these exercises should be performed more frequently than once daily, especially in the early postoperative period. Regular exercises help to maintain muscle strength, improve circulation, and promote overall mobility. The frequency and type of exercises should be tailored to the individual needs of the client and guided by a physical therapist.
Choice D: Secure the elastic bandage to the lowest joint
Securing the elastic bandage to the lowest joint is not recommended. The bandage should be wrapped in a way that provides even compression without restricting movement or circulation. The figure-eight configuration is preferred because it allows for better control of the compression and helps to shape the residual limb effectively. Securing the bandage to a joint can lead to discomfort and may impede proper blood flow.