A nurse is caring for a client who had a vaginal delivery 4 hours ago and reports perineal pain of 6 on a scale of 0 to 10. Which of the following actions should the nurse take?
Apply a corticosteroid cream to the perineal area twice daily.
Increase the client’s fluid intake for 48 hours.
Catheterize the client’s bladder.
Offer an ice pack to the client during the first 24 hours.
The Correct Answer is D
Choice A rationale
Applying a corticosteroid cream is not appropriate for acute perineal pain. It is more suitable for chronic inflammation or skin conditions.
Choice B rationale
Increasing fluid intake is beneficial for overall health, but it does not directly address acute perineal pain.
Choice C rationale
Catheterizing the bladder is not indicated for perineal pain unless there is a specific issue with urinary retention.
Choice D rationale
Offering an ice pack helps reduce swelling and numb the area, providing immediate relief for acute perineal pain. It is a standard intervention for postpartum perineal discomfort.
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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
A hemoglobin level of 9.5 g/dL is low for a full-term newborn and should be reported to the provider. Normal hemoglobin levels for newborns range from 14 to 24 g/dL4.
Choice B rationale
A white blood cell count of 10,000/mm³ is within the normal range for a newborn, which is typically between 9,000 and 30,000/mm³4.
Choice C rationale
A glucose level of 60 mg/dL is within the normal range for a newborn, which is typically between 40 and 60 mg/dL4.
Choice D rationale
A platelet count of 225,000/mm³ is within the normal range for a newborn, which is typically between 150,000 and 450,000/mm³4.