A serum electrolyte report for a client, 1 day post-cesarean delivery for eclampsia, has just been received by the nurse. The client is receiving 5% dextrose in 1/2 normal saline IV at 125 mL/hr and magnesium sulfate 2 G/hr IV via infusion pump. Which of the following values should the nurse report to the surgeon?

Correct Answer: A

Rationale: In this scenario, the nurse should report the magnesium level of 7 mg/dL to the surgeon. Postpartum eclampsia is a condition characterized by seizures and is treated with magnesium sulfate to prevent further seizures. Monitoring magnesium levels is crucial due to its narrow therapeutic range, and levels above 7-8 mg/dL can lead to magnesium toxicity, causing respiratory depression and cardiac arrest. The other options are incorrect because: - Option B, Sodium 136 mg/dL, is within the normal range. - Option C, Potassium 3.0 mg/dL, is slightly low but not critical in this context. - Option D, Calcium 9 mg/dL, is also within the normal range. Educationally, this case highlights the importance of monitoring electrolyte levels, especially magnesium, in postpartum eclampsia patients receiving magnesium sulfate therapy. Nurses should understand the significance of each electrolyte in relation to the patient's condition and treatment to provide safe and effective care. Regular monitoring and prompt reporting of abnormal values are essential in preventing complications and ensuring optimal patient outcomes.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Benadryl (diphenhydramine). The client's symptoms of pruritus and macular rash are indicative of an allergic reaction, which is a common side effect of spinal anesthesia. Benadryl is an antihistamine that can help alleviate these symptoms by blocking the histamine response responsible for the itching and rash. Option A) Reglan (metoclopramide) is used to treat nausea and vomiting, which are not the primary symptoms presented by the client. Option B) Zofran (ondansetron) is also used for nausea and vomiting, not pruritus or rash. Option C) Compazine (prochlorperazine) is an antiemetic used for nausea and vomiting, not allergic reactions like pruritus and rash. In an educational context, understanding the side effects and appropriate interventions for common medications used in the postpartum period is crucial for nurses caring for maternal clients. Recognizing and managing allergic reactions promptly is essential to ensure the well-being and comfort of the client. Diphenhydramine is a commonly used antihistamine in such situations, making it a valuable medication to have knowledge about in the postpartum setting.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Mastitis. Mastitis is an infection of the breast tissue that can occur due to various factors, including retained placental fragments. In this case, the retained placental fragments can lead to an infection, causing inflammation and pain in the affected breast. Common symptoms of mastitis include redness, warmth, swelling, and tenderness in the breast, accompanied by flu-like symptoms such as fever and body aches. Option A) Engorgement is incorrect because engorgement typically occurs when the breasts become overly full with milk, leading to swelling and discomfort, but it is not directly related to retained placental fragments causing an infection. Option C) Blocked milk duct is incorrect as it occurs when milk is unable to flow freely within the duct, often due to pressure on the duct, but it is not specifically associated with an infection caused by retained placental fragments. Option D) Low milk supply is incorrect in this context because retained placental fragments leading to mastitis would not directly impact milk production. Low milk supply can be influenced by various factors such as inadequate breastfeeding or hormonal issues, but it is not the expected complication in this scenario. Educationally, understanding the potential complications of retained placental fragments in breastfeeding women is crucial for nurses and healthcare providers to provide appropriate care and support. Recognizing the signs and symptoms of mastitis, differentiating it from other breastfeeding issues, and initiating prompt treatment are essential in ensuring the well-being of both the mother and the infant. This knowledge helps in promoting successful breastfeeding outcomes and maternal health postpartum.

Correct Answer: B

Rationale: In the context of postpartum hormonal changes, understanding different types of placentas and their implications is crucial for providing optimal care to postpartum clients. In this scenario, the correct answer is B) Succenturiate placenta. The succenturiate placenta is characterized by accessory lobes connected to the main placental mass by blood vessels. This condition can lead to complications such as retained placental tissue, postpartum hemorrhage, and increased risk of placental abnormalities in future pregnancies. Therefore, it is important for the nurse to accurately identify and document this type of placenta for appropriate monitoring and management. Now, let's discuss why the other options are incorrect: A) Circumvallate placenta: This refers to a placenta with a thickened ring-like edge, which can also lead to complications but is not depicted in the image provided. C) Placenta with velamentous cord insertion: This refers to a condition where the umbilical cord inserts into the fetal membranes before reaching the placenta, which is not the case in the image. D) Battledore placenta: This refers to a condition where the umbilical cord inserts at the edge of the placenta, resembling a tennis racket handle, which is not depicted in the image. Educationally, this question reinforces the importance of visual recognition and accurate documentation of placental variations to guide postpartum care. It highlights the significance of understanding placental anatomy in assessing postpartum risks and complications, thereby enhancing the nurse's ability to provide safe and effective care to postpartum clients.

Correct Answer: B

Rationale: The correct answer is B) "I'll take him to a specialist. Then he will get better." This statement suggests that the client is in the bargaining phase of grief where they are trying to negotiate or make deals to reverse the situation. This response shows a sense of hope and a belief that seeking medical help will lead to improvement in the baby's condition. Option A) "I hate myself. I caused my baby to be sick" indicates guilt and self-blame, which align more with the guilt phase of grief. Option C) "I can't seem to stop crying" suggests overwhelming sadness, which is characteristic of the depression phase of grief. Option D) "This can't be happening" reflects denial, which is common in the initial stages of grief. In an educational context, understanding the stages of grief can help healthcare providers support clients experiencing loss or challenging situations. Recognizing these stages can guide effective communication and provide appropriate emotional support to clients during the postpartum period. It is crucial for healthcare professionals to be aware of these emotional responses and be prepared to offer empathy, understanding, and resources to help clients navigate through their grief process.