The nurse suspects that a pregnant client might be experiencing ...

[hbsimmons88]

The nurse suspects that a pregnant client might be experiencing abuse when the client does which of the following? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
 
  1. Gives an inappropriate explanation for the injuries
  2. Hesitates in providing detailed information about the injury
  3. Makes eye contact with the nurse while answering questions
  4. Allows her partner to answer the nurse's questions
  5. Frequently calls to change appointment times

Question 2

A newborn is determined to have physiological jaundice. The nurse explains the steps involved in conjugation and excretion of bilirubin to the parents.
 
  Which factors would the nurse include in the explanation? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. At birth, the newborn's liver begins to conjugate bilirubin or convert it from a yellow lipid-soluble pigment to a water-soluble pigment.
  2. Unconjugated bilirubin can leave the bloodstream and enter the tissues, causing a yellow hue to the skin and sclera.
  3. Unconjugated bilirubin results from the destruction of white blood cells.
  4. The infant is able to excrete conjugated bilirubin, but not unconjugated bilirubin.
  5. The newborn's liver has greater metabolic and enzymatic activity at birth than does an adult liver, increasing the newborn's susceptibility to jaundice.

[sabina576]

Answer to Question 1

1, 2, 4, 5
Explanation: 1. Whenever a client gives an inappropriate explanation for injuries, such as being accident prone, the nurse should suspect abuse.
2. Clients experiencing abuse often hesitate in providing detailed information about an injury and how it occurred.
4. The client experiencing abuse may show signs of increased anxiety in the presence of the possible batterer, who frequently does most of the talking or hovers around the woman.
5. If a client has injuries sustained from abuse, she will often delay reporting of symptoms or seeking care for injuries.

Answer to Question 2

1,2,4
Rationale 1: Conjugation of bilirubin is the conversion of yellow lipid-soluble pigment into water-soluble pigment.
Rationale 2: Unconjugated bilirubin results in a yellow coloring known as jaundice.
Rationale 3: Unconjugated bilirubin is a product of the breakdown of red blood cells.
Rationale 4: Unconjugated bilirubin is not in an excretable form, and is a potential toxin.
Rationale 5: The newborn's liver has relatively less metabolic and enzymatic activity at birth and in the first few weeks of life than does an adult liver.