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Author Question: A patient who is 11 weeks pregnant presents to the emergency department with complaints of ... (Read 88 times)

laurencescou

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A patient who is 11 weeks pregnant presents to the emergency department with complaints of dizziness, lower abdominal pain, and right shoulder pain. Laboratory tests reveal a beta-hCG at a lower-than-expected level for this gestational age.
 
  An adnexal mass is palpable. Ultrasound confirms no intrauterine gestation. The patient is crying and asks what is happening. The nurse knows that the most likely diagnosis is an ectopic pregnancy. Which statement should the nurse include? 1. You're feeling dizzy because the pregnancy is compressing your vena cava.
  2. The pain is due to the baby putting pressure on nerves internally.
  3. The baby is in the fallopian tube; the tube has ruptured and is causing bleeding.
  4. This is a minor problem. The doctor will be right back to explain it to you.

Question 2

When doing a neurologic assessment of a newborn, what would the nurse recognize? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
 
  1. Muscle tone is assessed by moving various parts of the newborn's body while the newborn's head remains in a neutral position.
  2. The newborn is somewhat hypertonic.
  3. Muscle tone should be symmetrical.
  4. Shortly after birth, the infant is flaccid at rest.
  5. Diminished muscle tone requires further evaluation.



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wfdfwc23

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Answer to Question 1

3
Rationale 1: Dizziness from vena cava compression occurs in the third trimester when women are supine.
Rationale 2: The fetus is too small to be putting pressure on the nerves.
Rationale 3: Dizziness and abdominal pain with shoulder pain are symptoms of internal bleeding. A lower-than-expected beta-hCG indicates either an ectopic pregnancy or a pregnancy that is miscarrying; in this case, it is an ectopic pregnancy.
Rationale 4: Therapeutic communication requires giving the patient an answer rather than referring the patient to someone else.

Answer to Question 2

1, 2, 3, 5
Explanation: 1. Moving various parts of the newborn's body while the newborn's head remains in a neutral position is the correct way to assess muscle tone.
2. The newborn will resist the examiner's attempts to extend the elbow and knee joints.
3. Muscle tone should be symmetrical.
5. If decreased muscle tone is noted, further evaluation is necessary.





 

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