A postpartum client who delivered four hours ago and has a ...

[altibaby]

A postpartum client who delivered four hours ago and has a mediolateral episiotomy and large hemorrhoids is rating her pain at 7 on a scale of 110. She has a history of anaphylactic reaction to acetaminophen (Tylenol).
 
  Which nursing action would be best? 1. Offer the client 800 mg ibuprofen (Advil) orally with food.
   2. Provide 2 oxycodone with acetaminophen (Percocet) by mouth.
   3. Encourage use of benzocaine topical anesthetic spray (Dermoplast).
   4. Run very warm water into the tub and assist her into the bath.

Question 2

The operating room nurse is circulating during a surgical procedure to remove the right leg of a client. The nurse participates in a time out prior to surgery to avoid a possible sentinel event, such as:
 
  1. The client being mildly over-sedated.
   2. The removal of the client's left leg.
   3. The lack of healing of the stump.
   4. Ineffective control of the client's pain.

[tanna.moeller]

Answer to Question 1

1. Offer the client 800 mg ibuprofen (Advil) orally with food.

Rationale:
Offering ibuprofen (Advil) is the best option because the client is experiencing moderately severe pain with inflammation. Ibuprofen is a nonsteroidal antiinflammatory drug that both reduces inflammation and provides pain relief. Oxycodone with acetaminophen (Percocet) is contraindicated because of the client's allergic reaction to acetaminophen. Topical anesthetic sprays such as Dermoplast can be a helpful adjunct in pain relief but are not sufficient when a client has moderately severe pain. Ice packs instead of a warm bath would be better at this stage, because they will cause vasoconstriction to reduce edema and pain relief.

Answer to Question 2

2. The removal of the client's left leg

Rationale:
A sentinel event is an unexpected event that causes death or severe physical or psychological injury. The removal of the client's left leg instead of the right leg would be a sentinel event. Mild over-sedation is not a sentinel event as the client is most likely on a ventilator during surgery. The inability to heal properly is an expected event in a diabetic client. Pain control is individual and is not a sentinel event.

[altibaby]

TY

[tanna.moeller]

You're welcome