A postpartal client recovering from a deep vein thrombosis is ...

[nevelica]

A postpartal client recovering from a deep vein thrombosis is being discharged. What areas of teaching on self-care and anticipatory guidance should the nurse discuss with the client? Select all that apply.
 
  1. Avoid crossing of her legs.
  2. Avoid prolonged standing or sitting.
  3. Take frequent walks.
  4. Take a daily aspirin dose of 650 mg.
  5. Avoid long car trips.

Question 2

A primigravida is admitted to the birth setting in early labor. She is 3 cm dilated, 2 station, with intact membranes and FHR of 150 bpm. Her membranes rupture spontaneously, and the FHR drops to 90 bpm with variable decelerations.
 
  The initial response from the nurse would be to: 1. Perform a vaginal exam.
  2. Notify the physician.
  3. Place the client in a left lateral position.
  4. Administer oxygen at 2L per nasal cannula.

[al]

Answer to Question 1

1, 2, 3
Rationale:
1. Avoid crossing of legs, because of the pressure it causes.
2. Avoid prolonged standing or sitting, which contributes to venous stasis.
3. Take frequent walks to promote venous return.
4. Taking a daily aspirin increases anticoagulant activity, and should be avoided if the client is being treated with other anticoagulants.
5. Avoiding long car trips is not necessary. The client should be told to take frequent breaks during car trips, but not to avoid them entirely.

Answer to Question 2

1
Rationale:
1. A drop in fetal heart rate accompanied by variable decelerations is consistent with a prolapsed cord, and a vaginal exam is the best way to confirm.
2. The vaginal exam should be done before notification of the physician.
3. Positioning will not relieve the decreased heart rate if the cord is compromised.
4. Oxygen will not relieve the decreased heart rate if the cord is compromised.

[nevelica]

TYSM

[elyse44]

Gracias!