The nurse is caring for a client diagnosed with suspected acute ...

[karlynnae]

The nurse is caring for a client diagnosed with suspected acute pancreatitis. When reviewing the client's laboratory results, the nurse determines that which of these findings will support the diagnosis?
 
  1. Elevated serum lipase level
  2. Elevated serum bilirubin level
  3. Decreased serum trypsin level
  4. Decreased serum amylase level

Question 2

The rubella vaccine has been prescribed for a new mother. Which of the following statements should the postpartum nurse make when providing information about the vaccine to the client?
 
  1. You will need a second vaccination at your 6-week postpartum visit.
  2. You should avoid sexual intercourse for 2 weeks after the administration of the vaccine.
  3. You should not become pregnant for 1 to 3 months after the administration of the vaccine.
  4. You should avoid heat and extreme temperature changes for a week after the administration of the vaccine.

[yuyiding]

Answer to Question 1

1

Rationale: The serum lipase level is elevated in the presence of pancreatic cell injury. Serum trypsin and amylase levels are also elevated in pancreatic injury. Although bilirubin can be elevated in the client with pancreatitis, it is secondary to the hepatobiliary obstructive process.

Answer to Question 2

3

Rationale: Rubella vaccine is a live attenuated virus that provides immunity for 15 years. Be-cause rubella is a live vaccine, it will act as a virus and is potentially harmful to the organogenesis phase of fetal development. The client should be informed about the potential effects of this vaccine and the need to avoid becoming pregnant for 1 to 3 months after administration of the vaccine. Abstinence from sexual intercourse is unnecessary. A second vaccination is not required to attain immunity. Warmth and temperature or extreme changes in temperature have no effect on the person who has been vaccinated.

[karlynnae]

Gracias!

[peter]

TYSM