Few questions - fundal height pre post partum and priority

[jcutler]

Graduated this last June. Studying for NCLEX for Sept 8th and need some clarification.

So to my understanding fundal height during gestation can be measured at 20 weeks right? and then after that and should equal number of weeks gestation?

Post partum - where should fundus be. At level of umbilicus or one cm above? And to my understanding should decrease 1 cm a day for 10 days and that should be where it stays right?

Also, if someone has DKA, another with renal failure, and another with blood sugar of 300, who takes priority to see first? I remember having a question like this or similar and was confused. Don't know if wrong or right. I mean is DKA considered breathing issue?

Also, sickle cell, do you give fluids first or O2 first?

Or say a med toxicity issue SOB is occurring. Do you stop med first or O2?

Sorry don't have any specific examples but sometimes confused when going by the ABC's and issues with patient. Do you stop the irritant first or intervene first (e.g. O2).

[Jolie, BSN]

Perhaps you could post your thoughts on the priority of patient care and the experienced nurses here would evaluate them.

We're happy to help you with your critical thinking skills, but not so eager to feel like we're doing homework.

[jcutler]

I edited the post. But no. Is not my homework, just studying for nclex Sept 8th. Main problems with priority it do you go by ABC's first or remove irritant first.

E.g. if a pregnant women is having late decels, do you O2 first or turn left side?

[Jolie, BSN]

Thanks for clarifying. Sorry I jumped to conclusions :)

In reality, when you find a patient with decels, you are doing 2 or 3 things at once: turning the patient, reaching for oxygen, upping IV fluid rate (if available and safe to do so). I realize that it is of no comfort to you to know this, but questions like this are so artificial as to be useless.

It is my understanding that you should always follow ABC in choosing your interventions.

As far as removing the irritant first, that would be logical, as providing oxygen to counter-act the effect of medication toxicity is useless as long as the medication continues to be infused. But you have to make sure that the question clearly indicates that the medication is the source of the problem. Are you certain that the patient is reacting to a new IV medication, or is she experiencing a PE unrelated to the new drug?

I've probably added more confusion. My best wishes to you on NCLEX!

[caliotter3]

Are these questions from a resource that offers rationales? You might find that you waste less time by doing questions from study resources that provide the rationales for answers. Good luck on test day.

[jcutler]

No, I just know there are questions like these on NCLEX. What would you do first? Very confusing cause kaplan has some contradictary questions sometimes. E.g. What would be appropriate when communicating to a family member that is dying? Some questions say you should empathize first and some have an empathizing answer but turn out wrong and rationale is that you shoudl select the answer that has the patient express feelings first. It goes back and forth. As well as the what would you do first type questions also. which is it? That's why I am not relying on kaplan and asking on this site.