Nokea
Narcotic analgesia is administered to a laboring patient at 10am. The infant is delivered at 12:30pm. The nurse would anticipate what?
- A. Neonatal respiratory depression
- B. Increased infant alertness
- C. Decreased fetal heart rate variability
- D. No effects on the neonate
Correct Answer: A
Rationale: Narcotic analgesia, when administered to a laboring patient, can cross the placenta and affect the infant. It can cause neonatal respiratory depression in the newborn after delivery. This is because the medication can depress the respiratory drive of the infant, leading to potentially serious breathing problems. It is important for the healthcare provider to closely monitor and assess the newborn for signs of respiratory distress in such cases.
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The nurse is monitoring a client in active labor. What finding indicates the need for immediate intervention?
- A. Contractions every 2–3 minutes.
- B. Fetal heart rate of 90 beats/minute.
- C. Cervical dilation of 6 cm.
- D. Client reports back pain.
Correct Answer: B
Rationale: A fetal heart rate of 90 beats/minute is bradycardia, indicating potential fetal distress.
What is considered the first day of the menstrual cycle?
- A. day of ovulation
- B. first day of menstrual bleeding
- C. last day of menstrual bleeding
- D. when the corpus luteum forms
Correct Answer: B
Rationale:
Three hours after birth, a newborn of a mother with diabetes becomes jittery, has weak, high- pitched cry , and exhibits irregular respirations. The nurse recognizes that these signs are often associated with:
- A. Hypovolemia
- B. Hypocalcemia
- C. Hypoglycemia
- D. Hyperglycemia
Correct Answer: C
Rationale: The signs described in the scenario - jitteriness, weak high-pitched cry, irregular respirations - are indicative of hypoglycemia in a newborn. Babies born to mothers with diabetes are at risk for hypoglycemia due to their exposure to high blood sugar levels in utero. After birth, when the baby is separated from the mother's blood supply, their own insulin production may lead to a sudden drop in blood glucose levels.
What factor is known to increase the risk of gestational DM?
- A. Weigh 100kg prior to pregnancy
- B. Previous birth AGA
- C. Maternal age younger than 25
- D. Previous diagnosis of type 2 diabetes
Correct Answer: D
Rationale: A previous diagnosis of type 2 diabetes is a known risk factor for developing gestational diabetes mellitus (GDM). Women who have had diabetes prior to pregnancy are more likely to develop GDM due to pre-existing insulin resistance. This increased risk is why healthcare providers closely monitor pregnant women with a history of type 2 diabetes. It is important for these women to manage their blood sugar levels carefully during pregnancy to reduce the risk of complications for both the mother and the baby.
A nurse is caring for a client who is in labor and has an external fetal monitor. The nurse observes late decelerations on the monitor strip and interprets them as indicating which of the following?
- A. Uteroplacental insufficiency
- B. Maternal bradycardia
- C. Umbilical cord compression
- D. Fetal head compression
Correct Answer: A
Rationale: Late decelerations on the fetal monitor strip indicate uteroplacental insufficiency. These decelerations occur after the peak of a contraction, and the fetus may not receive enough oxygen-rich blood during contractions. Uteroplacental insufficiency can lead to fetal hypoxia and acidosis if not addressed promptly. It is important for the nurse to take appropriate steps to improve fetal oxygenation, such as repositioning the mother, administering oxygen, and adjusting IV fluids. If late decelerations persist, further interventions may be necessary to ensure the well-being of the fetus.