Atrium Health Womens Care Maternal Fetal Monitoring

Atrium Health Womens Care Maternal Fetal Monitoring Related

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The nurse is assessing a 38-week pregnant woman who is experiencing severe abdominal pain and has not felt her baby move for several hours. What is the most appropriate action for the nurse to take?

  • A. Encourage the patient to drink water and rest.
  • B. Notify the healthcare provider immediately.
  • C. Ask the patient to lie on her left side and monitor fetal movements.
  • D. Reassure the patient that this is common at the end of pregnancy.
Correct Answer: B

Rationale: The correct answer is B: Notify the healthcare provider immediately. This is the most appropriate action because the pregnant woman is experiencing severe abdominal pain and has not felt her baby move for several hours, which could indicate a potential emergency situation such as placental abruption or fetal distress. Prompt notification of the healthcare provider is crucial for timely evaluation and management to ensure the well-being of both the mother and the baby.

Choice A is incorrect because simply encouraging the patient to drink water and rest may delay necessary medical intervention. Choice C is incorrect as monitoring fetal movements without immediate healthcare provider notification may lead to a critical delay in assessment and treatment. Choice D is incorrect as reassuring the patient without further evaluation could overlook a serious issue.

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What is the purpose of administering Rh immunoglobulin (RhIg) to a postpartum person?

  • A. to prevent Rh sensitization in future pregnancies
  • B. to promote lactation in the birthing person
  • C. to reduce the risk of bleeding in Rh-negative pregnancies
  • D. to prevent infection and promote early bonding
Correct Answer: D

Rationale: The correct answer is D: to prevent infection and promote early bonding. Rh immunoglobulin (RhIg) is given to prevent Rh sensitization in Rh-negative individuals who have given birth to an Rh-positive baby. This prevents the mother from developing antibodies that could harm future pregnancies. The other choices are incorrect because RhIg does not promote lactation (B), reduce the risk of bleeding in Rh-negative pregnancies (C), or prevent Rh sensitization in future pregnancies (A). By preventing infection, RhIg helps protect the mother's health and promotes early bonding with the newborn.

The results of a contraction stress test (CST) are positive. Which intervention is necessary based on this test result?

  • A. Repeat the test in 1 week so that results can be trended based on this baseline result.
  • B. Contact the health care provider to discuss birth options for the patient.
  • C. Send the patient out for a meal and repeat the test to confirm that the results are valid.
  • D. Ask the patient to perform a fetal kick count assessment for the next 30 minutes and then reassess the patient.
Correct Answer: B

Rationale: A positive CST is an abnormal finding that may indicate fetal compromise, requiring immediate discussion of birth options.

A woman is 36 weeks’ gestation. Which of the following tests will be done during her prenatal visit?

  • A. Glucose challenge test.
  • B. Amniotic fluid volume assessment.
  • C. Vaginal and rectal cultures.
  • D. Karyotype analysis.
Correct Answer: C

Rationale: Vaginal and rectal cultures are performed to check for Group B Streptococcus (GBS), which can affect the newborn. Glucose challenge tests are typically done earlier in pregnancy, and karyotype analysis is not routine.

A woman states that she frequently awakens with 'painful leg cramps' during the night. Which of the following assessments should the nurse make?

  • A. Dietary evaluation.
  • B. Goodell’s sign.
  • C. Hegar’s sign.
  • D. Posture evaluation.
Correct Answer: A

Rationale: Leg cramps during pregnancy are often related to dietary deficiencies, particularly calcium and magnesium. A dietary evaluation is the most appropriate assessment.

A woman in labor has a history of previous cesarean section. What is the most important factor to monitor for during this labor?

  • A. Uterine rupture
  • B. Maternal hypotension
  • C. Fetal malpresentation
  • D. Prolonged labor
Correct Answer: A

Rationale: The correct answer is A: Uterine rupture. The most important factor to monitor in a woman with a history of previous cesarean section is the risk of uterine rupture during labor. Uterine rupture is a serious complication that can lead to life-threatening hemorrhage for both the mother and the baby. Monitoring for signs such as sudden onset of severe abdominal pain, abnormal fetal heart rate patterns, and cessation of contractions is crucial. Maternal hypotension (Choice B) is important but not as critical as uterine rupture. Fetal malpresentation (Choice C) and prolonged labor (Choice D) are important factors to monitor but do not pose the same level of immediate risk as uterine rupture in this situation.

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