Maternal Monitoring During Labor

Maternal Monitoring During Labor Related

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A nurse is assisting with a vaginal birth and is monitoring for signs of placental separation. What is the most reliable clinical indicator that the placenta has separated?

  • A. a gush of clear amniotic fluid
  • B. uterine contractions every 2 to 3 minutes
  • C. lengthening of the umbilical cord
  • D. maternal report of intense pain
Correct Answer: C

Rationale: The correct answer is C: lengthening of the umbilical cord. This is the most reliable indicator of placental separation because as the placenta detaches from the uterine wall, the cord lengthens as it moves downward. This signifies that the placenta has separated completely.

A: A gush of clear amniotic fluid is not a reliable indicator of placental separation as it can occur before or after placental separation.
B: Uterine contractions every 2 to 3 minutes are a sign of labor progression, not specifically placental separation.
D: Maternal report of intense pain can be subjective and may not always indicate placental separation.

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For which patient would an L/S ratio of 2:1 potentially be considered abnormal?

  • A. A 38-year-old gravida 2, para 1, who is 38 weeks’ gestation
  • B. A 24-year-old gravida 1, para 0, who has diabetes
  • C. A 44-year-old gravida 6, para 5, who is at term
  • D. An 18-year-old gravida 1, para 0, who is in early labor at term
Correct Answer: B

Rationale: In diabetic pregnancies, an L/S ratio of 2:1 may not reliably indicate lung maturity due to delayed surfactant production.

What response is appropriate regarding sushi consumption during pregnancy?

  • A. Fish is healthy
  • B. Sushi is too salty
  • C. Raw fish is high in mercury
  • D. Fish should be cooked
Correct Answer: D

Rationale: Cooking fish destroys harmful bacteria and parasites, reducing the risk of foodborne illnesses during pregnancy.

The nurse asks a 31-week gestation client to lie on the examining table during a prenatal examination.

  • A. Orthopneic.
  • B. Lateral-recumbent.
  • C. Sims'.
  • D. Semi-Fowler’s.
Correct Answer: B

Rationale: The lateral-recumbent position reduces pressure on the inferior vena cava and is safer for pregnant women compared to other positions.

A nurse is caring for a pregnant patient who is 24 weeks gestation and has been diagnosed with anemia. What should the nurse teach the patient about managing this condition?

  • A. Increase iron-rich foods and take iron supplements as prescribed.
  • B. Rest frequently and avoid physical activity to prevent exhaustion.
  • C. Limit intake of dairy products to prevent iron deficiency.
  • D. Incorporate more vitamin D-rich foods into the diet to help the body absorb iron.
Correct Answer: A

Rationale: The correct answer is A because increasing iron-rich foods and taking iron supplements as prescribed is the standard treatment for managing anemia during pregnancy. Iron is essential for red blood cell production, which is crucial for both the mother and the developing fetus. Resting frequently (choice B) may help with fatigue but does not address the root cause of anemia. Limiting dairy intake (choice C) is not necessary and may lead to other nutritional deficiencies. Incorporating vitamin D-rich foods (choice D) can be beneficial for overall health but does not specifically address the management of anemia.

The nurse is assessing the laboratory report of a 40-week gestation client. Which of the following values would the nurse expect to find elevated above prepregnancy levels? Select all that apply.

  • A. Glucose.
  • B. Fibrinogen.
  • C. Hematocrit.
  • D. Bilirubin.
Correct Answer: B

Rationale: Fibrinogen levels increase to prevent excessive blood loss during delivery, and white blood cell count rises to protect against infection. Glucose, hematocrit, and bilirubin levels should remain within normal limits.

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