Nokea
A client at 42 weeks of gestation is having an ultrasound. For which of the following conditions should the nurse prepare for an amnioinfusion? (Select all that apply)
- A. Oligohydramnios
- B. Hydramnios
- C. Fetal cord compression
- D. Polyhydramnios
Correct Answer: A
Rationale: Rationale: A client at 42 weeks of gestation is at risk for oligohydramnios, which is associated with decreased amniotic fluid levels. Amnioinfusion can be used to increase amniotic fluid volume to prevent fetal cord compression and facilitate fetal movement during labor.
Summary:
- B: Hydramnios (excessive amniotic fluid) does not require amnioinfusion.
- C: Fetal cord compression is a reason for amnioinfusion, not a condition to prepare for.
- D: Polyhydramnios (excessive amniotic fluid) does not typically require amnioinfusion unless there are complicating factors.
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In a prenatal clinic, a client in the first trimester of pregnancy has a health record that includes this data: G3 T1 P0 A1 L1. How should the nurse interpret this information? (Select all that apply)
- A. Client has delivered one newborn at term
- B. Client has experienced no preterm labor
- C. Client has had two prior pregnancies
- D. ALL OF THE ABOVE - has one living child
Correct Answer: D
Rationale: The data "G3 T1 P0 A1 L1" indicates the client has had 3 pregnancies (G3), 1 term delivery (T1), 0 preterm deliveries (P0), 1 living child (A1), and 1 living child currently (L1). Therefore, the correct interpretation is that the client has one living child (A1) from one term delivery (T1). Choice D ("ALL OF THE ABOVE - has one living child") is correct as it summarizes the information accurately. Choices A, B, and C are incorrect because they do not encompass all the aspects of the data provided in the client's health record.
A client in active labor reports back pain while being examined by a nurse who finds her to be 8 cm dilated, 100% effaced, -2 station, and in the occiput posterior position. What action should the nurse take?
- A. Perform effleurage during contractions.
- B. Place the client in lithotomy position.
- C. Assist the client to the hands and knees position.
- D. Apply a scalp electrode to the fetus.
Correct Answer: C
Rationale: The correct action is to assist the client to the hands and knees position. This position, also known as the all-fours position, can help alleviate back pain by encouraging the baby to rotate into a more favorable position for delivery. By being on hands and knees, gravity assists in the rotation of the baby. This position can also help relieve pressure on the mother's back and potentially facilitate a smoother labor progress. Effleurage (choice A) may provide comfort but doesn't address the positional issue. Placing the client in lithotomy position (choice B) can worsen the occiput posterior position. Applying a scalp electrode to the fetus (choice D) is not indicated in this scenario.
A woman in a women's health clinic is receiving teaching about nutritional intake during her 8th week of gestation. The healthcare provider should advise the woman to increase her daily intake of which of the following nutrients?
- A. Calcium
- B. Vitamin E
- C. Iron
- D. Vitamin D
Correct Answer: C
Rationale: The correct answer is C: Iron. During pregnancy, the body's demand for iron increases to support the growing fetus and placenta. Iron is essential for the production of hemoglobin, which carries oxygen to the baby. Inadequate iron intake can lead to maternal anemia and complications. Calcium is important for bone health, but the focus in the 8th week of gestation should be on iron. Vitamin E is an antioxidant that is important for overall health but not specifically targeted for increased intake in the 8th week of pregnancy. Vitamin D is crucial for calcium absorption and bone health, but iron takes precedence during this stage of pregnancy.
What is the most appropriate statement for a nurse to make to a client who has recently experienced a perinatal death?
- A. It must be a comfort to know you have another child.
- B. I'm sad for you.
- C. There is usually something wrong with the baby.
- D. You will always have an angel in heaven.
Correct Answer: B
Rationale: The correct answer is B: "I'm sad for you." This response shows empathy and acknowledges the client's feelings without making assumptions or providing false reassurance. It validates the client's emotions and offers support.
Incorrect choices:
A: This statement assumes the client's feelings and may not be comforting.
C: This statement is insensitive and can cause unnecessary guilt or blame.
D: While well-intentioned, this statement may not align with the client's beliefs and can be dismissive of their grief.
A client is postpartum and has idiopathic thrombocytopenic purpura (ITP). Which of the following findings should the nurse expect?
- A. Decreased platelet count
- B. Increased erythrocyte sedimentation rate (ESR)
- C. Decreased megakaryocytes
- D. Increased WBC
Correct Answer: A
Rationale: Step 1: In idiopathic thrombocytopenic purpura (ITP), there is a decreased platelet count due to immune-mediated destruction of platelets.
Step 2: This leads to an increased risk of bleeding and bruising in the postpartum client.
Step 3: Other choices are incorrect because in ITP, there is no increase in ESR or WBC. Also, megakaryocytes may be normal or increased due to compensatory production.