Nokea
A multigravida patient comes into the clinic for one of her second-trimester prenatal visits. The nurse reviews her laboratories that were drawn prior to the visit. Which laboratories results should concern the nurse most?
- A. Platelet count of 200,000 per μL (microliter) of blood
- B. Hemoglobin 9.5 g/dL
- C. White blood cell count of 11,000/μL
- D. Rubella titer ratio of 1:10
Correct Answer: B
Rationale: The correct answer is B: Hemoglobin 9.5 g/dL. This result indicates the patient is anemic, which is concerning during pregnancy as it can lead to complications like preterm birth or low birth weight. Anemia can also affect the mother's health. Platelet count of 200,000/μL is within the normal range, not a cause for concern. White blood cell count of 11,000/μL may indicate infection but is not as critical as anemia in pregnancy. Rubella titer ratio of 1:10 suggests immunity to rubella, which is not an immediate concern during the prenatal visit.
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Which statement correctly describes the nurse's responsibility related to electronic monitoring?
- A. Report abnormal findings to the physician before initiating corrective actions.
- B. Teach the woman and her support person about the monitoring equipment and discuss any of their questions.
- C. Document the frequency, duration, and intensity of contractions measured by the
- D. Inform the support person that the nurse will be responsible for all comfort
Correct Answer: B
Rationale: The correct answer is B because it aligns with the nurse's responsibility to educate and provide information to the patient and their support person. Teaching about the monitoring equipment and addressing any questions ensures that the patient and their support person are informed and empowered. This promotes patient understanding and involvement in their care, leading to better outcomes.
Choice A is incorrect because the nurse should initiate corrective actions promptly for abnormal findings without waiting for physician input. Choice C is incorrect as it focuses solely on documentation rather than patient education. Choice D is incorrect as it neglects the importance of involving the support person in the care process.
The physician has ordered an amnioinfusion for the laboring patient. Which data supports the use of this therapeutic procedure?
- A. Presenting part not engaged
- B. +4 meconium-stained amniotic fluid on artificial rupture of membranes (AROM)
- C. Breech position of fetus
- D. Twin gestation
Correct Answer: B
Rationale: The correct answer is B because +4 meconium-stained amniotic fluid on AROM indicates meconium passage by the fetus, which can lead to meconium aspiration syndrome. Amnioinfusion can help dilute the meconium, reducing the risk of respiratory complications for the newborn.
A: Presenting part not engaged is not a direct indication for amnioinfusion.
C: Breech position of the fetus does not specifically warrant amnioinfusion.
D: Twin gestation alone is not a direct indication for amnioinfusion.
What is a possible complication of uterine tachysystole?
- A. Category I fetal heart rate tracing
- B. placenta previa
- C. fetal hypoxia
- D. prolapsed cord
Correct Answer: C
Rationale: Uterine tachysystole is excessive uterine contractions, reducing placental perfusion and causing fetal hypoxia. This can lead to potential complications such as fetal distress and hypoxia. Category I fetal heart rate tracing is typically associated with normal fetal heart rate. Placenta previa is unrelated to uterine tachysystole. Prolapsed cord is a potential complication of uterine hyperstimulation, not tachysystole.
The nurse will monitor for aspiration, thought processes, and improved mobility after which complication?
- A. neurologic dysfunction
- B. Measure blood loss.
- C. gestational diabetes
- D. postpartum hemorrhage
Correct Answer: D
Rationale: The correct answer is D: postpartum hemorrhage. The nurse monitors for aspiration due to potential bleeding or clotting issues postpartum. Monitoring thought processes is important as postpartum hemorrhage can lead to hypovolemic shock affecting cognition. Improved mobility is assessed as excessive bleeding can cause weakness. Neurologic dysfunction (choice A) is not directly related to postpartum hemorrhage. Measuring blood loss (choice B) is important but not the primary focus after postpartum hemorrhage. Gestational diabetes (choice C) is a separate condition unrelated to postpartum hemorrhage.
Which of the following is theN pUriRorSitIy NinGteTrvBen.tiConO fMor the patient in a left side-lying position whose monitor strip shows a deceleration that extends beyond the end of the contraction?
- A. Administer O at 8 to 10 L/minut
- B. Decrease the IV rate to 100 mL/hour.
- C. Reposition the ultrasound transducer.
- D. Perform a vaginal exam to assess for cord prolaps
Correct Answer: A
Rationale: The correct answer is A: Administer O at 8 to 10 L/minut. In a left side-lying position, this deceleration indicates possible umbilical cord compression, reducing oxygen supply to the fetus. Administering oxygen at 8 to 10 L/min can help improve fetal oxygenation. Decreasing the IV rate (B) wouldn't directly address the fetal distress. Repositioning the ultrasound transducer (C) is irrelevant to the situation. Performing a vaginal exam (D) could worsen the cord compression if the cord is prolapsed.