Current Issues in Maternal-Newborn Nursing

Current Issues in Maternal-Newborn Nursing Related

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A nurse is admitting a patient to the labor and birth unit in early labor that was sent to the facility following a checkup with her health care provider in the office. The patient is a gravida 1, para 0, and is at term. No health issues are discerned from the initial assessment, and the nurse prepares to initiate physician orders based on standard procedures. Which action by the nurse manager is warranted in this situation?

  • A. No action is indicated because the nurse is acting within the scope of practice.
  • B. The nurse manager should intervene and ask the nurse to clarify admission orders directly with the physician.
  • C. The nurse manager should review standard procedures with the nurse to validate that orders are being carried out accurately.
  • D. The nurse manger should review the admission procedure with the nurse.
Correct Answer: B

Rationale: In this scenario, the nurse is admitting a patient based on orders initiated by the physician during an office visit. Given that the patient is in early labor and has no discernible health issues, the nurse manager should intervene and ask the nurse to clarify the admission orders directly with the physician. It is important to ensure clarity and accuracy when carrying out physician orders, especially in situations where there may be ambiguity or room for misinterpretation. By verifying the orders with the physician, the nurse can help prevent any potential errors or miscommunications that may impact the patient's care.

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The nurse is formulating a nursing care plan for a postpartum patient. Which actions by the nurse indicate use of critical thinking skills when formulating the care plan? (Select all that apply.)

  • A. Using a standardized postpartum care plan
  • B. Determining priorities for each diagnosis written
  • C. Writing interventions from a nursing diagnosis book
  • D. Reflecting and suspending judgment when writing the care plan
Correct Answer: B

Rationale: B. Determining priorities for each diagnosis written: Prioritizing nursing diagnoses based on the patient's needs and condition requires critical thinking skills. The nurse must be able to identify the most urgent issues to address first in the care plan.

What assessment finding suggests that a patient may have fibrocystic breast changes?

  • A. green-tinged nipple discharge
  • B. ongoing breast pain
  • C. firm, ropy feel of the breast tissue under the skin
  • D. peau d’orange appearance of the skin
Correct Answer: C

Rationale: Fibrocystic breast changes typically present with breast pain and a cyclic pattern of nodularity and/or lumps in the breast tissue. The characteristic assessment finding that suggests fibrocystic breast changes is the firm, ropy feel of the breast tissue under the skin. This texture is due to the presence of fibrous tissue and cysts within the breast, which can be felt during the physical examination. While nipple discharge and skin changes like peau d’orange can be associated with different breast conditions, the firm and ropy feel of the breast tissue is more specific to fibrocystic changes.

Which nursing diagnosis should the nurse identify as a priority for a patient in active labor?

  • A. Risk for anxiety related to upcoming birth
  • B. Risk for imbalanced nutrition related to NPO status
  • C. Risk for altered family processes related to new addition to the family
  • D. Risk for injury (maternal) related to altered sensations and positional or physical
    changes
Correct Answer: D

Rationale: The priority nursing diagnosis for a patient in active labor should focus on ensuring the safety and well-being of the mother and the baby. "Risk for injury (maternal) related to altered sensations and positional or physical changes" is the most crucial diagnosis in this scenario as it directly addresses potential risks and complications that may occur during labor and delivery. This nursing diagnosis includes considerations for the physical changes the mother undergoes during labor, such as altered sensations and positioning, which can increase the risk of injury. By identifying and addressing this risk promptly, the nurse can help prevent potential harm to the mother and ensure a safe delivery process.

Which statement best describes the advantage of a labor, birth, recovery, and postpartum (LDRP) room?

  • A. The family is in a familiar environment.
  • B. They are less expensive than traditional hospital rooms.
  • C. The infant is removed to the nursery to allow the mother to rest.
  • D. The woman’s support system is encouraged to stay until discharge.
Correct Answer: A

Rationale: One of the advantages of a labor, birth, recovery, and postpartum (LDRP) room is that the family is in a familiar environment. LDRP rooms are designed to provide a comfortable setting where the mother, baby, and family can stay together throughout the entire childbirth process. This environment allows for better continuity of care, enhances bonding between the baby and the family, and helps reduce stress and anxiety often associated with being in an unfamiliar hospital setting. Being in a familiar environment can also promote a sense of security and control for the mother, which can positively impact her overall birthing experience.

What information would the nurse include when teaching a patient about core needle biopsy?

  • A. It can be performed with or without ultrasound guidance.
  • B. Local anesthetic is not needed before this procedure.
  • C. It is usually performed in the outpatient surgery center.
  • D. A special dye is injected into the area around the tumor.
Correct Answer: C

Rationale: Core needle biopsy is typically performed in an outpatient setting such as a clinic or outpatient surgery center. This procedure involves using a hollow needle to extract a small tissue sample from the suspicious area for further examination. Performing the core needle biopsy in an outpatient setting allows for a more convenient and efficient process for both patients and healthcare providers. Additionally, outpatient facilities are equipped to handle minor procedures like core needle biopsies in a safe and controlled environment.

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