Maternal Fetal Monitoring

Maternal Fetal Monitoring Related

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A patient at 37 weeks gestation is admitted with ruptured membranes. What is the first priority action for the nurse?

  • A. Assess for signs of infection
  • B. Check for cord prolapse
  • C. Perform a vaginal exam to assess cervical dilation
  • D. Perform a vaginal examination to check for fetal descent
Correct Answer: B

Rationale: The correct answer is B: Check for cord prolapse. This is the first priority action because a prolapsed cord is a life-threatening emergency that requires immediate intervention to prevent fetal hypoxia and distress. The nurse should quickly assess for cord presentation by performing a vaginal exam and relieving pressure on the cord if present.

Incorrect choices:
A: Assess for signs of infection - While infection is a concern with ruptured membranes, it is not the immediate priority over checking for cord prolapse.
C: Perform a vaginal exam to assess cervical dilation - Assessing cervical dilation can wait until after ruling out cord prolapse.
D: Perform a vaginal examination to check for fetal descent - Fetal descent assessment is not urgent compared to checking for cord prolapse in this scenario.

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What organ does the ductus venosus shunt blood away from in fetal circulation?

  • A. Liver
  • B. Heart
  • C. Lungs
  • D. Kidneys
Correct Answer: A

Rationale: Fetal blood bypasses the liver through the ductus venosus by carrying blood directly to the inferior vena cava.

A nurse is caring for a pregnant patient at 36 weeks gestation who has been diagnosed with preeclampsia. Which of the following interventions should the nurse prioritize?

  • A. Encourage the patient to increase fluid intake to prevent dehydration.
  • B. Monitor the patient's blood pressure and assess for signs of worsening preeclampsia.
  • C. Provide education about managing gestational diabetes.
  • D. Administer pain relief to reduce discomfort from swelling.
Correct Answer: B

Rationale: The correct answer is B because monitoring the patient's blood pressure and assessing for signs of worsening preeclampsia is crucial in managing the condition and preventing potential complications. At 36 weeks gestation, close monitoring is essential to detect any changes in the patient's condition promptly. Increasing fluid intake (choice A) may not be recommended for patients with preeclampsia due to the risk of fluid overload. Providing education about managing gestational diabetes (choice C) is irrelevant in this scenario. Administering pain relief (choice D) may provide temporary relief but does not address the underlying issue of worsening preeclampsia. Prioritizing blood pressure monitoring ensures timely intervention and management of preeclampsia to promote the well-being of both the patient and the baby.

The nurse is teaching a pregnant patient about the importance of folic acid. Which statement by the patient indicates that the teaching has been effective?

  • A. Folic acid will help prevent spinal cord defects in my baby.
  • B. Folic acid is important for healthy skin development.
  • C. Folic acid will help reduce my risk of high blood pressure during pregnancy.
  • D. Folic acid helps prevent excessive weight gain during pregnancy.
Correct Answer: A

Rationale: Step 1: Folic acid is crucial for neural tube development in the fetus.
Step 2: Spinal cord defects are a type of neural tube defect.
Step 3: Statement A directly links folic acid to preventing spinal cord defects.
Therefore, choice A is correct as it demonstrates an understanding of the specific benefit of folic acid during pregnancy. Choices B, C, and D are incorrect as they do not accurately reflect the primary role of folic acid in pregnancy.

What procedure might the nurse perform to determine the presentation of the fetus?

  • A. vaginal exam
  • B. ultrasound
  • C. palpation of contractions
  • D. laboring person interview
Correct Answer: B

Rationale: The correct answer is B: ultrasound. Ultrasound is the most accurate and non-invasive method to determine the presentation of the fetus by visualizing the position of the baby in the womb. It allows the nurse to see if the fetus is in a cephalic (head-down) or breech (feet or buttocks down) position. This information is crucial for assessing the progress of labor and planning appropriate interventions.

A: Vaginal exam is not typically used to determine fetal presentation as it does not provide a clear view of the baby's position.
C: Palpation of contractions helps assess the strength and frequency of contractions but does not directly determine fetal presentation.
D: Laboring person interview may provide valuable information about symptoms and history but does not offer direct insight into fetal presentation.

A 34-week gestation woman calls the obstetric office stating, 'Since last night I have had three nosebleeds.'

  • A. You should see the doctor to make sure you are not becoming severely anemic.
  • B. Do you have a temperature?
  • C. One of the hormones of pregnancy makes the nasal passages prone to bleeds.
  • D. Do you use any inhaled drugs?
Correct Answer: C

Rationale: Pregnancy hormones increase blood supply to mucous membranes, making them more prone to bleeding. Nosebleeds are generally harmless unless associated with other symptoms.

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