Nokea
A patient taking magnesium sulfate has a respiratory rate of 10 breaths per minute. In addition to discontinuing the medication, which action should the nurse take?
- A. Increase the patient's IV fluids.
- B. Administer calcium gluconate.
- C. Vigorously stimulate the patient.
- D. Instruct the patient to take deep breaths.
Correct Answer: B
Rationale: The correct answer is B: Administer calcium gluconate. This is because magnesium sulfate can lead to respiratory depression by inhibiting neuromuscular transmission. Calcium gluconate is the antidote as it competes with magnesium for binding sites, reversing its effects. Increasing IV fluids (A) is not directly related to addressing respiratory depression. Vigorously stimulating the patient (C) can exacerbate respiratory depression. Instructing the patient to take deep breaths (D) may not be effective in addressing respiratory depression caused by magnesium sulfate.
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The nurse applies fetal and uterine monitors to the abdomen of a client in active labor. When the client has contractions, the nurse notes a 15 beats/min deceleration of the fetal heart rate below the baseline lasting 15 seconds. Which is the next nursing action?
- A. Calling the primary health care provider
- B. Changing the maternal position
- C. Obtaining the maternal blood pressure
- D. Preparing the environment for an immediate birth
Correct Answer: B
Rationale: The correct answer is B: Changing the maternal position. Deceleration of fetal heart rate during contractions can indicate umbilical cord compression. Changing the maternal position can relieve pressure on the cord, improving blood flow to the fetus. This action is a non-invasive and immediate intervention that can potentially improve fetal oxygenation. Calling the primary health care provider (A) can be done after addressing the immediate concern. Obtaining maternal blood pressure (C) is not the priority in this situation. Preparing for an immediate birth (D) is premature without first attempting non-invasive interventions.
Which intervention would the nurse initiate when a fetal heart pattern signifying uteroplacental insufficiency occurs?
- A. Inserting a urinary catheter
- B. Administering oxygen by means of nasal cannula
- C. Helping the client turn to the side-lying position
- D. Encouraging the client to pant with her next contraction
Correct Answer: C
Rationale: The correct answer is C: Helping the client turn to the side-lying position. This intervention facilitates increased blood flow to the placenta, improving oxygenation to the fetus during uteroplacental insufficiency. The side-lying position relieves pressure on the vena cava, enhancing blood flow. Inserting a urinary catheter (A) is not indicated for addressing uteroplacental insufficiency. Administering oxygen (B) is important, but turning the client to the side is the priority as it directly improves blood flow. Encouraging panting (D) is not effective in addressing uteroplacental insufficiency.
What virus is highly contagious, spread through airborne particles, and can cause intrauterine fetal demise, skin scarring, eye, limb or neurologic abnormalities, anemia, thrombocytopenia, and low birth weight in the fetus?
- A. toxoplasmosis
- B. syphilis
- C. rubella
- D. Varicella (chickenpox)
Correct Answer: D
Rationale: The correct answer is D: Varicella (chickenpox). Varicella virus is highly contagious and spreads through airborne particles. It can cause intrauterine fetal demise, skin scarring, eye, limb, or neurologic abnormalities, anemia, thrombocytopenia, and low birth weight in the fetus. Varicella infection during pregnancy can lead to severe complications for both the mother and the fetus. Toxoplasmosis (A), syphilis (B), and rubella (C) can also cause complications during pregnancy, but they do not match all the characteristics mentioned in the question.
What is not a complication associated with chronic hypertension during pregnancy?
- A. preeclampsia
- B. gestational diabetes
- C. fetal growth restriction
- D. polyhydramnios
Correct Answer: B
Rationale: The correct answer is B, gestational diabetes. Chronic hypertension in pregnancy can lead to preeclampsia, fetal growth restriction, and polyhydramnios due to placental dysfunction and impaired blood flow. Gestational diabetes, on the other hand, is a separate condition caused by insulin resistance during pregnancy. It is not directly related to chronic hypertension and its complications. Therefore, gestational diabetes is not a complication associated with chronic hypertension during pregnancy.
The health-care provider is caring for an adolescent patient who is pregnant. The health-care provider knows that pregnancy during adolescence is linked with what influencing factor or factors? Select all that apply.
- A. low socioeconomic status
- B. psychologic problems
- C. social problems
- D. unemployment
Correct Answer: A,B,C
Rationale: A: Low socioeconomic status is a contributing factor to adolescent pregnancy due to limited access to education, healthcare, and contraception. B: Psychologic problems such as low self-esteem or mental health issues can increase the likelihood of adolescent pregnancy. C: Social problems like lack of support from family or peers, or exposure to risky behaviors, can also influence adolescent pregnancy. D: Unemployment, while a potential issue, is not directly linked to adolescent pregnancy as the other factors are more significant in this context.