Maternal Fetal Monitoring

Maternal Fetal Monitoring Related

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A patient who is about to undergo a cesarean section for breech presentation without fetal distress asks her nurse what kind of anesthesia would be best for her. The nurse explains that which of the following is the preferred method of anesthesia in this nonemergent case?

  • A. Spinal block
  • B. Epidural block
  • C. General anesthesia
  • D. Intravenous sedation
Correct Answer: A

Rationale: The correct answer is A: Spinal block. Spinal anesthesia provides rapid onset and reliable anesthesia for cesarean section, making it the preferred method in nonemergent cases. It is safe for both the mother and the baby, as it does not cross the placental barrier. Spinal anesthesia also allows for better pain control postoperatively compared to other methods.

Choice B (Epidural block) may be a suitable option, but spinal anesthesia is preferred due to its faster onset and reliability.

Choice C (General anesthesia) is not the preferred method in nonemergent cases as it carries more risks compared to regional anesthesia and may have adverse effects on the baby.

Choice D (Intravenous sedation) is not appropriate for cesarean section as it does not provide adequate anesthesia for the procedure and may not be safe for the baby.

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The following four changes occur during pregnancy. Which of them usually increases the father’s interest and involvement in the pregnancy?

  • A. Learning the results of the pregnancy test.
  • B. Attending childbirth education classes.
  • C. Hearing the fetal heartbeat.
  • D. Meeting the obstetrician or midwife.
Correct Answer: C

Rationale: Hearing the fetal heartbeat is a significant moment that often increases the father’s interest and involvement in the pregnancy. The other options may also increase involvement but are less impactful.

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 pregnant woman states, “My husband hopes I will give him a boy because we have three girls.” What will the nurse explain to this woman?

  • A. The sex chromosome of the fertilized ovum determines the gender of the child.
  • B. When the sperm and ovum are united, there is a 75% chance the child will be a girl.
  • C. When the pH of the female reproductive tract is acidic, the child will be a girl.
  • D. If a sperm carrying a Y chromosome fertilizes an ovum, then a boy is produced.
Correct Answer: D

Rationale: When a Y-bearing sperm fertilizes an ovum, a male child is produced.

A nurse is caring for a pregnant patient who is at 32 weeks gestation and reports frequent headaches and nausea. What should the nurse do first?

  • A. Monitor the patient's blood pressure and assess for signs of preeclampsia.
  • B. Administer anti-nausea medication and provide comfort measures.
  • C. Encourage the patient to rest and drink fluids.
  • D. Schedule a follow-up appointment for further evaluation.
Correct Answer: A

Rationale: The correct answer is A: Monitor the patient's blood pressure and assess for signs of preeclampsia. At 32 weeks gestation, headaches and nausea could be symptoms of preeclampsia, a serious condition in pregnancy. Monitoring blood pressure is crucial as preeclampsia is characterized by high blood pressure. Assessing for signs of preeclampsia, such as proteinuria or visual disturbances, is essential for timely intervention. Administering anti-nausea medication or encouraging rest without addressing the possibility of preeclampsia could delay necessary treatment. Scheduling a follow-up appointment without immediate assessment could also put the patient at risk if preeclampsia is present.

The nurse is caring for a pregnant patient who is 32 weeks gestation and is concerned about the safety of taking prescription medications. Which response by the nurse is most appropriate?

  • A. You should avoid all prescription medications during pregnancy.
  • B. Consult with your healthcare provider to ensure the medications are safe for you and your baby.
  • C. Take your prescription medications as directed without any concerns during pregnancy.
  • D. You can take your prescription medications as long as they are not over-the-counter products.
Correct Answer: B

Rationale: The correct answer, B, is appropriate because it emphasizes the importance of consulting with a healthcare provider to ensure the safety of prescription medications during pregnancy. This step is crucial as healthcare providers can assess the risks versus benefits of medication use in pregnancy and provide personalized recommendations. Choice A is incorrect as some medications may be necessary for the health of the mother and baby. Choice C is incorrect as not all prescription medications are safe during pregnancy. Choice D is incorrect as the safety of prescription medications in pregnancy is not solely determined by whether they are over-the-counter or not. Consulting with a healthcare provider is the best course of action to ensure the well-being of both the mother and the baby.

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