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A patient with a history of gestational diabetes is admitted to the labor and delivery unit. What is the most important factor to monitor during labor?
- A. Maternal blood pressure
- B. Fetal heart rate
- C. Blood glucose levels
- D. Maternal temperature
Correct Answer: C
Rationale: The correct answer is C: Blood glucose levels. During labor, it is crucial to monitor the blood glucose levels of a patient with a history of gestational diabetes to prevent complications such as hyperglycemia or hypoglycemia. Fluctuations in blood glucose levels can impact both the mother and the baby's health. Monitoring maternal blood pressure (A) is important but not the most critical factor in this scenario. Fetal heart rate (B) is essential but does not directly address the specific needs of a patient with a history of gestational diabetes. Maternal temperature (D) is also important but does not take precedence over monitoring blood glucose levels in this case.
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During the postpartum period, a nurse is caring for a birthing person who is receiving uterotonic medications. The nurse's assessment reveals a boggy and enlarged uterus. What is the nurse's immediate action?
- A. Document the findings as normal.
- B. Continue to administer the uterotonic medication.
- C. Perform fundal massage to promote uterine firmness.
- D. Administer an analgesic for the birthing person's pain.
Correct Answer: C
Rationale: The correct immediate action is C: Perform fundal massage to promote uterine firmness. Fundal massage helps prevent postpartum hemorrhage by promoting uterine contraction and firmness. A: Documenting the findings as normal is incorrect as a boggy and enlarged uterus is not a normal finding postpartum. B: Continuing to administer uterotonic medication without addressing the boggy uterus can lead to ineffective contraction. D: Administering an analgesic for pain does not address the underlying issue of uterine atony.
A patient in labor is undergoing an epidural block and is given intravenous fluid. What is the purpose of this?
- A. To treat hypotension that results from hemorrhage
- B. To increase urine output
- C. To treat insensible fluid losses
- D. To treat hypotension that results from sympathetic blockade
Correct Answer: D
Rationale: The correct answer is D: To treat hypotension that results from sympathetic blockade. When an epidural block is administered during labor, sympathetic blockade can lead to a drop in blood pressure. By providing intravenous fluid, the goal is to increase preload and maintain blood pressure to counteract the hypotension caused by sympathetic blockade.
A: Treating hypotension from hemorrhage is not the primary purpose in this scenario.
B: Increasing urine output is not the main goal of giving intravenous fluid during an epidural block.
C: Treating insensible fluid losses is not the immediate concern when a patient is experiencing hypotension from sympathetic blockade.
What is the most common indication for performing an episiotomy?
- A. to prevent severe perineal tears
- B. to allow the birth to occur more quickly
- C. to relieve the risk of shoulder dystocia
- D. to control excessive vaginal bleeding
Correct Answer: D
Rationale: The correct answer is D: to control excessive vaginal bleeding. Episiotomy is primarily performed to manage and control postpartum hemorrhage by facilitating better visualization and access for suturing any bleeding vessels. It is not routinely done for preventing severe tears, expediting birth, or addressing shoulder dystocia, as there are alternative interventions for these situations. Episiotomy should be carefully considered and performed only when necessary to avoid unnecessary complications and promote better outcomes.
A nurse is assisting with a vaginal delivery. What is the most important action to take when the fetal head crowns?
- A. apply gentle downward pressure
- B. assist with shoulder delivery
- C. assist with perineal massage
- D. administer pain relief
Correct Answer: A
Rationale: The correct answer is A: apply gentle downward pressure. This action helps prevent rapid delivery, reducing the risk of perineal tearing and ensuring a controlled birth. Applying too much pressure can cause trauma to the mother and baby. Incorrect choices: B is premature, as shoulder delivery should only be done after the head and shoulders are delivered. C is not the most important action at crowning. D is not necessary at this specific stage of delivery.
A client is in the 10th week of her pregnancy. Which of the following symptoms would the nurse expect the client to exhibit? Select all that apply.
- A. Backache.
- B. Urinary frequency.
- C. Dyspnea on exertion.
- D. Fatigue.
Correct Answer: A
Rationale: Backache, urinary frequency, and fatigue are common symptoms during the first trimester. Dyspnea on exertion is more common later in pregnancy.