External Maternal Monitoring

External Maternal Monitoring Related

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A pregnant patient at 30 weeks gestation is complaining of severe heartburn. What should the nurse recommend?

  • A. Lie down after meals to improve digestion.
  • B. Drink a large amount of water after eating.
  • C. Eat smaller meals more frequently and avoid lying down after meals.
  • D. Take antacids regularly to relieve heartburn.
Correct Answer: C

Rationale: The correct answer is C: Eat smaller meals more frequently and avoid lying down after meals. This is the best recommendation for the pregnant patient experiencing severe heartburn at 30 weeks gestation. Eating smaller meals more frequently can help reduce the amount of stomach acid produced, thus decreasing the likelihood of heartburn. Avoiding lying down after meals can prevent stomach acid from flowing back into the esophagus, further reducing heartburn symptoms.

Rationale for why other choices are incorrect:
A: Lying down after meals can worsen heartburn by allowing stomach acid to flow back into the esophagus.
B: Drinking a large amount of water after eating may worsen heartburn by increasing stomach pressure and pushing stomach acid back up.
D: Taking antacids regularly may provide temporary relief but is not addressing the root cause of the heartburn and may not be safe for long-term use during pregnancy.

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The primary reason for evaluating alpha-fetoprotein (AFP) levels in maternal serum is to determine whether the fetus has which condition?

  • A. Hemophilia
  • B. Sickle cell anemia
  • C. A neural tube defect
  • D. Abnormal lecithin-to-sphingomyelin ratio
Correct Answer: C

Rationale: An open neural tube allows a high level of AFP to seep into the amniotic fluid and enter maternal serum, indicating a neural tube defect.

Of what is the normal umbilical cord comprised?

  • A. 1 artery carrying blood to the fetus and 1 vein carrying blood away from the fetus
  • B. 1 artery carrying blood to the fetus and 2 veins carrying blood away from the fetus
  • C. 2 arteries carrying blood away from the fetus and 1 vein carrying blood to the fetus
  • D. 2 arteries carrying blood to the fetus and 2 veins carrying blood away from the fetus
Correct Answer: C

Rationale: The umbilical cord is comprised of 2 arteries carrying blood away from the fetus and 1 vein carrying blood to the fetus.

In a low-risk laboring person who is not receiving oxytocin, how often should the nurse assess the fetal heart rate during the second stage of labor?

  • A. every 5 minutes with contractions
  • B. at least every 30 minutes
  • C. every 5–15 minutes
  • D. only when the physician orders assessment
Correct Answer: C

Rationale: The correct answer is C: every 5-15 minutes. During the second stage of labor, frequent assessment of the fetal heart rate is crucial to monitor fetal well-being and detect any signs of distress promptly. Assessing every 5-15 minutes allows the nurse to closely monitor the fetal heart rate pattern and response to uterine contractions, ensuring timely interventions if needed. Option A (every 5 minutes with contractions) may be too frequent and unnecessary, causing patient discomfort. Option B (at least every 30 minutes) is too infrequent and may miss important changes in fetal status. Option D (only when the physician orders assessment) is incorrect as nurses should proactively monitor fetal well-being without waiting for physician orders.

A nurse is preparing a laboring person for an epidural. What is the most important nursing action before the procedure?

  • A. ensure informed consent is signed
  • B. administer pain medication
  • C. administer IV fluids
  • D. administer an analgesic
Correct Answer: A

Rationale: The correct answer is A: ensure informed consent is signed. Before any procedure, obtaining informed consent is essential to ensure the laboring person understands the risks, benefits, and alternatives of the epidural. This helps promote autonomy and respect for the individual's decision-making. Administering pain medication (choice B), IV fluids (choice C), or an analgesic (choice D) without informed consent is not ethical and violates the principle of autonomy. The focus should be on providing comprehensive information and obtaining consent before proceeding with the intervention.

The nurse is counseling a pregnant patient who is concerned about gestational diabetes. The patient has a family history of diabetes and is overweight. Which statement by the nurse would be most appropriate?

  • A. Gestational diabetes usually resolves after delivery and will not affect your baby.
  • B. Gestational diabetes can cause excessive birth weight, which may lead to delivery complications.
  • C. You should avoid eating carbohydrates entirely to manage gestational diabetes.
  • D. Gestational diabetes has no impact on your risk for developing type 2 diabetes later in life.
Correct Answer: B

Rationale: The correct answer is B because gestational diabetes can indeed cause excessive birth weight, leading to delivery complications such as shoulder dystocia and cesarean section. This is important for the patient to be aware of to ensure the health and safety of both herself and her baby.

Choice A is incorrect because gestational diabetes can persist after delivery and may increase the risk of developing type 2 diabetes later in life for both the mother and the baby.

Choice C is incorrect because pregnant women with gestational diabetes still need carbohydrates for proper nutrition; however, they should monitor their carbohydrate intake and choose complex carbohydrates to manage blood sugar levels.

Choice D is incorrect because having gestational diabetes does increase the risk of developing type 2 diabetes later in life. It is important for the patient to understand this potential risk and take steps to manage their health accordingly.

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