Ethical Issues in Maternal Newborn Nursing

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A primipara patient asks about possible support options for her during the labor process. She is apprehensive that her family members will not be prepared to assist her during this time. Which option would be most effective for this patient?

  • A. Reassure the patient that the labor and birth staff consists of highly trained nurses who are well educated to take care of laboring patients so that should be sufficient.
  • B. Encourage the patient to take prepared childbirth classes with her husband because that should provide the best support by a family member.
  • C. Provide information to the patient about obtaining a doula during the labor process.
  • D. Tell the patient that this is a normal feeling based on fear of the unknown and that it will subside once she starts the labor process.
Correct Answer: C

Rationale: Providing information to the patient about obtaining a doula during the labor process is the most effective option in this scenario. A doula is a trained professional who provides physical, emotional, and informational support to the mother before, during, and after childbirth. They can help the mother feel supported and empowered during labor, especially if family members are unavailable or unprepared to offer the necessary support. Doulas can also help in communication with the medical staff, advocate for the mother's preferences, and provide comfort measures. Therefore, recommending the option of obtaining a doula would help address the patient's concerns about support during labor.

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The nurse is providing care to the 35-year-old female patient at the family practice clinic who is in the office for her annual physical examination. Which tests should the nurse recommend are the most appropriate for this patient? Select all that apply.

  • A. Papanicolaou test every 5 years
  • B. Mammogram every 2 years
  • C. DEXA screen every 2 years
  • D. HPV every 5 years
Correct Answer: A

Rationale: A. Papanicolaou test (Pap smear) every 5 years - This test is recommended for cervical cancer screening in women aged 30-65 years old. It helps in early detection and prevention of cervical cancer.

Preconception and prenatal care have become important components of women's health. What is the guiding principle of preconception care?

  • A. Ensure that pregnancy complications do not occur.
  • B. Identify the woman who should not become pregnant.
  • C. Encourage healthy lifestyles for families desiring pregnancy.
  • D. Ensure that women know about prenatal care.
Correct Answer: C

Rationale: The main focus of preconception care is to encourage healthy lifestyles and address any potential risks before pregnancy occurs.

A woman gave birth to an infant+2:230 boy 10 hours ago. Where does the nurse expect to locate this woman's fundus?

  • A. 1 centimeter above the umbilicus
  • B. 2 centimeters below the umbilicus
  • C. Midway between the umbilicus and the symphysis pubis
  • D. Nonpalpable abdominally
Correct Answer: A

Rationale: The fundus descends approximately 1 to 2 cm every 24 hours. Within 12 hours after delivery, the fundus may be approximately 1 cm above the umbilicus.

With regard to an obstetric litigation case, a nurse working in labor and birth is found to be negligent. Which intervention performed by the nurse indicates that a breach of duty has occurred?

  • A. The nurse did not document fetal heart tones (FHR) during the second stage of labor.
  • B. The patient was only provided ice chips during the labor period, which lasted 8 hours.
  • C. The nurse allowed the patient to use the bathroom rather than a bedpan during the first stage of labor.
  • D. The nurse asked family members to leave the room when she prepared to do a pelvic exam on the patient.
Correct Answer: A

Rationale: In an obstetric setting, failure to document fetal heart tones (FHR) during the second stage of labor is a critical breach of duty by the nurse. Monitoring FHR is essential to assess fetal well-being and detect any signs of distress or complications during labor. Neglecting to document this important vital sign could result in delayed recognition of fetal distress, potentially leading to adverse outcomes for the baby and the mother. Therefore, this intervention indicates negligence on the part of the nurse in this scenario.

Many communities now offer the availability of free-standing birth centers to provide care for low-risk women during pregnancy, birth, and postpartum. When counseling the newly pregnant patient regarding this option, the nurse should be aware that this type of care setting includes which advantages? (Select all that apply.)

  • A. Staffing by lay midwives
  • B. Equipped for obstetric emergencies
  • C. Less expensive than acute care hospitals
  • D. Safe, homelike births in a familiar setting
Correct Answer: B

Rationale: B. Equipped for obstetric emergencies: Free-standing birth centers are equipped to handle any obstetric emergencies that may arise during labor and birth. They have the necessary equipment and trained staff to respond quickly and effectively to emergencies to ensure the safety of both the mother and baby.

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