Nokea
Three hours after birth, a newborn of a mother with diabetes becomes jittery, has weak, high- pitched cry , and exhibits irregular respirations. The nurse recognizes that these signs are often associated with:
- A. Hypovolemia
- B. Hypocalcemia
- C. Hypoglycemia
- D. Hyperglycemia
Correct Answer: C
Rationale: The signs described in the scenario - jitteriness, weak high-pitched cry, irregular respirations - are indicative of hypoglycemia in a newborn. Babies born to mothers with diabetes are at risk for hypoglycemia due to their exposure to high blood sugar levels in utero. After birth, when the baby is separated from the mother's blood supply, their own insulin production may lead to a sudden drop in blood glucose levels.
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A labor client has been diagnosed with CPD following attempts of pushing for 2 hours with no progress. Based on the info, which birth method is available when you have CPD (baby can't come out)?
- A. C/S
- B. Induced labor
- C. Vaginal birth with vacuum
- D. Insert foley catheter to empty bladder and make more room
Correct Answer: A
Rationale: CPD (cephalopelvic disproportion) occurs when the baby's head or body is too large to pass through the mother's pelvis. In cases where CPD is diagnosed and labor has stalled despite adequate efforts (such as pushing for 2 hours with no progress), the safest and most appropriate method to deliver the baby is through a cesarean section (C/S). This surgical procedure allows for a safe delivery when vaginal delivery is not possible due to CPD, ensuring the well-being of both the baby and the mother. Induced labor, vaginal birth with vacuum, or inserting a foley catheter to empty the bladder would not be effective or safe in cases of CPD where the baby cannot pass through the birth canal.
Narcotic analgesia is administered to a laboring patient at 10am. The infant is delivered at 12:30pm. The nurse would anticipate what?
- A. Neonatal respiratory depression
- B. Increased infant alertness
- C. Decreased fetal heart rate variability
- D. No effects on the neonate
Correct Answer: A
Rationale: Narcotic analgesia, when administered to a laboring patient, can cross the placenta and affect the infant. It can cause neonatal respiratory depression in the newborn after delivery. This is because the medication can depress the respiratory drive of the infant, leading to potentially serious breathing problems. It is important for the healthcare provider to closely monitor and assess the newborn for signs of respiratory distress in such cases.
The nurse is monitoring a pregnant client with gestational hypertension. What is the primary complication to prevent?
- A. Preterm labor.
- B. Placenta previa.
- C. Eclampsia.
- D. Abruptio placentae.
Correct Answer: C
Rationale: Gestational hypertension can progress to eclampsia, characterized by seizures, and requires close monitoring.
A 28-year-old patient has decided to use the patch contraception. The nurse is educating her on the best site to use. Where is the best place to put the patch? Select one that does not that apply.
- A. Buttocks
- B. Leg
- C. Breast
- D. Arm
Correct Answer: C
Rationale: The best sites for applying the contraceptive patch are the buttocks, arm, and leg. These areas have sufficient fat and are away from areas that might rub off the patch. Choice B (Neck) is incorrect as the neck is not recommended for patch application due to the potential for irritation and the high blood flow area. Choice C (Breast) is not recommended because the breast tissue may affect the adhesion of the patch.
A nurse on a labor and delivery unit is providing teaching to a client who plans to use hypnosis to control labor pain. Which of the following information should the nurse include?
- A. Focusing on controlling body functions
- B. "Synchronized breathing will be required during hypnosis"
- C. "Hypnosis can be beneficial in you practiced it during the prenatal period"
- D. "Hypnosis does not work for controlling pain associated with labor".
Correct Answer: C
Rationale: The correct information that the nurse should include is that "Hypnosis can be beneficial if you practiced it during the prenatal period." This statement is true because hypnosis is a tool that can help individuals manage pain and stress through focused attention and suggestion. By practicing hypnosis techniques during the prenatal period, the individual can become more familiar and comfortable with the practice, making it more effective during labor. It is important to establish a routine and practice hypnosis consistently to maximize its benefits during labor.