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In a research study performed by Schneuder, L., Crenshaw, J., and Gilder, R. (2017), which action by the nurse will be implemented following a cesarean delivery?
- A. Allow the birth partner to hand the neonate to the mother.
- B. Assist the mother and partner to cut the umbilical cord.
- C. Move the neonate into the visual field of the mother.
- D. Encourage skin-to-skin contact between the mother and neonate.
Correct Answer: D
Rationale: The correct answer is D: Encourage skin-to-skin contact between the mother and neonate. This action is crucial following a cesarean delivery to promote bonding, regulate the baby's temperature, and facilitate breastfeeding. Skin-to-skin contact also helps stabilize the baby's heart rate, breathing, and blood sugar levels.
A: Allowing the birth partner to hand the neonate to the mother may be a good practice but is not as essential as skin-to-skin contact for immediate benefits.
B: Assisting the mother and partner to cut the umbilical cord is not typically the nurse's responsibility immediately after a cesarean delivery and does not provide the same benefits as skin-to-skin contact.
C: Moving the neonate into the visual field of the mother is important for bonding but does not offer the same physiological benefits as direct skin-to-skin contact.
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The nurse is educating a gravida 1 para 0 who is 28 weeks pregnant. Which educational topics are appropriate for the nurse to discuss with the patient at this prenatal visit? Select all that apply.
- A. Discussion of prenatal classes
- B. Discussion of alcohol use
- C. Discussion of family history for pregnancy-induced hypertension
- D. Discussion of signs and symptoms of preterm labor
Correct Answer: B
Rationale: The correct answer is B, Discussion of alcohol use. This topic is important for prenatal education to ensure the well-being of the mother and baby. Alcohol consumption during pregnancy can lead to fetal alcohol spectrum disorders. The other choices are incorrect because:
A: Discussion of prenatal classes is relevant, but not a priority at 28 weeks.
C: Discussion of family history for pregnancy-induced hypertension is important but not usually discussed at every prenatal visit.
D: Discussion of signs and symptoms of preterm labor is crucial, but typically discussed later in pregnancy.
Which nursing action is correct when initiating electronic fetal monitoring?
- A. Lubricate the tocotransducer with an ultrasound gel.
- B. Securely apply the tocotransducer with a strap or belt.
- C. Inform the patient that she should remain in the semi-Fowler position.
- D. Determine the position of the fetus before attaching the electrode to the maternal abdomen.
Correct Answer: D
Rationale: The correct answer is D because determining the position of the fetus before attaching the electrode is crucial for accurate monitoring. This step ensures proper placement, reducing the risk of misinterpretation of data. Lubricating the tocotransducer with gel (A) is unnecessary and may interfere with the signal. Securing the tocotransducer with a strap (B) is important but should come after determining fetal position. Informing the patient to remain in semi-Fowler position (C) is not directly related to the correct initiation of electronic fetal monitoring.
The nurse is making a plan of care for a patient who is in the first 24-hour period past a cesarean delivery. Which interventions will the nurse include in regards to medications? Select all that apply.
- A. Continue a daily stool softener.
- B. Manage pain with morphine.
- C. Ensure the availability of naloxone.
- D. Provide prophylaxis antibiotics.
Correct Answer: C
Rationale: The correct answer is C: Ensure the availability of naloxone. Naloxone is an opioid antagonist used to reverse the effects of opioid overdose, which could occur if the patient is receiving morphine for pain management post-cesarean delivery. It is essential to have naloxone readily available to counteract any potential opioid-related respiratory depression.
A: Continuing a daily stool softener is not directly related to medications typically given post-cesarean delivery and is not a priority in the immediate post-operative period.
B: Managing pain with morphine is a common practice post-cesarean delivery, but the focus here is on the intervention related to medication safety, which is ensuring naloxone availability.
D: Providing prophylactic antibiotics is important post-cesarean delivery to prevent infection but is not directly related to medication safety in this scenario.
What newborn complication does type 1 diabetes mellitus cause?
- A. hyperglycemia
- B. fetal macrosomia
- C. group B strep
- D. cyanosis
Correct Answer: C
Rationale: The correct answer is C: group B strep. Women with type 1 diabetes are at higher risk of developing infections, including group B strep, which can be passed to the newborn during childbirth. This can lead to serious complications such as pneumonia, sepsis, and meningitis in the newborn. Hyperglycemia (choice A) is a common complication of maternal diabetes but is not specific to type 1 diabetes. Fetal macrosomia (choice B) is a condition where the baby is larger than average, which can be a complication of diabetes but not specific to type 1. Cyanosis (choice D) refers to a bluish discoloration of the skin due to lack of oxygen and is not directly related to type 1 diabetes complications in newborns.
Which patient is a candidate for internal monitoring with an intrauterine pressure catheter?
- A. Obese patient whose contractions are 3 to 6 minutes apart, lasting 20 to 50 seconds
- B. Gravida 1, para 0, whose contractions are 2 to 3 minutes apart, lasting 60 seconds
- C. Multigravida whose contractions are 2 minutes apart, lasting 60 to 70 seconds
- D. Gravida 2, para 1, in latent phase whose contractions are irregular and mild
Correct Answer: B
Rationale: The correct answer is B because the patient is a primigravida (first pregnancy) with frequent contractions (2 to 3 minutes apart, lasting 60 seconds), which indicates active labor and the need for internal monitoring with an intrauterine pressure catheter. This level of contraction frequency and duration suggests progression towards the active phase of labor, where accurate monitoring is crucial for the well-being of both the mother and the baby.
Choice A is incorrect because the contractions are not as frequent or long-lasting as in active labor. Choice C is incorrect because although the contractions are frequent, the duration is longer than typical active labor. Choice D is incorrect because the contractions are irregular and mild, indicating the latent phase of labor where internal monitoring is not necessary.