VATI Maternal Newborn Assessment

VATI Maternal Newborn Assessment Related

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A nurse is caring for a client 2 hr after a spontaneous vaginal birth and the client has saturated two perineal pads with blood in a 30-min period. Which of the following is the priority nursing intervention at this time?

  • A. Palpate the client's uterine fundus.
  • B. Assist the client on a bedpan to urinate.
  • C. Prepare to administer oxytocic medication.
  • D. Increase the client's fluid intake.
Correct Answer: A

Rationale: The priority nursing intervention in this situation is to palpate the client's uterine fundus. Saturating two perineal pads with blood in a 30-minute period after childbirth is indicative of excessive postpartum bleeding, also known as postpartum hemorrhage (PPH). Palpating the uterine fundus helps the nurse assess for uterine atony, a common cause of PPH. If the fundus is boggy or not firm, it indicates that the uterus is not contracting effectively to control bleeding, which can lead to further complications if not addressed promptly. Once uterine atony is identified, other interventions such as administering oxytocic medications can be initiated to help the uterus contract and control bleeding.

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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.

The nurse is assessing a client at 36 weeks' gestation who reports swelling in the hands and face. What is the priority nursing action?

  • A. Check the client’s blood pressure.
  • B. Reassure the client that swelling is normal.
  • C. Encourage the client to reduce salt intake.
  • D. Evaluate the fetal heart rate.
Correct Answer: A

Rationale: Swelling in the hands and face may indicate preeclampsia, requiring immediate blood pressure assessment.

What factor is known to increase the risk of gestational DM?

  • A. Weigh 100kg prior to pregnancy
  • B. Previous birth AGA
  • C. Maternal age younger than 25
  • D. Previous diagnosis of type 2 diabetes
Correct Answer: D

Rationale: A previous diagnosis of type 2 diabetes is a known risk factor for developing gestational diabetes mellitus (GDM). Women who have had diabetes prior to pregnancy are more likely to develop GDM due to pre-existing insulin resistance. This increased risk is why healthcare providers closely monitor pregnant women with a history of type 2 diabetes. It is important for these women to manage their blood sugar levels carefully during pregnancy to reduce the risk of complications for both the mother and the baby.

How should a nurse handle a newborn with meconium-stained amniotic fluid?

  • A. Suction the airway immediately after birth
  • B. Monitor for signs of aspiration
  • C. Encourage immediate skin-to-skin contact
  • D. Administer antibiotics to the newborn immediately
Correct Answer: A

Rationale: Suctioning the airway immediately reduces the risk of aspiration and respiratory complications.

A client in the first trimester reports nausea. What dietary recommendation should the nurse make?

  • A. Eat dry crackers before getting out of bed.
  • B. Avoid eating throughout the day.
  • C. Increase intake of spicy foods.
  • D. Consume large, infrequent meals.
Correct Answer: A

Rationale: Dry crackers before rising can help manage nausea by stabilizing blood sugar and reducing gastric discomfort.

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