Nokea
The healthcare provider prescribes oxytocin 2 milliunits/minute to induce labor for a client at 41-weeks gestation. The nurse initiates an infusion of Ringer's Lactate solution 1000 mL with oxytocin 10 units. How many mL/hour should the nurse program the infusion pump? (Enter numeric value only. If rounding is required, round to the nearest whole number)
Correct Answer: 12
Rationale: To deliver 2 milliunits/minute from a solution of 10 units (10,000 milliunits) in 1000 mL, the concentration is 10 milliunits/mL. Thus, 2 milliunits/minute requires 0.2 mL/minute, which is 0.2 x 60 = 12 mL/hour.
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A client is admitted to the postpartum unit and tells the nurse she had rheumatic fever as a child, which resulted in some 'heart damage.' The nurse knows that this client is at particular risk for developing heart failure during the immediate postpartum period. Based on this client's history, which nursing problem has the highest priority?
- A. Sleep deprivation.
- B. Fluid volume excess
- C. Nausea and vomiting
- D. Risk for infection.
Correct Answer: B
Rationale: Heart damage from rheumatic fever increases the risk of heart failure, particularly postpartum due to fluid shifts. Managing fluid volume excess is the priority.
A client who had her first baby three months ago and is breastfeeding her infant tells the nurse that she is currently using the same diaphragm that she used before becoming pregnant. Which information should the nurse provide this client?
- A. After ceasing breastfeeding the diaphragm should be resized.
- B. Use an alternate form of contraception until a new diaphragm is obtained.
- C. If no more than 20 pounds was gained during pregnancy, the diaphragm is safe to use.
- D. Avoid intercourse during ovulation until the size of the diaphragm has been evaluated
Correct Answer: B
Rationale: Pregnancy and childbirth can alter vaginal anatomy, making a pre-pregnancy diaphragm ineffective. An alternate contraception method is needed until a new diaphragm is fitted.
The nurse is providing preconception counseling. Which supplement should the nurse recommend to help prevent the occurrence of anencephaly?
- A. Calcium.
- B. Iron
- C. Folic acid.
- D. Vitamin D.
Correct Answer: C
Rationale: Folic acid is essential for preventing neural tube defects, including anencephaly, and is recommended for women of childbearing age.
The nurse is preparing to administer magnesium sulfate to a laboring client whose blood pressure has increased from 110/60 mmHg to 140/90 mmHg Which nursing protocol has the highest priority?
- A. Insert a Foley catheter with a urimeter to monitor hourly output
- B. Have calcium gluconate immediately available
- C. Provide a quiet environment with subdued lighting.
- D. Assess deep tendon reflexes (DTRS) every 4 hours.
Correct Answer: B
Rationale: Magnesium sulfate toxicity can cause neuromuscular blockade, making calcium gluconate, the antidote, critical to have immediately available in case of toxicity signs like loss of deep tendon reflexes.
What is the most important assessment for the nurse to conduct following the administration of epidural anesthesia to a client who is at 40-weeks gestation?
- A. Level of pain sensation.
- B. Variability of fetal heart rate
- C. Maternal blood pressure
- D. Station of presenting part
Correct Answer: C
Rationale: Epidural anesthesia can cause a sudden drop in maternal blood pressure, which may affect placental perfusion, making blood pressure monitoring the priority.