Maternal Fetal Monitoring

Maternal Fetal Monitoring Related

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The nurse is caring for a 23-year-old patient who arrives at the clinic for a pregnancy test. The test confirms the patient is pregnant. The patient states, 'I do not need to stop smoking my electronic cigarette because it will not harm my baby.' Which is the best response by the nurse?

  • A. You are correct. Electronic cigarettes are not harmful during pregnancy.
  • B. Tobacco products, including electronic cigarettes, should not be used during pregnancy due to risking nicotine toxicity.
  • C. According to the FDA, although electronic cigarettes are safe for you, they can cause harm to the fetus during pregnancy.
  • D. Electronic cigarettes are considered harmful only in the first trimester.
Correct Answer: B

Rationale: The correct answer is B: Tobacco products, including electronic cigarettes, should not be used during pregnancy due to risking nicotine toxicity.

Rationale:
1. Nicotine from electronic cigarettes can cross the placenta, affecting fetal development.
2. Nicotine exposure during pregnancy is associated with adverse outcomes like low birth weight and preterm birth.
3. The best practice during pregnancy is to avoid all tobacco products, including electronic cigarettes.

Summary:
A: Incorrect. Electronic cigarettes can harm the fetus due to nicotine exposure.
C: Incorrect. FDA does not consider electronic cigarettes safe during pregnancy.
D: Incorrect. Harm from electronic cigarettes is not limited to the first trimester.

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A pregnant patient has received the results of her triple-screen testing and it is positive. What would the nurse anticipate as the next step in the patient’s plan of care?

  • A. No further testing is indicated at this time because results are normal.
  • B. Refer to the physician for additional testing.
  • C. Validate the results with the lab facility.
  • D. Repeat the test in 2 weeks and have the patient return for her regularly scheduled prenatal visit.
Correct Answer: B

Rationale: A positive triple-screen test suggests an increased risk of genetic abnormalities, requiring additional diagnostic testing.

A pregnant patient’s biophysical profile score is 8. The patient asks the nurse to explain the results. What is the nurse’s most appropriate response?

  • A. The test results are within normal limits.
  • B. Immediate birth by cesarean birth is being considered.
  • C. Further testing will be performed to determine the meaning of this score.
  • D. An obstetric specialist will evaluate the results of this profile and, within the next week, will inform you of your options regarding birth.
Correct Answer: A

Rationale: A score of 8-10 is within the normal range for a biophysical profile, indicating no immediate concerns for the fetus.

A nurse is preparing to administer a medication to a birthing person with a history of hypertension. What is the nurse's priority assessment before administering this medication?

  • A. Blood pressure and pulse rate
  • B. Respiratory rate and oxygen saturation
  • C. Temperature and urine output
  • D. Oxygen saturation and urine output
Correct Answer: A

Rationale: The correct answer is A: Blood pressure and pulse rate. For a birthing person with a history of hypertension, it is crucial to assess their blood pressure and pulse rate before administering medication to ensure the medication does not exacerbate their hypertension. Monitoring these vital signs helps in determining the appropriateness and safety of the medication.

Summary:
- Choice B is incorrect because respiratory rate and oxygen saturation are not the priority assessments for a person with a history of hypertension.
- Choice C is incorrect as temperature and urine output are not directly related to assessing the risk of exacerbating hypertension.
- Choice D is incorrect as oxygen saturation and urine output are not the primary indicators of medication safety for someone with hypertension.

A patient at 37 weeks gestation is admitted with ruptured membranes. What is the first priority action for the nurse?

  • A. Assess for signs of infection
  • B. Check for cord prolapse
  • C. Perform a vaginal exam to assess cervical dilation
  • D. Perform a vaginal examination to check for fetal descent
Correct Answer: B

Rationale: The correct answer is B: Check for cord prolapse. This is the first priority action because a prolapsed cord is a life-threatening emergency that requires immediate intervention to prevent fetal hypoxia and distress. The nurse should quickly assess for cord presentation by performing a vaginal exam and relieving pressure on the cord if present.

Incorrect choices:
A: Assess for signs of infection - While infection is a concern with ruptured membranes, it is not the immediate priority over checking for cord prolapse.
C: Perform a vaginal exam to assess cervical dilation - Assessing cervical dilation can wait until after ruling out cord prolapse.
D: Perform a vaginal examination to check for fetal descent - Fetal descent assessment is not urgent compared to checking for cord prolapse in this scenario.

A client, in her third trimester, is concerned that she will not know the difference between labor contractions and normal aches and pains of pregnancy.

  • A. Don't worry. You'll know the difference when the contractions start.
  • B. The contractions may feel just like a backache
  • C. but they will come and go.
  • D. Contractions are a lot worse than your pregnancy aches and pains.
Correct Answer: B

Rationale: Labor contractions typically have a pattern, coming and going at regular intervals, whereas normal aches and pains do not follow such a predictable pattern.

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