Nokea
A patient with Type 1 Diabetes delivers a 9-pound 10 oz. baby by cesarian birth in her 36th week of pregnancy. When monitoring the infant of a mother with diabetes, the nurse should monitor for signs of:
- A. Meconium ileus
- B. Respiratory distress
- C. Physiologic jaundice
- D. Increased intracranial pressure
Correct Answer: B
Rationale: Infants of diabetic mothers are at increased risk for developing respiratory distress syndrome due to factors such as prematurity, intrauterine stress, and macrosomia (large birth weight). Additionally, babies born to mothers with diabetes may have delayed lung maturation, resulting in decreased surfactant production and increased risk of respiratory complications. Therefore, it is crucial for the nurse to monitor the infant for signs of respiratory distress, such as tachypnea, grunting, retractions, and cyanosis, and provide necessary interventions promptly.
You may also like to solve these questions
A nurse is caring for a client who is experiencing sore nipples from breastfeeding. Which of the following actions should the nurse take?
- A. Place a snug dressing on the client's nipple when not breastfeeding.
- B. Ensure the newborn's mouth is wide open before latching to the breast.
- C. Encourage the client to limit the newborn's feeding to 10 min on each breast.
- D. Instruct the client to begin the feeding with the nipple that is most tender.
Correct Answer: B
Rationale: Ensuring the newborn's mouth is wide open before latching to the breast is the correct action to take when caring for a client experiencing sore nipples from breastfeeding. When the newborn latches onto the breast correctly with a wide open mouth, it helps to prevent nipple soreness and discomfort by allowing proper positioning and attachment, which reduces pressure on the nipple. This action can promote effective and comfortable breastfeeding for both the client and the newborn. Placing a snug dressing on the nipple when not breastfeeding (Choice A) could hinder air circulation, leading to moisture, which may increase the risk of nipple soreness. Limiting the newborn's feeding to 10 minutes on each breast (Choice C) can be insufficient for adequate milk intake and can lead to feeding issues. Instructing the client to begin the feeding with the nipple that is most tender (Choice D) may exacerbate the issue and cause further discomfort.
The nurse is monitoring a client at 36 weeks' gestation with suspected polyhydramnios. What complication is associated with this condition?
- A. Preterm labor.
- B. Placenta previa.
- C. Cord prolapse.
- D. Gestational hypertension.
Correct Answer: C
Rationale: Excessive amniotic fluid increases the risk of cord prolapse, especially after membrane rupture.
Which client would be at greatest risk for developing
- A. Thick breast cancer?
- B. Wet/slippery with egg white consistency
- C. Client who had her first baby at the age of 24
- D. Client who did not breastfeed
Correct Answer: D
Rationale: Not breastfeeding has been identified as a risk factor for developing breast cancer. Breastfeeding has been shown to have a protective effect against breast cancer due to its impact on hormonal levels and breast tissue changes that occur during lactation. Therefore, compared to other options, the client who did not breastfeed would be at greater risk for developing breast cancer.
If the physician indicates shoulder dystocia during the delivery of a macrosomic fetus, how would the nurse assist?
- A. Assisting the woman into McRoberts maneuver
- B. Calling a second physician to assist
- C. Preparing for immediate c/s delivery
- D. Utilizing fundal pressure to push the fetus out
Correct Answer: A
Rationale: In the scenario of shoulder dystocia during the delivery of a macrosomic fetus, the appropriate action for the nurse to assist would be to help the woman into the McRoberts maneuver. The McRoberts maneuver involves flexing the mother's thighs tightly against her abdomen to flatten the pelvis, allowing for more space to maneuver the baby's shoulder out from behind the pubic bone. This maneuver is often effective at resolving shoulder dystocia without the need for additional interventions such as a cesarean section or fundal pressure. It is a recommended initial step in managing shoulder dystocia and has been shown to be successful in many cases.
A client at 12 weeks' gestation asks why folic acid is important during pregnancy. What is the nurse's best response?
- A. It helps prevent gestational diabetes.
- B. It promotes fetal brain development.
- C. It reduces the risk of neural tube defects.
- D. It increases maternal energy levels.
Correct Answer: C
Rationale: Folic acid is essential during early pregnancy to reduce the risk of neural tube defects like spina bifida.