Maternal Monitoring During Labor

Maternal Monitoring During Labor Related

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The nurse is caring for a patient at 7 weeks gestation. The nurse suspects that a pregnant patient may have been using marijuana. With consent, the nurse confirms via urine drug screen. Which statement by the nurse is most appropriate?

  • A. Did you smoke marijuana when pregnant with your other child?
  • B. To avoid negative effects on your baby, you'll need to stop using marijuana during your last trimester.
  • C. Using marijuana while pregnant can have a negative effect on the neurological development of your baby.
  • D. Marijuana use while pregnant greatly increases your risk of miscarriage.
Correct Answer: C

Rationale: The correct answer is C: Using marijuana while pregnant can have a negative effect on the neurological development of your baby.

Rationale:
1. Marijuana use during pregnancy has been associated with adverse effects on the developing fetus, including potential negative impacts on neurological development.
2. The nurse's statement acknowledges the potential harm to the baby's neurological development, emphasizing the importance of avoiding marijuana during pregnancy.
3. This response focuses on providing essential information to the patient about the specific risks associated with marijuana use during pregnancy, highlighting the importance of making informed choices for the health of the baby.

Summary:
A: This choice makes assumptions about the patient's past behavior and does not provide essential information about the risks of marijuana use during pregnancy.
B: This choice focuses on the timing of stopping marijuana use rather than addressing the potential harm to the baby's neurological development.
D: This choice mentions miscarriage as a risk, which is not the primary concern associated with marijuana use during pregnancy.

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For which patient would an L/S ratio of 2:1 potentially be considered abnormal?

  • A. A 38-year-old gravida 2, para 1, who is 38 weeks’ gestation
  • B. A 24-year-old gravida 1, para 0, who has diabetes
  • C. A 44-year-old gravida 6, para 5, who is at term
  • D. An 18-year-old gravida 1, para 0, who is in early labor at term
Correct Answer: B

Rationale: In diabetic pregnancies, an L/S ratio of 2:1 may not reliably indicate lung maturity due to delayed surfactant production.

Which of the following vital sign changes should the nurse highlight for a pregnant woman’s obstetrician?

  • A. Prepregnancy blood pressure (BP) 100/60 and third trimester BP 140/90.
  • B. Prepregnancy respiratory rate (RR) 16 rpm and third trimester RR 22 rpm.
  • C. Prepregnancy heart rate (HR) 76 bpm and third trimester HR 88 bpm.
  • D. Prepregnancy temperature (T) 98.6°F and third trimester T 99.2°F.
Correct Answer: A

Rationale: A significant increase in blood pressure, particularly to 140/90, could indicate preeclampsia and should be highlighted for further evaluation. The other changes are within normal limits for pregnancy.

A laboring person requests an epidural for pain relief. What is the nurse's priority action before the procedure?

  • A. administer a test dose of anesthesia
  • B. ensure informed consent is obtained
  • C. administer IV fluids
  • D. ensure continuous fetal monitoring
Correct Answer: A

Rationale: The correct answer is A: administer a test dose of anesthesia. Before administering an epidural, it is crucial to perform a test dose to assess the person's response and ensure correct placement of the catheter. This step helps prevent potential complications such as unintentional intravascular injection.

Summary:
B: Ensuring informed consent is important but not the priority before administering the test dose.
C: Administering IV fluids is important for hydration but not the immediate priority before the test dose.
D: Continuous fetal monitoring is essential during labor, but it is not the priority before administering the test dose of anesthesia.

A 26-year-old pregnant woman who is 12 weeks gestation asks the nurse about the importance of folic acid. Which of the following is the best response by the nurse?

  • A. Folic acid helps prevent birth defects of the spine and brain.
  • B. Folic acid increases the chances of having a boy.
  • C. Folic acid prevents nausea during pregnancy.
  • D. Folic acid helps the placenta attach to the uterus.
Correct Answer: A

Rationale: The correct answer is A: Folic acid helps prevent birth defects of the spine and brain. Folic acid is crucial during pregnancy as it plays a key role in neural tube development, reducing the risk of neural tube defects like spina bifida. This is supported by research and guidelines.

B: Folic acid does not influence the gender of the baby, as it is determined by the father's sperm.
C: Folic acid does not directly prevent nausea during pregnancy; it is mainly for neural tube development.
D: Folic acid does not specifically help the placenta attach to the uterus; that process is regulated by other factors.

In summary, choice A is correct as it directly relates to the essential role of folic acid in preventing birth defects, while the other choices are unrelated or inaccurate in the context of folic acid's benefits during pregnancy.

A nurse is caring for a 38-week pregnant patient who is experiencing a decrease in fetal movement. Which of the following should be the nurse's first action?

  • A. Encourage the patient to drink a cold beverage and lie down.
  • B. Instruct the patient to wait 24 hours and monitor fetal movements.
  • C. Order an ultrasound to check the baby's health.
  • D. Call the healthcare provider immediately to report the decrease in movement.
Correct Answer: A

Rationale: The correct answer is A: Encourage the patient to drink a cold beverage and lie down. This is the correct action as it promotes fetal movement by stimulating the baby with a change in temperature and position. It is a non-invasive and immediate measure that can be taken by the patient herself.

Choice B is incorrect because waiting 24 hours could delay necessary intervention if the fetus is in distress. Choice C is incorrect as ordering an ultrasound may not be the most immediate or necessary action at this point. Choice D is incorrect as calling the healthcare provider immediately may not be necessary if the issue can be resolved by the patient changing her position and trying to stimulate fetal movement first.

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