External Maternal Monitoring

External Maternal Monitoring Related

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The nurse is caring for a patient who is in labor with her first child. The patient's mother is present for support and notes that things have changed in the delivery room since she last gave birth in the early 1980s. Which current trend or intervention may the patient's mother find most different?

  • A. Fetal monitoring throughout labor
  • B. Postpartum stay of 10 days
  • C. Expectant partner and family in operating room for cesarean birth
  • D. Hospital support for breastfeeding
Correct Answer: D

Rationale: 1. The correct answer is D: Hospital support for breastfeeding. This is the most different trend compared to the early 1980s.
2. In the past, breastfeeding support in hospitals was minimal, but now it is a standard practice to provide education and assistance.
3. Fetal monitoring throughout labor (A) has been a common practice for many years and is not a recent trend.
4. Postpartum stay of 10 days (B) is excessive; postpartum stays have actually become shorter over time.
5. Having expectant partners and family in the operating room for cesarean birth (C) is a more recent practice but has become increasingly common in recent years.

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A 20-year-old client states that the at-home pregnancy test that she took this morning was positive. Which of the following comments by the nurse is appropriate at this time?

  • A. Congratulations, you and your family must be so happy.
  • B. Have you told the baby’s father yet?
  • C. How do you feel about the results?
  • D. Please tell me when your last menstrual period was.
Correct Answer: C

Rationale: It is important to assess the client's emotional response to the pregnancy test result before providing further guidance or congratulations.

Which of the following findings in an 8-week gestation client, G2 P1001, should the nurse highlight for the nurse midwife? Select all that apply.

  • A. Body mass index of 17 kg/m².
  • B. Rubella titer of 1:8.
  • C. Blood pressure of 100/60 mm Hg.
  • D. Hematocrit of 30%.
Correct Answer: A

Rationale: A low BMI, low rubella titer, and low hematocrit are all concerning findings that should be highlighted for further evaluation. A blood pressure of 100/60 mm Hg is within normal limits.

A nurse is monitoring a laboring person for signs of fetal distress. Which finding is most indicative of fetal distress?

  • A. bradycardia
  • B. tachycardia
  • C. late decelerations
  • D. variable decelerations
Correct Answer: A

Rationale: The correct answer is A: bradycardia. Fetal distress is often indicated by a decreased fetal heart rate (bradycardia), which can be a sign of inadequate oxygenation. Bradycardia is a serious concern in labor and requires immediate intervention. Tachycardia (B) is an increased heart rate, which can indicate fetal distress but is not as specific as bradycardia. Late decelerations (C) are associated with uteroplacental insufficiency, not necessarily fetal distress. Variable decelerations (D) are often related to cord compression and can be a sign of fetal distress, but bradycardia is a more direct indicator.

The nurse is educating the pregnant patient with a body mass index (BMI) of 33. The nurse knows that teaching has been effective when the patient states which of the following?

  • A. My child may be at increased risk for birth injury.
  • B. My child may have a decreased risk of developing childhood diabetes.
  • C. I will probably give birth vaginally.
  • D. I have a lower risk of developing gestational hypertension.
Correct Answer: A

Rationale: The correct answer is A: "My child may be at increased risk for birth injury." This is correct because a pregnant patient with a BMI of 33 is considered obese, which can increase the risk of birth injury to the baby due to complications such as macrosomia (large birth weight).

Explanation:
1. Obesity in pregnancy can lead to complications such as macrosomia, shoulder dystocia, and birth trauma.
2. Higher BMI can also increase the risk of cesarean delivery, which may be necessary to prevent birth injuries.
3. Childhood diabetes risk is not decreased with maternal obesity.
4. Mode of delivery (vaginal or cesarean) is not solely determined by BMI.
5. Gestational hypertension risk is actually higher in women with obesity.

In summary, choice A is correct because it directly relates to the increased risk of birth injury associated with maternal obesity, while the other choices are not directly linked to the patient's BMI and pregnancy complications.

Which statement about fetal circulation is correct?

  • A. The foramen ovale is between ventricles
  • B. Umbilical vein contains oxygen-poor blood
  • C. Right atrium contains mixed blood
  • D. Ductus venosus lies between aorta and pulmonary artery
Correct Answer: C

Rationale: The right atrium contains both oxygen-rich and oxygen-poor blood due to the unique fetal circulatory system.

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