Maternal Fetal Monitoring

Maternal Fetal Monitoring Related

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The nurse is caring for a pregnant patient at 38 weeks gestation who is experiencing sudden, severe abdominal pain and vaginal bleeding. What should the nurse do first?

  • A. Assess the fetal heart rate and prepare for delivery.
  • B. Encourage the patient to rest and monitor for changes in symptoms.
  • C. Call the healthcare provider immediately to report the symptoms.
  • D. Provide pain relief and monitor the patient's vital signs.
Correct Answer: C

Rationale: The correct answer is C: Call the healthcare provider immediately to report the symptoms. This is the first step because sudden, severe abdominal pain and vaginal bleeding in a pregnant patient at 38 weeks gestation could indicate a serious complication such as placental abruption or preterm labor. Notifying the healthcare provider promptly allows for timely intervention and appropriate management.

Choice A is incorrect as assessing the fetal heart rate and preparing for delivery should not be the first action without consulting the healthcare provider. Choice B is incorrect as encouraging the patient to rest is not appropriate in this emergent situation. Choice D is incorrect as providing pain relief and monitoring vital signs should not take precedence over notifying the healthcare provider for further evaluation and management.

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A pregnant woman who is 28 weeks gestation reports that she feels dizzy and faint when she stands up. What should the nurse instruct the patient to do?

  • A. Lie down flat on your back immediately.
  • B. Stand up quickly to prevent dizziness from worsening.
  • C. Drink a large amount of water to alleviate the dizziness.
  • D. Get up slowly and avoid standing for long periods.
Correct Answer: D

Rationale: The correct answer is D, instructing the pregnant woman to get up slowly and avoid standing for long periods. This is because during pregnancy, blood pressure can drop when standing up quickly, leading to dizziness and fainting. Getting up slowly allows the body to adjust gradually, preventing a sudden drop in blood pressure. Standing for long periods can worsen these symptoms, so it is important to avoid prolonged standing.

A: Lying down flat on the back immediately can worsen symptoms in this case by reducing blood flow to the brain.
B: Standing up quickly can exacerbate dizziness and fainting by causing a sudden drop in blood pressure.
C: Drinking a large amount of water may not address the underlying issue of postural hypotension and could potentially worsen symptoms by increasing blood volume without addressing the drop in blood pressure.

A pregnant patient at 26 weeks gestation reports nausea and vomiting. What is the nurse's priority action?

  • A. Administer anti-nausea medications as prescribed.
  • B. Instruct the patient to eat larger meals less frequently.
  • C. Encourage the patient to eat smaller, more frequent meals and avoid greasy foods.
  • D. Encourage the patient to rest and avoid physical activity.
Correct Answer: C

Rationale: The correct answer is C because nausea and vomiting are common during pregnancy and can be alleviated by eating smaller, more frequent meals and avoiding greasy foods. This strategy helps maintain stable blood sugar levels and reduces gastric distress. Administering anti-nausea medications (A) should only be considered if conservative measures fail. Instructing the patient to eat larger meals less frequently (B) may worsen symptoms. Encouraging rest and avoiding physical activity (D) may be beneficial but addressing dietary factors is the priority in this case.

A nurse is caring for a pregnant patient who is at 40 weeks gestation and is experiencing a sudden increase in vaginal discharge. What is the nurse's priority action?

  • A. Check for signs of labor and assess fetal heart rate.
  • B. Encourage the patient to rest and monitor for changes in discharge.
  • C. Perform a pelvic exam to assess the amount of discharge.
  • D. Call the healthcare provider immediately to report the change in discharge.
Correct Answer: A

Rationale: The correct answer is A because the sudden increase in vaginal discharge at 40 weeks gestation could indicate the onset of labor. Checking for signs of labor, such as contractions and assessing fetal heart rate, is crucial to determine if the patient is in active labor. This helps in timely intervention and ensuring the well-being of both the mother and baby.

Summary:
- Choice B: Encouraging rest and monitoring changes in discharge may not address the urgency of the situation.
- Choice C: Performing a pelvic exam without assessing signs of labor or fetal well-being may delay necessary actions.
- Choice D: While reporting to the healthcare provider is important, immediate assessment of labor signs and fetal heart rate takes precedence.

A 34-week gestation woman calls the obstetric office stating, 'Since last night I have had three nosebleeds.'

  • A. You should see the doctor to make sure you are not becoming severely anemic.
  • B. Do you have a temperature?
  • C. One of the hormones of pregnancy makes the nasal passages prone to bleeds.
  • D. Do you use any inhaled drugs?
Correct Answer: C

Rationale: Pregnancy hormones increase blood supply to mucous membranes, making them more prone to bleeding. Nosebleeds are generally harmless unless associated with other symptoms.

Which of the following exercises should be taught to a pregnant woman who complains of backaches?

  • A. Kegeling.
  • B. Pelvic tilting.
  • C. Leg lifting.
  • D. Crunching.
Correct Answer: B

Rationale: Pelvic tilting exercises help to alleviate backaches by strengthening the abdominal and lower back muscles. Kegeling, leg lifting, and crunching are not specifically targeted at relieving backaches.

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