Atrium Health Womens Care Maternal Fetal Monitoring

Atrium Health Womens Care Maternal Fetal Monitoring Related

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The nurse is caring for a pregnant patient who is at 25 weeks gestation and is concerned about gestational diabetes. Which of the following symptoms should the nurse educate the patient to watch for?

  • A. Increased thirst and frequent urination
  • B. Severe leg cramps and dizziness
  • C. Constant fatigue and swollen feet
  • D. Shortness of breath and dizziness upon standing
Correct Answer: A

Rationale: The correct answer is A: Increased thirst and frequent urination. These symptoms are indicative of gestational diabetes due to elevated blood sugar levels. Increased thirst is a result of the body trying to dilute the excess glucose through increased fluid intake, leading to frequent urination. This occurs because the kidneys work to eliminate the excess glucose from the blood by excreting it in the urine. Therefore, educating the patient to watch for these symptoms is crucial for early detection and management of gestational diabetes.

Choices B, C, and D are incorrect as they do not directly correlate with the symptoms of gestational diabetes. Severe leg cramps and dizziness (Choice B) may be related to other factors such as dehydration or electrolyte imbalance. Constant fatigue and swollen feet (Choice C) could be common symptoms during pregnancy but are not specific to gestational diabetes. Shortness of breath and dizziness upon standing (Choice D) are more likely to be related to issues such as anemia or changes

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A nurse is preparing a laboring person for a cesarean birth. What is the most important action the nurse should take prior to the procedure?

  • A. administer a preoperative medication
  • B. assist with positioning the person
  • C. perform a cesarean section
  • D. monitor fetal heart tones
Correct Answer: A

Rationale: The correct answer is A: administer a preoperative medication. This is the most important action because it helps prepare the laboring person for the cesarean birth by ensuring they are adequately medicated for the procedure. Administering preoperative medication can help reduce anxiety, manage pain, and ensure the person is in a suitable condition for surgery.

Summary of other choices:
B: Assisting with positioning the person is important but not the most critical action before a cesarean birth.
C: Performing a cesarean section is not a nursing responsibility and is done by the healthcare provider.
D: Monitoring fetal heart tones is important but not the most crucial action for preparing the laboring person for a cesarean birth.

A pregnant patient at 26 weeks gestation reports pain in the lower abdomen and back. What should the nurse do first?

  • A. Encourage the patient to rest and monitor for changes in symptoms.
  • B. Perform a pelvic exam to assess for possible cervical dilation.
  • C. Administer pain medication to relieve the discomfort.
  • D. Assess the patient's blood pressure and check for signs of preeclampsia.
Correct Answer: A

Rationale: The correct answer is A: Encourage the patient to rest and monitor for changes in symptoms. At 26 weeks gestation, lower abdominal and back pain could indicate preterm labor. The first step is to have the patient rest to reduce uterine activity. Monitoring for changes in symptoms is crucial to assess if the pain is worsening and if there are any signs of preterm labor. Performing a pelvic exam (B) could potentially stimulate contractions and should be avoided unless absolutely necessary. Administering pain medication (C) does not address the underlying cause and could mask symptoms. Assessing blood pressure for signs of preeclampsia (D) is important but not the first priority in this scenario.

A pregnant woman informs the nurse that her last normal menstrual period was on September 20, 2012. Using Nagele’s rule, the nurse calculates the client’s estimated date of delivery as:

  • A. May 30, 2013.
  • B. June 20, 2013.
  • C. June 27, 2013.
  • D. July 3, 2013.
Correct Answer: C

Rationale: Using Nagele’s rule (adding 7 days to the first day of the last menstrual period, subtracting 3 months, and adding 1 year), the calculated EDD is June 27, 2013.

A nurse is caring for a laboring person who is in the first stage of labor. What is the most important intervention to support the person during this stage?

  • A. provide non-pharmacological pain relief
  • B. administer pain relief
  • C. administer analgesics
  • D. administer IV fluids
Correct Answer: A

Rationale: The correct answer is A: provide non-pharmacological pain relief. During the first stage of labor, it is crucial to prioritize non-pharmacological pain relief techniques such as breathing exercises, massage, and positioning to help manage the discomfort and promote comfort. This approach aligns with the goal of supporting the person's natural labor process and minimizing interventions that could potentially affect the progress of labor. Administering pain relief (B) or analgesics (C) may not be necessary or advisable at this stage unless specifically requested by the laboring person or deemed appropriate by the healthcare provider. Administering IV fluids (D) is important for hydration but is not the most critical intervention during the first stage of labor.

A woman in labor has a history of previous cesarean section. What is the most important factor to monitor for during this labor?

  • A. Uterine rupture
  • B. Maternal hypotension
  • C. Fetal malpresentation
  • D. Prolonged labor
Correct Answer: A

Rationale: The correct answer is A: Uterine rupture. The most important factor to monitor in a woman with a history of previous cesarean section is the risk of uterine rupture during labor. Uterine rupture is a serious complication that can lead to life-threatening hemorrhage for both the mother and the baby. Monitoring for signs such as sudden onset of severe abdominal pain, abnormal fetal heart rate patterns, and cessation of contractions is crucial. Maternal hypotension (Choice B) is important but not as critical as uterine rupture. Fetal malpresentation (Choice C) and prolonged labor (Choice D) are important factors to monitor but do not pose the same level of immediate risk as uterine rupture in this situation.

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