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The nurse is preparing supplies for an amnioinfusion on a patient with intact membranes. Which supplies should the nurse gather? (Select all that apply.)
- A. Extra underpads
- B. Solution of 3% normal saline
- C. Amniotic hook to perform an amniotomy
- D. Solid intrauterine pressure catheter with a pressure transducer on its tip
Correct Answer: A
Rationale: The correct answer is A: Extra underpads. For an amnioinfusion on a patient with intact membranes, extra underpads are necessary to absorb any excess fluid leakage during the procedure. The other choices are incorrect because:
B: Solution of 3% normal saline is not necessary for an amnioinfusion with intact membranes as there is no need for amniotic fluid replacement.
C: Amniotic hook to perform an amniotomy is not required when the patient's membranes are intact; this procedure involves rupturing the membranes.
D: Solid intrauterine pressure catheter with a pressure transducer on its tip is used for monitoring intrauterine pressure during labor, not for an amnioinfusion procedure.
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The nurse is educating a gravida 1 para 0 who is 28 weeks pregnant. Which educational topics are appropriate for the nurse to discuss with the patient at this prenatal visit? Select all that apply.
- A. Discussion of prenatal classes
- B. Discussion of alcohol use
- C. Discussion of family history for pregnancy-induced hypertension
- D. Discussion of signs and symptoms of preterm labor
Correct Answer: B
Rationale: The correct answer is B, Discussion of alcohol use. This topic is important for prenatal education to ensure the well-being of the mother and baby. Alcohol consumption during pregnancy can lead to fetal alcohol spectrum disorders. The other choices are incorrect because:
A: Discussion of prenatal classes is relevant, but not a priority at 28 weeks.
C: Discussion of family history for pregnancy-induced hypertension is important but not usually discussed at every prenatal visit.
D: Discussion of signs and symptoms of preterm labor is crucial, but typically discussed later in pregnancy.
Shoulder dystocia is difficult to predict. What are thought to be predictors for shoulder dystocia?
- A. estimated birth weight of 4,000 g
- B. gestational diabetes
- C. previous shoulder dystocia
- D. hypertension
Correct Answer: B
Rationale: The correct answer is B: gestational diabetes. Gestational diabetes can lead to larger fetal size, increasing the risk of shoulder dystocia. It is a known risk factor that healthcare providers consider when assessing the likelihood of shoulder dystocia. Estimated birth weight alone (A) may not accurately predict shoulder dystocia. While previous shoulder dystocia (C) is a risk factor, it is not a predictor as it is based on past occurrences. Hypertension (D) is not directly associated with an increased risk of shoulder dystocia.
The patient presenting at 38 weeks' gestation, gravida 1, para 0, vaginal exam 4 cm, 100% effaced, +1 station vertex. What is the most likely intervention for this fetal heart rate pattern?
- A. Continue oxytocin (Pitocin) infusion.
- B. Contact the anesthesia department for epidural administration.
- C. Change maternal position.
- D. Administer Narcan to patient and prepare for immediate vaginal delivery.
Correct Answer: C
Rationale: The correct answer is C: Change maternal position. At 38 weeks' gestation with 4 cm dilation and 100% effacement, the fetal heart rate pattern suggests possible umbilical cord compression due to the +1 station vertex position. Changing maternal position can relieve this compression, improving fetal heart rate. Continuing oxytocin infusion (A) can worsen the situation by increasing contractions. Contacting anesthesia for epidural (B) is not indicated as it doesn't address the immediate concern. Administering Narcan and preparing for immediate delivery (D) is unnecessary and not supported by the given scenario.
A gravida 1 para 0 who is 10 weeks pregnant has her first prenatal visit. After performing a history and physical, which test ordered by the physician should the nurse verify with the examiner?
- A. Serological test for syphilis
- B. Rubella vaccine
- C. Clean-catch urinalysis
- D. Abdominal ultrasound
Correct Answer: D
Rationale: The correct answer is D: Abdominal ultrasound. At 10 weeks gestation, an abdominal ultrasound is typically ordered to confirm the viability of the pregnancy, assess fetal development, and determine gestational age. This test allows the healthcare provider to visualize the fetus, placenta, and amniotic fluid. It is essential in monitoring the progress of the pregnancy and identifying any potential complications.
Rationale for other choices:
A: Serological test for syphilis - While this test is important in prenatal care to screen for syphilis, it is usually done as part of routine prenatal blood work and not typically verified immediately after the first visit.
B: Rubella vaccine - Administering the rubella vaccine during pregnancy is contraindicated as it poses a risk to the developing fetus.
C: Clean-catch urinalysis - While urinalysis is a common test in prenatal care to screen for urinary tract infections and other conditions, it is not typically the first test verified following
What condition is related to an increased risk for fetal demise?
- A. diabetes
- B. migraine headache
- C. spina bifida
- D. thyroid disorder
Correct Answer: A
Rationale: The correct answer is A: diabetes. Diabetes is associated with an increased risk of fetal demise due to complications such as congenital anomalies, macrosomia, and placental insufficiency. High blood sugar levels can lead to adverse effects on the fetus, including stillbirth. Migraine headache (B) and spina bifida (C) are not directly linked to fetal demise. Thyroid disorders (D) can impact pregnancy outcomes but are not specifically associated with an increased risk of fetal demise.