A 29-year-old low-risk primiparous patient has just placental abruption?

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Maternal Newborn Nursing Questions

Question 1 of 5

A 29-year-old low-risk primiparous patient has just placental abruption?

Correct Answer: B

Rationale: Placental abruption is classified based on the severity of symptoms and extent of separation of the placenta from the uterine wall. In a low-risk primiparous patient like the one described, a moderate placental abruption (Grade 2) is likely when there is some vaginal bleeding, mild to moderate abdominal pain, and signs of fetal distress such as abnormal fetal heart rate patterns.

Question 2 of 5

Screening at 24 weeks gestation reveals that a pregnant woman has gestational diabetes mellitus (GDM). In planning the woman9s care. The nurse and the woman mutually agree that an expected outcome is to prevent injury to the fetus due to the GDM. The nurse identifies that the fetus is at risk for which of the following? Congenital anomalies of the central nervous system Macrosomia Preterm birth Low birth weight Screening at 24 weeks of gestation reveals that a pregnant woman has gestational diabetes mellitus (GDM). In planning her care, the nurse and the woman mutually agree that an expected outcome is to prevent injury to the fetus as a result of GDM. The nurse identifies that the fetus is at greatest risk for:

Correct Answer: A

Rationale: Gestational diabetes mellitus (GDM) is a condition where high blood sugar levels develop during pregnancy in women who didn't have diabetes before pregnancy. One of the primary risks associated with GDM is fetal overgrowth, also known as macrosomia. This means the baby is larger than normal. Macrosomia can lead to complications during delivery, such as shoulder dystocia (when the baby's shoulders get stuck during delivery) and an increased risk of birth injuries for both the baby and the mother. It can also increase the likelihood of a cesarean section delivery. Therefore, preventing macrosomia is an important goal in managing GDM to ensure the safety and well-being of both the mother and the baby.

Question 3 of 5

A nurse on a labor unit is admitting a client who reports painful contractions. The nurse determines that the contractions have a duration of 1 min and a frequency of 3 min. The nurse obtains the following vital signs: fetal heart rate 130/min, maternal heart rate 128/min and maternal blood pressure 92/54 mm Hg. Which of the following is the priority action for the nurse to take?

Correct Answer: A

Rationale: The priority action for the nurse in this situation is to notify the provider of the vital signs and the client's condition. The maternal blood pressure of 92/54 mm Hg is low, which can indicate hypotension. Hypotension during labor can lead to decreased perfusion to both the mother and baby, potentially causing harm. Therefore, the provider needs to be notified promptly so that appropriate interventions can be initiated to address the maternal hypotension and ensure the well-being of both the mother and the baby. Positioning the client with one hip elevated, asking about pain medication, and having the client void can be important interventions, but they are not the priority in this situation where maternal hypotension is a concern.

Question 4 of 5

A nurse on the labor and delivery unit is caring for a client who is having a difficult, prolonged labor with severe backache. Which of the following contributing causes should the nurse identify

Correct Answer: D

Rationale: In a labor where the fetal position is persistent occiput posterior, the baby is positioned face up, which can lead to a longer and more difficult labor. In this position, the baby's head is pressing against the mother's spine, causing severe backache for the mother. This malposition can slow down the progress of labor, making it more prolonged and challenging. It can also increase the likelihood of complications such as increased risk of instrumental delivery or cesarean section. Therefore, identifying the fetal position as persistent occiput posterior as a contributing cause to the difficult, prolonged labor with severe backache is crucial for effective management and intervention.

Question 5 of 5

A nurse receives report about assigned clients at the start of the shift. Which of the following clients should the nurse plan to see first?

Correct Answer: A

Rationale: The client who experienced a cesarean birth 4 hours ago and is reporting pain should be seen first by the nurse. Pain assessment and management are crucial following a cesarean birth to ensure the client's comfort and well-being. Uncontrolled pain can lead to complications and affect the client's recovery process. Addressing the client's pain promptly is a priority to promote their comfort and facilitate their recovery.

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