ATI RN
Perinatal Loss Nursing Care Questions
Question 1 of 5
A 36-week gestation gravid lies flat on her back. Which of the following maternal signs/symptoms would the nurse expect to observe?
Correct Answer: B
Rationale: In this scenario, the correct answer is B) Dizziness. When a gravid at 36 weeks gestation lies flat on her back, she may experience supine hypotensive syndrome due to compression of the inferior vena cava by the weight of the uterus. This can lead to decreased blood flow returning to the heart, resulting in symptoms like dizziness. A) Hypertension is unlikely in this context as lying flat on the back would not typically cause hypertension. C) Rales (abnormal crackling sounds heard on auscultation of the lungs) are not directly related to the position of the gravid lying flat on her back. D) Chloasma (skin discoloration often seen in pregnant women) is a cosmetic concern and not a direct result of lying on the back. Educationally, it is important for nurses caring for pregnant individuals to understand the physiological changes that occur during pregnancy and how certain positions or actions can impact both the mother and the fetus. This knowledge helps in providing safe and effective care to prevent complications such as supine hypotensive syndrome.
Question 2 of 5
The nurse is obtaining information to support the need for improved prenatal care services in the community. Which of the following information is most important to include?
Correct Answer: B
Rationale: In the context of advocating for improved prenatal care services in the community, the most important information to include is the infant mortality rate (Option B). Infant mortality rate reflects the number of deaths of infants under one year of age per 1,000 live births. This rate is a critical indicator of the overall health and well-being of a population, including the impact of prenatal care on infant outcomes. The other options are not as directly relevant to the need for improved prenatal care services in the community. Maternal mortality rate (Option A) focuses on the deaths of mothers related to childbirth, which while important, may not directly reflect the need for improved prenatal care services. Perinatal mortality rate (Option C) includes stillbirths and early neonatal deaths, which are also important but may not convey the specific impact of prenatal care on infant survival. Neonatal mortality rate (Option D) specifically looks at deaths that occur within the first 28 days of life, which is important but does not capture the broader impact of prenatal care on overall infant health outcomes. Educationally, understanding the nuances of different mortality rates can help nurses and healthcare providers advocate for targeted interventions and resources to improve perinatal outcomes. By focusing on the infant mortality rate, healthcare professionals can better identify areas for improvement in prenatal care services to ultimately reduce infant deaths in the community.
Question 3 of 5
Which of the following is a priority nursing diagnosis for a woman, G10P6226, who is PP1 from a spontaneous vaginal delivery with a significant postpartum hemorrhage?
Correct Answer: C
Rationale: The priority nursing diagnosis for a woman like G10P6226 who experienced a significant postpartum hemorrhage after a spontaneous vaginal delivery is "Fluid volume deficit related to blood loss" (Option C). This is the most critical issue to address first because postpartum hemorrhage can lead to severe hypovolemia and shock if not managed promptly. Replacing lost fluids and blood is essential to stabilize the patient's condition and prevent further complications. Option A, "Alteration in comfort related to afterbirth pains," is not the priority in this situation because the patient's physiological stability takes precedence over pain management. Option B, "Risk for altered parenting related to grand multiparity," is not an immediate concern when the patient is experiencing a life-threatening complication like fluid volume deficit. Option D, "Risk for sleep deprivation related to mothering role," is also not the priority as it is a long-term concern compared to the urgent need to address the fluid volume deficit. Educationally, understanding the concept of prioritizing nursing diagnoses based on the patient's immediate needs is crucial in providing effective and safe patient care. Nurses need to be able to recognize and address life-threatening conditions first before addressing other less urgent issues. This case highlights the importance of quick assessment and intervention in managing postpartum complications.
Question 4 of 5
A woman, who wishes to breastfeed, advises the nurse that she has had breast augmentation surgery. Which of the following responses by the nurse is appropriate?
Correct Answer: D
Rationale: The correct response is D) Women who have implants are often able exclusively to breastfeed. This is the appropriate response because having breast implants does not necessarily prevent a woman from being able to breastfeed. Breast augmentation surgery typically does not affect the milk ducts or the ability to produce milk. It is important for the nurse to provide accurate and supportive information to encourage the woman's desire to breastfeed. Option A is incorrect because breast implants do not inherently contaminate breast milk with toxins. Option B is incorrect as breast augmentation surgery does not necessarily indicate a deficiency in glandular tissue. Option C is incorrect because while some women may experience difficulty with latching initially, it is not a general rule for all women with breast implants. Educational context: It is crucial for nurses to have accurate knowledge about breastfeeding and breast augmentation to provide appropriate support and guidance to women who wish to breastfeed after surgery. Understanding the facts and dispelling myths surrounding breastfeeding with implants can help empower women to make informed decisions about their breastfeeding journey.
Question 5 of 5
A client, G1P0000, is PP1 from a normal spontaneous delivery of a baby boy, Apgar 5/6. Because the client exhibited addictive behaviors, a toxicology assessment was performed; the results were positive for alcohol and cocaine. Which of the following interventions is appropriate for this postpartum client?
Correct Answer: D
Rationale: The correct answer is D) Provide the client with supervised instruction on baby care skills. Rationale: The client's positive toxicology results for alcohol and cocaine indicate substance use that can impair her ability to care for her newborn safely. Providing supervised instruction on baby care skills ensures that the client receives guidance and support in understanding the baby's needs and how to care for him effectively despite her substance use issues. Option A) Strongly advising the client to breastfeed her baby is not appropriate in this situation due to the potential harmful effects of alcohol and cocaine exposure through breast milk. Option B) Performing hourly incentive spirometer respiratory assessments is not relevant to the client's situation of substance use and does not address the immediate need for appropriate baby care. Option C) Suggesting that the nursery nurse feed the baby in the nursery does not address the underlying issue of the client's ability to care for her baby independently and safely. Educational Context: In cases of perinatal loss and postpartum clients with substance use issues, it is crucial to provide tailored education and support to ensure the safety and well-being of both the mother and the newborn. Supervised instruction on baby care skills can help empower the client to care for her baby appropriately and mitigate potential risks associated with her substance use. It is essential for healthcare providers to address these complex situations with sensitivity, empathy, and evidence-based interventions to promote optimal outcomes for both mother and baby.