A client at 28 weeks' gestation reports uterine contractions every 10 minutes. What is the priority nursing action?

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Assess for signs of preterm labor. The priority nursing action when a client at 28 weeks' gestation reports uterine contractions every 10 minutes is to assess for signs of preterm labor. This is crucial because preterm labor can have serious implications for both the mother and the baby. By assessing for signs of preterm labor, the nurse can determine the appropriate course of action to prevent premature birth and its associated complications. Option A) Encourage rest and hydration is not the priority in this situation because the client's symptoms indicate a potentially serious issue that requires immediate attention. Option C) Administer tocolytic medication is not the priority until preterm labor is confirmed. Tocolytic medications are used to halt preterm labor, but their administration should be based on a thorough assessment and diagnosis. Option D) Perform a vaginal examination is not the initial priority as it can potentially stimulate the uterus and worsen the contractions. It should only be done after assessing for signs of preterm labor and confirming the need for further evaluation. In an educational context, understanding how to prioritize nursing actions in situations of potential preterm labor is crucial for providing safe and effective care to pregnant clients. Nurses must be able to quickly assess and intervene in such situations to prevent adverse outcomes for both the mother and the baby. This question highlights the importance of timely assessment and intervention in maternal care.

Correct Answer: C

Rationale: In this scenario, the correct answer is option C: Pulmonary hypoplasia. Oligohydramnios, which is a condition characterized by a decreased amount of amniotic fluid surrounding the fetus, can lead to various complications. Pulmonary hypoplasia is a significant concern in cases of oligohydramnios because amniotic fluid plays a crucial role in fetal lung development. Adequate levels of amniotic fluid are necessary for the normal growth and expansion of the fetal lungs. When oligohydramnios is present, there is a risk of underdeveloped or hypoplastic lungs, which can result in respiratory distress for the newborn after birth. Now, let's discuss why the other options are incorrect: A) Fetal macrosomia: This condition refers to a large baby at birth, which is not directly associated with oligohydramnios. Fetal macrosomia is more commonly linked to maternal conditions like gestational diabetes. B) Cord prolapse: Cord prolapse occurs when the umbilical cord slips through the cervix ahead of the baby. While oligohydramnios can increase the risk of cord compression, it is not directly associated with cord prolapse. D) Placenta previa: Placenta previa is a condition where the placenta partially or completely covers the cervix, which can lead to bleeding during pregnancy. Oligohydramnios is not a typical complication of placenta previa. In an educational context, understanding the implications of oligohydramnios on fetal development is crucial for healthcare providers caring for pregnant women. This knowledge helps in identifying potential complications, providing appropriate interventions, and ensuring the best possible outcomes for both the mother and the baby. It underscores the importance of prenatal monitoring and timely interventions to address conditions that can impact fetal well-being.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Ensure signed informed consent is on file. The priority action before any procedure, especially a cesarean delivery, is to ensure that the patient has provided informed consent. This is crucial because it upholds the principles of autonomy and ensures that the patient is aware of the risks, benefits, and alternatives to the procedure. Option A) Obtain baseline maternal vital signs is important but not the priority when compared to ensuring informed consent. Vital signs can be obtained after ensuring the patient's readiness for the procedure. Option B) Assisting with positioning for spinal anesthesia is also important for the procedure but is not as critical as confirming informed consent. Option C) Verifying fetal heart tones before the procedure is essential, but it should not take precedence over ensuring informed consent. Educationally, this question highlights the significance of informed consent in healthcare practice. It emphasizes the nurse's role in advocating for the patient's right to make informed decisions about their care. By prioritizing informed consent, nurses demonstrate respect for the patient's autonomy and uphold ethical standards in healthcare delivery.

Correct Answer: B

Rationale: In caring for a client with gestational diabetes during labor, the nurse should monitor for the complication of macrosomia, which is the correct answer (B). Macrosomia refers to a condition where the baby is significantly larger than average, often due to excessive glucose crossing the placenta. This poses risks during labor, such as shoulder dystocia and birth injuries. Placental abruption (A) is a separation of the placenta from the uterine wall before delivery, which is not directly linked to gestational diabetes. Preterm labor (C) is premature contractions leading to early delivery, not specifically associated with gestational diabetes. Postpartum hemorrhage (D) is excessive bleeding after childbirth and can occur in any laboring woman, not solely those with gestational diabetes. Educationally, understanding the implications of gestational diabetes on labor and delivery outcomes is crucial for nurses caring for these clients. Monitoring for complications like macrosomia allows for timely interventions to ensure the safety of both the mother and the baby. Nurses need to be knowledgeable about the specific risks and complications associated with gestational diabetes to provide optimal care during labor and delivery.

Correct Answer: C

Rationale: In the context of preparing a client for cesarean delivery, the priority nursing action is to verify signed informed consent (Option C). This is crucial because it ensures that the client has been informed about the procedure, its risks, benefits, and alternatives, and has given their voluntary consent. Without valid informed consent, proceeding with the surgery would be ethically and legally inappropriate. Obtaining baseline vital signs (Option A) is important but not the priority in this scenario where ensuring informed consent takes precedence. Inserting an indwelling urinary catheter (Option B) is typically done after the client has been prepared for surgery and is in the operating room. Administering prophylactic antibiotics (Option D) is important in preventing infection but is not the immediate priority compared to ensuring informed consent. Educationally, this question highlights the significance of informed consent in healthcare decision-making. It underscores the nursing responsibility to advocate for patients' rights and autonomy, ensuring they are fully informed and actively participate in their care. Understanding the prioritization of actions in maternal newborn care, especially before surgical interventions, is vital for safe and ethical practice.