A client at 32 weeks' gestation is experiencing preterm labor. What is the primary goal of tocolytic therapy?

Correct Answer: B

Rationale: In the context of pharmacology in maternal newborn nursing, the primary goal of tocolytic therapy in a client experiencing preterm labor at 32 weeks' gestation is to delay delivery and improve fetal lung maturity (Option B). Tocolytic agents are used to inhibit uterine contractions temporarily, allowing time for corticosteroids to enhance fetal lung development and for the administration of magnesium sulfate for neuroprotection in the preterm neonate. Option A, to prevent fetal hypoxia, is not the primary goal of tocolytic therapy. While delaying delivery can indirectly contribute to reducing fetal hypoxia by allowing time for appropriate interventions, it is not the direct aim of tocolysis. Option C, to reduce maternal blood pressure, is not typically a primary goal of tocolytic therapy. Tocolytic agents primarily target uterine smooth muscle to delay labor and do not have a direct effect on maternal blood pressure. Option D, to increase uteroplacental blood flow, is not the primary goal of tocolytic therapy. While maintaining adequate uteroplacental perfusion is important in pregnancy, tocolytic therapy is specifically aimed at inhibiting uterine contractions to delay preterm labor and its associated risks. Understanding the rationale behind tocolytic therapy is crucial for nurses caring for pregnant individuals at risk for preterm labor. By delaying delivery, healthcare providers can optimize outcomes for both the mother and the preterm neonate, emphasizing the importance of fetal lung maturity and appropriate interventions before birth.

Correct Answer: C

Rationale: In the context of educating a client with gestational diabetes about blood sugar monitoring, option C, "I will monitor my blood sugar four times a day as prescribed," is the correct statement that indicates understanding. This statement reflects the importance of regular monitoring as per the healthcare provider's instructions to manage gestational diabetes effectively. Option A, "I will check my blood sugar once a week," is incorrect because gestational diabetes requires more frequent monitoring due to the dynamic nature of blood sugar levels during pregnancy. Option B, "I should avoid all carbohydrates," is incorrect as complete avoidance of carbohydrates is not recommended. The focus should be on consuming complex carbohydrates in moderation and balancing them with proteins and healthy fats. Option D, "I can skip insulin on days I feel well," is incorrect as insulin therapy should be followed as prescribed by the healthcare provider, regardless of how the individual feels on a particular day. In an educational context, it is essential to emphasize the significance of consistent blood sugar monitoring to ensure timely adjustments in treatment plans, maintain optimal glucose levels for both maternal and fetal health, and reduce the risk of complications associated with gestational diabetes. Patients need to understand the rationale behind monitoring frequency and the potential consequences of inadequate monitoring or deviations from the prescribed management plan.

Correct Answer: A

Rationale: In fetal circulation, the correct answer is A) Ductus arteriosus. The ductus arteriosus is a fetal blood vessel that allows blood to bypass the fetal lungs by connecting the pulmonary artery to the aorta. This shunts blood away from the non-functional fetal lungs to ensure oxygenated blood is circulated throughout the body. Option B) Ductus venosus carries oxygenated blood from the placenta to the fetal heart, aiding in bypassing the liver. Option C) Foramen ovale is an opening between the atria of the fetal heart, allowing blood to bypass the pulmonary circulation. Option D) Umbilical vein carries oxygenated blood from the placenta to the fetus. Understanding fetal circulation is crucial in maternal newborn nursing as it impacts fetal oxygenation and overall well-being. Teaching this concept helps prenatal caregivers understand the unique circulatory adaptations in the fetus and recognize any deviations that may require intervention.

Correct Answer: C

Rationale: In the scenario of a client receiving magnesium sulfate for preeclampsia, the finding that indicates magnesium toxicity is a respiratory rate of 10 breaths per minute (Option C). This is due to the fact that magnesium sulfate is a central nervous system depressant and can lead to respiratory depression as a sign of toxicity. A decreased respiratory rate is a critical indicator of magnesium toxicity and requires prompt intervention to prevent further complications such as respiratory arrest. Option A, increased urine output, is not indicative of magnesium toxicity but rather a desired effect of magnesium sulfate which helps to prevent fluid overload and maintain renal function in preeclamptic clients. Option B, deep tendon reflexes +4, is a common finding in clients receiving magnesium sulfate as it is a magnesium antagonist. Hyperactive reflexes are actually a sign of magnesium deficiency rather than toxicity. Option D, a blood pressure of 140/90 mmHg, is within normal range for a pregnant client with preeclampsia and does not specifically indicate magnesium toxicity. Educationally, understanding the signs and symptoms of magnesium toxicity is crucial for nurses caring for clients receiving magnesium sulfate therapy during pregnancy. Recognizing these signs promptly is essential to prevent serious complications and ensure the safety of both the mother and the baby. Regular monitoring and assessment are key components of managing clients on magnesium therapy.

Correct Answer: B

Rationale: In this scenario, option B "I should seek help if I have trouble bonding with my baby" is the correct answer. This statement indicates understanding because it recognizes a key symptom of postpartum depression, which is difficulty bonding with the newborn. Seeking help is crucial in managing postpartum depression and ensuring the well-being of both the mother and the baby. Option A is incorrect because while it is common to experience mood changes postpartum, feeling sad for the first 6 months is not necessarily indicative of postpartum depression. Option C is incorrect as postpartum depression can occur in any mother, regardless of whether it is their first pregnancy or not. Option D is also incorrect as ignoring feelings of hopelessness can exacerbate the situation and delay appropriate treatment. Educationally, it is important for nurses to teach clients about the signs and symptoms of postpartum depression to promote early detection and intervention. By emphasizing the importance of seeking help and providing support, nurses can empower mothers to prioritize their mental health during the postpartum period.