A newborn is born to a mother with gestational diabetes. What complication is the nurse most likely to monitor for?

Correct Answer: A

Rationale: In the case of a newborn born to a mother with gestational diabetes, the nurse would most likely monitor for hypoglycemia. This is because the newborn may have been exposed to high levels of glucose in utero, leading to increased insulin production. After birth, the abrupt cessation of maternal glucose supply can result in hypoglycemia in the newborn as their insulin levels remain elevated. Monitoring blood glucose levels is crucial to prevent complications associated with hypoglycemia in these infants, such as seizures or long-term neurological damage. The other options can be ruled out based on the following explanations: - Hyperthermia is not typically associated with gestational diabetes in newborns. - Jaundice may occur in newborns for various reasons, but it is not directly linked to gestational diabetes. - Respiratory alkalosis is not a common complication of gestational diabetes in newborns. From an educational standpoint, understanding the impact of maternal health conditions on newborns is crucial for nurses working in maternal newborn care. This knowledge helps them anticipate potential complications, provide appropriate monitoring and interventions, and ensure the best outcomes for both mother and baby. In the context of gestational diabetes, vigilance for hypoglycemia in the newborn is essential to promote early detection and management of this common complication.

Correct Answer: C

Rationale: The correct answer is C) Educate the mother on kangaroo care. Kangaroo care involves skin-to-skin contact between the mother and the preterm infant, providing numerous benefits such as promoting bonding, regulating the baby's temperature, improving breastfeeding success, and overall enhancing the infant's well-being. This teaching is crucial for the mother as it empowers her to actively participate in the care of her preterm infant, fostering a sense of closeness and promoting positive developmental outcomes. Option A) Emphasizing the importance of frequent temperature checks is important, but it may not be the most critical teaching for the mother of a preterm infant in an incubator. The healthcare team typically manages temperature regulation within the incubator. Option B) Demonstrating proper hand hygiene practices is essential to prevent infection, but it is not the most crucial teaching for the mother of a preterm infant in an incubator. Option D) Explaining the importance of reduced stimulation is important to create a soothing environment for the preterm infant, but educating the mother on kangaroo care has more direct benefits for both the infant and the mother in this specific scenario. In the context of maternal newborn nursing, empowering mothers with knowledge and skills such as kangaroo care promotes maternal-infant bonding, enhances caregiving confidence, and contributes to positive health outcomes for the preterm infant.

Correct Answer: A

Rationale: A history of previous pelvic inflammatory disease (PID) treatment would lead to suspicion of an ectopic pregnancy in a client presenting with abdominal pain and bleeding at 8 weeks' gestation. PID can cause scarring and damage to the fallopian tubes, increasing the risk of an ectopic pregnancy where the fertilized egg implants outside of the uterus, usually in the fallopian tubes. Symptoms of an ectopic pregnancy can include abdominal pain, vaginal bleeding, and signs of shock, making it important to consider this possibility in a client with a history of PID.

Correct Answer: C

Rationale: The foramen ovale is a normal fetal structure that allows blood to bypass the lungs by shunting blood from the right atrium to the left atrium. This is essential during fetal development since the lungs are not functioning until birth. After birth, when the baby takes its first breaths and the lungs start working, the pressure in the left atrium increases due to the increased blood flow from the pulmonary circulation. This increased pressure in the left atrium causes the foramen ovale to close, preventing blood from flowing from the right atrium to the left atrium. Therefore, the closure of the foramen ovale is a result of the increased pressure in the left atrium rather than any other cardiovascular changes.

Correct Answer: C

Rationale: The patient who should be seen first is the 35 weeks' gestation with grade I abruptio placenta in labor who has a strong urge to push. Abruptio placenta is a serious condition where the placenta detaches from the uterine wall before delivery, leading to significant bleeding and potential compromise to both the mother and baby. The strong urge to push indicates that the baby is in distress and immediate intervention is required to prevent potential harm. This patient needs urgent assessment and intervention to ensure the safety of both the mother and the baby.