A nurse is caring for a client who is experiencing preterm labor and has a new prescription for terbutaline. Which of the following findings is a contraindication for the administration of this medication?

Correct Answer: A

Rationale: Rationale: The correct answer is option A) Heart disease. Terbutaline is a tocolytic medication used to inhibit preterm labor by relaxing the uterine smooth muscle. It is contraindicated in clients with heart disease due to its potential to cause cardiovascular side effects, such as tachycardia and arrhythmias. Administration of terbutaline in clients with underlying heart disease can exacerbate these conditions and pose a serious risk to the client's health. Option B) Cervical dilation of 2 cm is not a contraindication for terbutaline administration. In fact, terbutaline is often used in cases of preterm labor where cervical dilation has begun to help delay labor and allow for administration of corticosteroids to improve fetal outcomes. Option C) Gestational age of 34 weeks is not a contraindication for terbutaline use. Terbutaline can be used up to 37 weeks of gestation to delay preterm labor and allow for appropriate interventions to improve neonatal outcomes. Option D) Allergy to penicillin is unrelated to the administration of terbutaline. Allergy to penicillin would not impact the use of terbutaline in managing preterm labor. Educational context: Understanding contraindications for medications used in maternal newborn nursing is crucial for nurses caring for pregnant clients. By knowing the contraindications of medications like terbutaline, nurses can ensure safe and effective care for both the mother and the fetus. It is essential to consider the client's medical history and potential risks associated with medication administration to make informed decisions that promote positive outcomes for both the mother and the newborn.

Correct Answer: A

Rationale: In evaluating the level of a pregnant woman's risk of having a low-birth-weight (LBW) infant, the most important factor for the nurse to consider is the pregnant woman's race, specifically African-American race (Option A). This is because research has consistently shown that African-American women are at a higher risk of giving birth to LBW infants compared to women of other races. Cigarette smoking (Option B) is a significant risk factor for LBW infants, but it is not as consistently associated with adverse outcomes as race in this context. Poor nutritional status (Option C) and limited maternal education (Option D) can also contribute to the risk of LBW infants, but they are generally considered secondary factors compared to race and smoking. Educational context: Understanding the factors influencing LBW infants is crucial for nurses in maternal newborn care to provide targeted support and interventions to at-risk populations. By recognizing the disproportionate impact of race on birth outcomes, nurses can advocate for culturally sensitive care and tailored interventions to improve maternal and infant health in high-risk populations.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Outcomes-oriented practice. Outcomes-oriented practice involves comparing one's performance against established clinical standards to assess the quality of care provided. This process focuses on achieving positive outcomes for patients, which is crucial in maternal-newborn nursing where the health and well-being of both mother and baby are of utmost importance. Option A) Best practices network refers to a collaborative group sharing best practices but does not specifically involve performance comparison against standards. Option B) Clinical benchmarking involves comparing performance metrics with other facilities or standards but may not necessarily focus on outcomes. Option D) Evidence-based practice involves using the best available evidence to make clinical decisions, but it does not directly involve the comparison of one's performance against established standards. Educationally, understanding outcomes-oriented practice is essential for nurses to continuously improve their practice, enhance patient care, and ensure adherence to quality standards in maternal-newborn nursing. By regularly evaluating and comparing their performance against clinical standards, nurses can identify areas for improvement and deliver evidence-based, high-quality care to their patients.

Correct Answer: D

Rationale: In this question on ethical issues in maternal newborn nursing, the correct answer is option D, "Foreign object retained after surgery," because this does not directly pertain to maternal and child health as outlined by the National Quality Forum's list of 'never events.' Retaining a foreign object after surgery is a serious medical error but is not specific to maternal and child health care. Options A, B, and C are incorrect because they directly relate to maternal and child health. Option A highlights the risk of an infant being discharged to the wrong person, which can lead to serious safety concerns for the newborn. Option B addresses the prevention of kernicterus by identifying and treating hyperbilirubinemia, a critical issue in newborn care. Option C focuses on the ethical implications of using the correct donor sperm or egg in artificial insemination procedures to maintain the integrity and accuracy of genetic information in maternal and child health care. Understanding these 'never events' in maternal and child health is crucial for nurses and healthcare providers to ensure the safety, well-being, and ethical standards of care for mothers and newborns. By being aware of these specific issues, healthcare professionals can work towards preventing errors and promoting quality care in this specialized area of nursing practice.

Correct Answer: A

Rationale: In the context of ethical issues in maternal newborn nursing, the correct answer is A) Standard of care. This is because the minimum level of practice that a reasonably prudent nurse is expected to provide is to adhere to the established standard of care, which represents the level of skill, care, and judgment that a nurse with similar training and experience would provide in similar circumstances. Option B) Risk management refers to the process of identifying, assessing, and prioritizing risks, which is important in nursing practice but is not directly related to the minimum level of care provision. Option C) Sentinel event refers to an unexpected occurrence involving death or serious physical or psychological injury, which is not directly related to the minimum level of practice. Option D) Failure to rescue refers to the inability to save a patient from a life-threatening situation, which is an outcome rather than a standard of care. In an educational context, understanding the concept of the standard of care is crucial for nurses to ensure they provide safe and competent care to maternal newborn patients. By adhering to the standard of care, nurses can uphold ethical principles, promote patient safety, and minimize the risk of adverse outcomes. It also serves as a benchmark for evaluating nursing practice and professional accountability.