A nurse is caring for a client who is in premature labor and is receiving terbutaline. The nurse should monitor the client for which of the following adverse effects that should be reported to the provider?

Correct Answer: C

Rationale: Terbutaline is a beta-adrenergic agonist that is commonly used to suppress preterm labor by relaxing the uterine smooth muscle. Adverse effects of terbutaline can include respiratory distress or dyspnea, which is a serious concern and should be reported to the healthcare provider immediately. Both the nurse and the client should be alert for signs of difficulty breathing, such as shortness of breath or chest tightness, as these symptoms could indicate a potential serious reaction to the medication. Headaches, nervousness, and tremors are common side effects of terbutaline that are less concerning and may not require immediate provider notification unless they become severe or persistent.

Correct Answer: C

Rationale: Observing for crowning is the appropriate action for the nurse to take when the fetal head is at 3+ station after a vaginal examination. Crowning refers to the appearance of the baby's head at the vaginal opening during delivery. This indicates that the baby is descending and will be born soon. It is important for the nurse to be prepared for the actual birth once crowning is observed, as it signifies that the second stage of labor is progressing and delivery is imminent. Applying fundal pressure, observing for a nuchal cord, or preparing to administer oxytocin are not appropriate actions at this stage of labor when crowning has been observed.

Correct Answer: A

Rationale: Positioning the infant to grasp the nipple to express milk is an essential step in helping the patient begin breastfeeding successfully. As a nurse, it is crucial to ensure that the infant is properly latched onto the breast to facilitate effective feeding and milk transfer. This involves positioning the infant in a way that allows them to effectively grasp the nipple, promoting proper suckling and milk production. By assisting the patient in positioning the infant correctly, the nurse is supporting the establishment of successful breastfeeding and ensuring optimal nutrition for the baby.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Proteinuria of +2 on a urine dipstick, which is most concerning at 32 weeks gestation. Proteinuria can indicate a potential problem with the kidneys, specifically preeclampsia, a serious condition characterized by high blood pressure and protein in the urine. Preeclampsia can lead to complications for both the mother and the baby if not managed promptly. Option A, a blood pressure of 120/80 mmHg, falls within the normal range during pregnancy and is not typically a cause for concern. Option B, mild lower back pain, is common in pregnancy and may not signal a serious issue unless accompanied by other symptoms. Option C, a weight gain of 2 pounds in one week, can be normal in pregnancy as long as it is within recommended guidelines. Educationally, it is crucial for healthcare providers to recognize the significance of proteinuria in prenatal care as it can indicate a potentially life-threatening condition like preeclampsia. Regular monitoring of blood pressure, urine dipstick tests, and other prenatal assessments is essential to detect and manage complications early, ensuring the best possible outcomes for both the mother and the baby.

Correct Answer: B

Rationale: In educating parents about safe sleeping practices for newborns, the nurse must emphasize the importance of placing the baby on a firm mattress and avoiding loose bedding, as option B states. This recommendation aligns with the guidelines from the American Academy of Pediatrics (AAP) to reduce the risk of Sudden Infant Death Syndrome (SIDS) and suffocation. A firm mattress provides a stable sleeping surface, reducing the risk of the baby's face becoming covered by soft bedding. Loose bedding, such as blankets, pillows, and stuffed animals, can pose suffocation hazards. Options A, C, and D are incorrect and potentially dangerous practices. Placing the newborn in the prone (on the stomach) position (Option A) increases the risk of SIDS. Co-sleeping with the baby on a soft mattress (Option C) raises the risk of accidental suffocation or overlaying by the adult. Encouraging side-lying sleeping position (Option D) may also pose a risk of accidental rolling onto the stomach, increasing the risk of SIDS. Educationally, it is crucial for nurses to provide evidence-based information on safe sleep practices to prevent adverse outcomes in newborns. By explaining the rationale behind the correct choice and the potential dangers of the incorrect options, nurses can empower parents to create a safe sleep environment for their newborns, promoting infant safety and well-being.