A nurse is reviewing a laboratory report for a client who is at 33 weeks of gestation and has preeclampsiWhich of the following laboratory results should the nurse report to the provider?

Correct Answer: A

Rationale: In this scenario, the correct laboratory result to report to the provider is option A) BUN 35 mg/dL. Elevated BUN levels can indicate kidney dysfunction, which is a significant concern in a client with preeclampsia. Kidney dysfunction is a serious complication of preeclampsia that can lead to adverse maternal and fetal outcomes if not promptly addressed. Option B) Hgb 15 mg/dL is within normal range for a pregnant individual and would not be a priority concern in this situation. Option C) Bilirubin 0.6 mg/dL is also within normal limits and would not be as critical to report as the elevated BUN level. Option D) Hct 37% is slightly below the normal range for a pregnant individual but is not as concerning as the elevated BUN level in a client with preeclampsia. Educationally, understanding the significance of specific laboratory values in the context of pregnancy complications like preeclampsia is crucial for nurses providing care to pregnant individuals. Recognizing abnormal values and knowing which ones require immediate attention helps ensure timely interventions to prevent complications and promote positive outcomes for both the mother and the baby.

Correct Answer: D

Rationale: In this scenario, the correct action for the nurse to take first is to place the client in a left lateral position (Option D). This is because placing the client in a left lateral position can help improve placental perfusion and oxygenation to the fetus by relieving pressure on the maternal vena cava, thus potentially improving fetal oxygenation and reducing the variable decelerations of the fetal heart rate (FHR). Option A, preparing for an amnioinfusion, is not the first priority because it is a more invasive intervention and should be considered after initial non-invasive measures have been taken. Administering oxygen via a nonrebreather face mask (Option B) is important in cases of fetal distress, but in this situation, addressing the maternal position to improve fetal oxygenation is the priority. Discontinuing the oxytocin infusion (Option C) may eventually be necessary if the variable decelerations persist, but changing the maternal position is the initial step to attempt to improve fetal well-being before considering discontinuing the oxytocin infusion. Educationally, understanding the rationale behind positioning interventions in obstetric care is crucial for nurses to effectively manage fetal distress during labor. It is essential for nurses to prioritize interventions based on their potential to improve fetal oxygenation and minimize risks during childbirth.

Correct Answer: A

Rationale: In this scenario, the correct action for the nurse to take is option A: Encourage the mother to breastfeed the newborn. This is the appropriate choice because breastfeeding is the most natural and effective way to increase the newborn's blood glucose level. Breast milk contains the necessary nutrients and sugars that can help regulate the baby's glucose levels. Option B, gavage feeding 60 mL of glucose water, is incorrect because it introduces an unnecessary intervention that may not align with the infant's actual needs. Providing glucose water may also disrupt the establishment of breastfeeding. Option C, administering 10 mL of D W via IV, is not the first-line intervention for a newborn with low blood glucose levels. Intravenous administration should be reserved for severe cases where oral intake is not feasible or effective. Option D, rechecking the glucose level in 2 hours, is not the most appropriate immediate action when dealing with a newborn with low blood glucose levels. Prompt intervention is crucial to prevent further complications associated with hypoglycemia in neonates. In an educational context, understanding the significance of promoting breastfeeding for newborns is crucial for healthcare professionals working in maternity care. Encouraging breastfeeding not only provides optimal nutrition but also helps establish bonding between the mother and the infant. It is essential for nurses to prioritize evidence-based practices that support the well-being of both the newborn and the mother in maternity care settings.

Correct Answer: A

Rationale: In this scenario, option A, "You should keep the car seat rear-facing until your baby is at least 2 years old," is the correct statement for the nurse to make. This recommendation aligns with current safety guidelines from organizations like the American Academy of Pediatrics (AAP) and the National Highway Traffic Safety Administration (NHTSA). Rear-facing car seats provide the best protection for infants and young children in the event of a crash by supporting the child's head, neck, and spine. Options B, C, and D are incorrect statements. Positioning the retainer clip over the upper part of the baby's abdomen (Option B) can result in serious internal injuries in a crash. Placing the baby in the car seat at a 90-degree angle (Option C) is not necessary and may not be practical in all vehicles. Lastly, placing the shoulder harness straps in the slots above the baby's shoulders (Option D) can lead to improper fit and decreased safety in the event of a crash. Educationally, it is crucial for healthcare providers to provide evidence-based information on car seat safety to parents. By understanding and following the recommended guidelines, parents can significantly reduce the risk of injury to their child in a motor vehicle accident. Nurses play a vital role in educating families on best practices to ensure the safety and well-being of infants and children during car travel.

Correct Answer: C

Rationale: In this scenario, the nurse should prioritize option C, which is to massage the client's fundus. Massaging the fundus helps to stimulate uterine contractions, which can effectively control postpartum bleeding by promoting the expulsion of clots and initiating the process of uterine involution. This intervention is crucial in preventing postpartum hemorrhage, a potentially life-threatening complication. Option A, elevating the client's legs, is not the priority in this situation as it does not address the underlying cause of the excessive bleeding. While elevating the legs can improve venous return and circulation, it is not as directly beneficial as fundal massage in managing postpartum hemorrhage. Inserting an indwelling urinary catheter (option B) is not the priority action because the client's excessive bleeding takes precedence. Monitoring urinary output is essential but can be done after addressing the bleeding. Initiating an infusion of oxytocin (option D) is a valid intervention to help control postpartum bleeding, but it should come after fundal massage. Oxytocin can be administered after ensuring that the uterus is contracting effectively through fundal massage. In an educational context, it is crucial for nurses caring for postpartum clients to understand the significance of fundal massage in managing postpartum hemorrhage. This knowledge ensures they can provide timely and appropriate care to prevent complications and promote maternal well-being.