A nurse midwife is examining a client who is a primigravida at 42 weeks of gestation and states that she believes she is in labor. Which of the following findings confirm to the nurse that the client is in labor

Correct Answer: A

Rationale: Cervical dilation is a key physiological change that confirms labor has begun. During the late stages of pregnancy, the cervix starts to soften, thin out (efface), and open up (dilate) in preparation for childbirth. Therefore, cervical dilation is a critical finding that indicates the onset of labor. Pain above the umbilicus, brownish vaginal discharge, and amniotic fluid in the vaginal vault are not definitive signs of labor and do not confirm the initiation of the labor process.

Correct Answer: A

Rationale: The large black and blue areas on the buttocks and legs of the newborn are likely Mongolian spots. Mongolian spots are common in infants with dark skin and are not a result of birth trauma. They are benign birthmarks caused by pigment that did not make it to the top layer of the skin before birth. These spots typically fade over time and may disappear completely within a few years. It is important to educate parents about Mongolian spots to alleviate any concerns they may have about their baby's skin markings.

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: In the scenario of a mother experiencing severe vaginal bleeding during labor, the initial action of administering oxygen at 10L/min via a mask (Option C) is the correct choice. Oxygen therapy helps to improve oxygenation to both the mother and the fetus, stabilizing their conditions in cases of hemorrhage. This intervention supports tissue perfusion and minimizes the risk of hypoxia, which is crucial in a situation of acute blood loss. Monitoring vital signs and providing IV fluids (Option A) is important, but oxygenation takes precedence in addressing the immediate threat of hypoxia. Positioning the mother on her left side (Option B) can help improve blood flow to the placenta but is not the initial priority in managing severe vaginal bleeding. Preparing for an immediate cesarean section (Option D) may be necessary if other interventions fail, but it is not the first step in managing maternal hemorrhage. Educationally, this question highlights the importance of quick and appropriate interventions in emergency obstetric situations. Understanding the rationale behind each option helps nurses and healthcare providers prioritize care effectively to ensure the best outcomes for both the mother and the baby. It emphasizes the significance of rapid assessment and intervention in maternal and newborn care to address potentially life-threatening complications.

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.