A pregnant client asks why she needs to avoid lying on her back during the third trimester. What is the best response?

Correct Answer: B

Rationale: The correct answer is B) Lying on your back can reduce blood flow to your baby. During the third trimester of pregnancy, the weight of the growing uterus can compress the vena cava, a large vein that carries deoxygenated blood from the lower body back to the heart. This compression can impede blood flow to the fetus and reduce the amount of oxygen and nutrients reaching the baby. This can potentially lead to fetal distress or complications. Option A, stating that lying on your back increases the risk of preterm labor, is incorrect because the main concern is the reduced blood flow to the baby, not preterm labor specifically. Option C, mentioning increased fetal movements, is not directly related to the physiological effects of lying on the back. Option D, stating that lying on your back is uncomfortable for most women, is not the primary reason for the recommended position change. Educationally, this question highlights the importance of maternal positioning in pregnancy and how it can impact fetal well-being. It underscores the need for pregnant individuals to be aware of how their positioning can affect blood flow and oxygenation to the fetus, emphasizing the significance of proper posture for a healthy pregnancy.

Correct Answer: A

Rationale: In the context of monitoring a pregnant client undergoing a nonstress test, the reassuring finding is option A) Two accelerations in 20 minutes. Accelerations are indicative of a healthy fetal response to stimulation, suggesting an intact central nervous system. This pattern of accelerations indicates fetal well-being and adequate oxygenation. Option B) Baseline fetal heart rate of 170 beats/minute is not a reassuring finding as it is above the normal range for fetal heart rate. A baseline heart rate above 160 bpm may indicate fetal distress. Option C) Decreased fetal movement is a concerning finding as it could signal potential issues with fetal well-being, such as fetal distress or hypoxia. Option D) Variable decelerations are also not reassuring as they may indicate umbilical cord compression or other issues affecting fetal oxygenation. In an educational context, understanding the interpretation of fetal monitoring findings is crucial for nurses caring for pregnant clients. Nonstress tests are used to assess fetal well-being by evaluating the fetal heart rate response to movement. Nurses must be able to accurately interpret these findings to provide appropriate care and interventions for both the mother and the fetus.

Correct Answer: B

Rationale: In the context of pharmacology, understanding maternal conditions and their implications on fetal health is crucial for nurses and healthcare providers. Oligohydramnios, characterized by a decreased volume of amniotic fluid, is associated with fetal growth restriction (option B). This complication occurs because amniotic fluid plays a vital role in facilitating fetal movement, lung development, and preventing umbilical cord compression. In oligohydramnios, the restricted amount of amniotic fluid can lead to poor fetal growth and development. Regarding the other options: - Preterm labor (option A) is not directly associated with oligohydramnios. While oligohydramnios can sometimes lead to preterm labor due to underlying causes, it is not the primary complication. - Cord prolapse (option C) is more commonly associated with conditions like polyhydramnios where there is excess amniotic fluid, leading to the cord slipping through the cervix before the baby during labor. - Placenta previa (option D) is a condition where the placenta partially or completely covers the cervix, unrelated to oligohydramnios. Educationally, this question highlights the importance of recognizing the impact of maternal conditions on fetal well-being and the need for appropriate monitoring and intervention to prevent complications. Understanding these relationships is essential for providing safe and effective care to pregnant individuals and their unborn babies.

Correct Answer: C

Rationale: In the case of a client at 36 weeks' gestation with suspected polyhydramnios, the complication associated with this condition is cord prolapse (Option C). Polyhydramnios refers to an excess of amniotic fluid, which can increase the risk of cord prolapse during labor and delivery. Cord prolapse occurs when the umbilical cord slips through the cervix ahead of the baby, which can lead to compression of the cord and compromise fetal blood flow and oxygenation. Option A, preterm labor, is not directly associated with polyhydramnios. Preterm labor refers to the onset of labor before 37 weeks of gestation due to various reasons, but not specifically linked to polyhydramnios. Option B, placenta previa, involves the abnormal placement of the placenta over or near the cervical opening, causing bleeding during labor. While placenta previa is a potential complication in pregnancy, it is not directly related to polyhydramnios. Option D, gestational hypertension, is characterized by high blood pressure during pregnancy and can lead to complications such as preeclampsia. While gestational hypertension is a significant concern in pregnancy, it is not the primary complication associated with polyhydramnios. Educationally, understanding the complications of polyhydramnios is crucial for nurses caring for pregnant clients. Recognizing the risks associated with this condition allows for prompt intervention and management to ensure the best outcomes for both the mother and the baby. Monitoring for potential complications like cord prolapse in cases of polyhydramnios is essential for providing safe and effective care during labor and delivery.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Assess for signs of preterm labor. The priority nursing action when a client at 28 weeks' gestation reports uterine contractions every 10 minutes is to assess for signs of preterm labor. This is crucial because preterm labor can have serious implications for both the mother and the baby. By assessing for signs of preterm labor, the nurse can determine the appropriate course of action to prevent premature birth and its associated complications. Option A) Encourage rest and hydration is not the priority in this situation because the client's symptoms indicate a potentially serious issue that requires immediate attention. Option C) Administer tocolytic medication is not the priority until preterm labor is confirmed. Tocolytic medications are used to halt preterm labor, but their administration should be based on a thorough assessment and diagnosis. Option D) Perform a vaginal examination is not the initial priority as it can potentially stimulate the uterus and worsen the contractions. It should only be done after assessing for signs of preterm labor and confirming the need for further evaluation. In an educational context, understanding how to prioritize nursing actions in situations of potential preterm labor is crucial for providing safe and effective care to pregnant clients. Nurses must be able to quickly assess and intervene in such situations to prevent adverse outcomes for both the mother and the baby. This question highlights the importance of timely assessment and intervention in maternal care.