A pregnant client is diagnosed with anemia. What dietary recommendation should the nurse provide?

Correct Answer: B

Rationale: In the context of maternal and newborn nursing, it is crucial for nurses to understand the importance of proper nutrition during pregnancy, especially when managing conditions like anemia. The correct answer, B) Consume more lean red meat, is the most appropriate recommendation for a pregnant client diagnosed with anemia due to its high iron content in the form of heme iron, which is more readily absorbed by the body compared to non-heme iron found in plant-based sources. Iron is essential for the production of hemoglobin, which carries oxygen to tissues and organs, making it vital during pregnancy to support the increased blood volume and fetal development. Option A) Increase intake of dairy products is not the best recommendation for addressing anemia in pregnancy as dairy products are not significant sources of iron. While dairy is important for calcium intake during pregnancy, it does not directly address the iron deficiency associated with anemia. Option C) Drink tea with meals is not advisable for individuals with anemia as tea contains compounds like tannins that can inhibit iron absorption. Consuming tea alongside meals high in iron can further reduce the already limited absorption of iron, hence exacerbating the anemia. Option D) Avoid citrus fruits is also not the most appropriate recommendation for anemic pregnant clients. Citrus fruits are sources of vitamin C, which actually enhance non-heme iron absorption from plant-based sources. Therefore, including citrus fruits in the diet can be beneficial for individuals with anemia when consumed alongside iron-rich foods. By understanding the specific nutritional needs of pregnant clients with anemia, nurses can provide targeted dietary recommendations to support maternal health and optimal fetal development, thereby exemplifying the importance of evidence-based practice in maternal and newborn nursing care.

Correct Answer: B

Rationale: In the context of severe preeclampsia, the assessment finding that requires immediate intervention is option B) Urine output of 25 mL/hr. This is because a decreased urine output can indicate declining renal function, which could progress to renal failure in severe cases of preeclampsia. In preeclampsia, there is a risk of developing HELLP syndrome, a condition characterized by hemolysis, elevated liver enzymes, and low platelet count, which can further worsen renal function. Option A) Blood pressure of 150/90 mmHg is elevated but not the most concerning finding in severe preeclampsia. However, it does require monitoring and potential intervention. Option C) Headache relieved by acetaminophen can be a symptom of preeclampsia but does not indicate an immediate threat to the client's health. It is important to address pain and discomfort in clients but not as urgent as addressing renal function. Option D) Deep tendon reflexes +2 are a typical finding in preeclampsia due to hyperreflexia. While this finding is associated with the condition, it is not as urgent as addressing renal impairment indicated by decreased urine output. In an educational context, understanding the priority assessments in clients with severe preeclampsia is crucial for nurses caring for pregnant individuals. Timely recognition and intervention can prevent serious complications such as eclampsia, placental abruption, and organ damage. Nurses must prioritize assessments based on the client's condition to provide safe and effective care.

Correct Answer: B

Rationale: In the context of maternal and newborn nursing, educating a client with gestational hypertension about home care is crucial for ensuring the well-being of both the mother and the baby. The correct answer, "B) Report any sudden swelling or weight gain," is the most appropriate instruction to include in the client's education for several reasons. Firstly, sudden swelling or weight gain can be indicative of worsening gestational hypertension or preeclampsia, which are serious conditions that require immediate medical attention to prevent complications such as seizures, organ damage, or preterm birth. By instructing the client to report these symptoms promptly, the nurse is emphasizing the importance of monitoring for warning signs and seeking timely intervention. Conversely, options A, C, and D are incorrect for the following reasons: A) Monitoring blood pressure once a week may not be frequent enough for a client with gestational hypertension, as more frequent monitoring may be necessary to detect any sudden changes or trends that require medical intervention. C) Increasing sodium intake is contraindicated in clients with hypertension, as excess sodium can contribute to fluid retention and exacerbate high blood pressure. D) Advising the client to avoid taking daily medications is inappropriate if the client has been prescribed antihypertensive medications by their healthcare provider. Consistent adherence to prescribed medications is essential for managing gestational hypertension effectively. In conclusion, emphasizing the importance of reporting sudden swelling or weight gain to healthcare providers is critical in the care of clients with gestational hypertension, as it promotes early detection and intervention to ensure the best outcomes for both the mother and the baby.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Macrosomia. Gestational diabetes increases the risk of delivering a macrosomic baby, which refers to a newborn significantly larger than average. This occurs because maternal hyperglycemia crosses the placenta, stimulating the baby's pancreas to produce extra insulin, leading to increased fetal growth. Macrosomia poses risks during delivery such as shoulder dystocia and birth injuries. Option A) Preterm labor is less likely in gestational diabetes compared to other maternal conditions like hypertension. Option B) Placenta previa is not directly associated with gestational diabetes. Option D) Abruptio placentae, while a serious complication, is not the most common risk in gestational diabetes. Educationally, understanding these complications is crucial for nurses caring for pregnant women with gestational diabetes. Proper management, monitoring, and education on blood sugar control can help reduce the risk of complications like macrosomia, ensuring better outcomes for both the mother and the newborn.

Correct Answer: C

Rationale: In the postpartum period, assessing a breastfeeding mother is crucial for early detection of any issues that may impact successful breastfeeding. In this scenario, the correct answer is C) Cracked and bleeding nipples, which requires further evaluation. This finding can indicate poor latch technique, improper positioning, or a possible fungal infection like thrush, all of which can lead to pain, difficulty breastfeeding, and potential nipple damage. Option A) Engorgement on day 3 postpartum is a common physiological response as milk production increases, usually resolving with proper breastfeeding techniques. Option B) Mild nipple tenderness can be expected initially but should improve with correct positioning and latch. Option D) Colostrum present in the first 48 hours is a positive sign of early milk production and is normal in the immediate postpartum period. Educationally, understanding these nuances helps nurses provide quality care to breastfeeding mothers by identifying and addressing issues promptly to support successful breastfeeding and maternal-infant bonding. Early intervention for cracked and bleeding nipples can prevent further complications and ensure a positive breastfeeding experience.