A pregnant client reports frequent urination and lower abdominal pressure at 36 weeks. What should the nurse explain?

Correct Answer: C

Rationale: In this scenario, the correct answer is C) This is common due to fetal descent. Rationale: - Lower abdominal pressure and frequent urination at 36 weeks are common symptoms due to the descent of the fetal head into the pelvis, known as engagement or lightening. This physiological process occurs as the baby prepares for birth. - Preterm labor (Option A) typically presents with regular contractions, lower back pain, and sometimes vaginal bleeding. It is crucial to differentiate between normal signs of pregnancy progression and potential signs of preterm labor to ensure appropriate interventions and monitoring. - Urinary tract infections (Option B) may present with symptoms like burning sensation during urination, cloudy urine, and strong-smelling urine. While pregnant women are more susceptible to UTIs, the symptoms described in the question are more related to fetal descent. - Braxton Hicks contractions (Option D) are irregular, painless contractions that can occur throughout pregnancy. While they may cause some discomfort, they are not typically associated with lower abdominal pressure and frequent urination at 36 weeks. Educational context: Understanding the physiological changes that occur during late pregnancy is crucial for maternal newborn nurses to provide accurate information, support, and care to pregnant clients. Educating clients about common signs and symptoms of pregnancy progression versus potential complications like preterm labor or infections empowers them to make informed decisions about their health and well-being.

Correct Answer: C

Rationale: In the context of managing gestational diabetes, the best recommendation for managing blood sugar levels is option C: Eat balanced meals and monitor blood sugar levels. This recommendation is crucial as it emphasizes a holistic approach to managing blood sugar levels during pregnancy. Eating balanced meals ensures that the client receives a mix of nutrients, including carbohydrates, which are essential for energy. Monitoring blood sugar levels allows the client to track how different foods affect their blood sugar and make necessary adjustments. This approach promotes stable blood sugar levels, which is vital for the health of both the mother and the baby. Option A, avoiding all carbohydrates, is not recommended as carbohydrates are an important source of energy and nutrients. Completely eliminating them can lead to nutritional deficiencies and is not sustainable in the long term. Option B, exercising for 60 minutes daily, is beneficial for overall health but may not be sufficient on its own to manage blood sugar levels in gestational diabetes. While exercise is important, dietary management and blood sugar monitoring play a more direct role in controlling blood sugar levels. Option D, only taking insulin when blood sugar is high, is not a comprehensive approach to managing gestational diabetes. Relying solely on insulin without addressing dietary factors and monitoring blood sugar levels may not provide optimal control and can lead to fluctuations in blood sugar levels. In an educational context, it is important for nurses to emphasize the importance of a balanced approach to managing gestational diabetes, including proper nutrition, regular monitoring, and, if needed, appropriate medication. Empowering clients with the knowledge and skills to manage their condition effectively can lead to better outcomes for both the mother and the baby.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Assess fetal heart rate and contraction pattern. The priority action for a client at 34 weeks' gestation experiencing regular uterine contractions is to assess the fetal well-being to determine if the contractions are affecting the baby. This assessment helps in identifying any signs of fetal distress or compromise. Option A) Encouraging ambulation may be beneficial in some situations to relieve discomfort, but it is not the priority when fetal well-being is at stake. Option B) Performing a sterile vaginal examination is invasive and not indicated as the initial action in this situation. It could potentially introduce infection or cause further irritation. Option D) Administering an analgesic without assessing the fetal status first could mask important signs of distress in the baby, which could be detrimental. Educationally, understanding the rationale behind the priority actions in maternal newborn nursing is crucial for providing safe and effective care to both the mother and the baby. Assessing fetal well-being in cases of maternal contractions is a fundamental aspect of monitoring and ensuring a positive outcome for both patients.

Correct Answer: B

Rationale: In the postpartum period, the finding that indicates a need for immediate intervention is option B) Lochia rubra with large clots. Lochia rubra is the normal vaginal discharge after childbirth, but the presence of large clots can indicate excessive bleeding or retained placental tissue, which are serious postpartum complications requiring immediate medical attention to prevent hemorrhage and infection. Option A) Fundus firm and midline is a normal finding indicating proper uterine involution, which is expected in the postpartum period. Option C) Perineal pain after delivery is common due to the trauma of childbirth and is managed with pain relief measures. Option D) Slight swelling of the feet can be a normal postpartum symptom due to fluid shifts, but it does not require immediate intervention unless it is severe and associated with other signs of preeclampsia. In an educational context, it is crucial for nurses working in maternal newborn care to recognize abnormal postpartum findings that require immediate intervention to ensure the well-being of the mother. Understanding normal postpartum changes and potential complications is essential in providing safe and effective care to postpartum clients. Regular assessment and early detection of abnormal findings can prevent serious postpartum complications and promote optimal recovery for the mother.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Compression of pelvic nerves. Leg cramps during pregnancy, especially at 20 weeks' gestation, can be attributed to the growing uterus exerting pressure on the pelvic nerves, leading to compression and subsequent leg cramps. This is a common occurrence in pregnancy due to the expanding uterus putting pressure on surrounding structures. Option A) Dehydration is less likely to be the cause of leg cramps in this case, as the physiological changes in pregnancy often lead to an increased need for fluid intake. However, dehydration can contribute to muscle cramps in general. Option B) Calcium deficiency is an important consideration during pregnancy, but it is less likely to be the primary cause of leg cramps at 20 weeks' gestation. Adequate calcium intake is crucial for bone health and muscle function, but in this case, nerve compression is the more likely cause. Option C) Increased blood volume is a normal adaptation during pregnancy, but it is not directly linked to the development of leg cramps. While changes in blood volume can impact circulation and potentially contribute to other symptoms, it is not the primary reason for leg cramps in this context. Educationally, understanding the physiological changes and common discomforts experienced during pregnancy is essential for nurses caring for expectant mothers. Recognizing the causes of symptoms like leg cramps helps nurses provide appropriate education, support, and interventions to promote maternal well-being throughout pregnancy.