A pregnant patient with a BMI of 35 is concerned about health effects she and her baby may face during pregnancy. During routine testing, the patient tested negative for sexually transmitted illnesses (STIs) and indicated that she is in a committed, long-term relationship with the child's father. Which of the following is accurate?

Correct Answer: C

Rationale: In this scenario, option C is accurate because a pregnant patient with a BMI of 35 is considered obese, which predisposes her to an increased risk of wound infection during pregnancy and delivery. This risk is due to factors such as impaired immune function, difficulty with wound healing, and increased likelihood of requiring a cesarean section, all of which contribute to a higher likelihood of wound complications. Option A is incorrect because neonatal blindness is not directly associated with the mother's BMI or STI status. Option B is incorrect as the risk of birth injury is not necessarily decreased in a patient with obesity. Option D is also inaccurate as obesity is actually a risk factor for developing preeclampsia, a condition characterized by high blood pressure and potential organ damage during pregnancy. From an educational perspective, it is crucial for healthcare providers to understand the specific risks and considerations associated with caring for pregnant patients with obesity. Educating patients about these risks, such as the increased likelihood of wound infections, can help them make informed decisions about their prenatal care and potentially mitigate adverse outcomes. It underscores the importance of individualized care and tailored interventions to optimize maternal and fetal health outcomes in this population.

Correct Answer: C

Rationale: In this scenario, the correct answer is option C) Hematocrit - 26%. The nurse should report this result to the primary health care provider because a hematocrit level of 26% in a 2-day postpartum patient is indicative of potential postpartum hemorrhage, which is a serious complication that requires immediate attention and intervention. A hematocrit level of 26% is below the normal range, suggesting a decrease in red blood cell volume and potential blood loss. Option A) White blood cells - 12,500 cells/mm3 and option B) Red blood cells - 4,500,000 cells/mm3 are within normal ranges and do not indicate an immediate concern related to postpartum complications like hemorrhage. Therefore, these results do not warrant immediate reporting to the primary health care provider. Educationally, understanding the significance of laboratory values in postpartum care is crucial for nurses providing care to women during this vulnerable period. Recognizing abnormal values and knowing when to escalate concerns to the healthcare provider can help prevent and manage complications effectively, ensuring the safety and well-being of postpartum patients.

Correct Answer: B

Rationale: The correct answer is B) Orange juice. When a physician orders an iron supplement for a postpartum woman, it is crucial to consider the bioavailability of iron. Iron is better absorbed in the presence of vitamin C, which helps convert iron into a more easily absorbable form. Orange juice is rich in vitamin C, making it an ideal choice to enhance iron absorption from the supplement. Option A) Milk is not the best choice because calcium found in milk can inhibit iron absorption. Calcium competes with iron for absorption in the intestines, reducing the effectiveness of the iron supplement. Options C) Coffee and D) Tea contain compounds known as tannins, which can also interfere with iron absorption. Tannins can bind to iron, forming complexes that are poorly absorbed by the body. Therefore, coffee and tea are not recommended to be taken with iron supplements. In an educational context, understanding the importance of proper iron supplementation in postpartum care is essential for nurses caring for women during this vulnerable period. By knowing which drinks enhance or inhibit iron absorption, nurses can provide evidence-based recommendations to support optimal maternal health and recovery after childbirth. This knowledge empowers nurses to advocate for the best practices in perinatal care and promote positive outcomes for women experiencing perinatal loss.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Dizziness. When a gravid at 36 weeks gestation lies flat on her back, she may experience supine hypotensive syndrome due to compression of the inferior vena cava by the weight of the uterus. This can lead to decreased blood flow returning to the heart, resulting in symptoms like dizziness. A) Hypertension is unlikely in this context as lying flat on the back would not typically cause hypertension. C) Rales (abnormal crackling sounds heard on auscultation of the lungs) are not directly related to the position of the gravid lying flat on her back. D) Chloasma (skin discoloration often seen in pregnant women) is a cosmetic concern and not a direct result of lying on the back. Educationally, it is important for nurses caring for pregnant individuals to understand the physiological changes that occur during pregnancy and how certain positions or actions can impact both the mother and the fetus. This knowledge helps in providing safe and effective care to prevent complications such as supine hypotensive syndrome.

Correct Answer: B

Rationale: In the context of perinatal loss nursing care, it is crucial for educators to ensure that clients have a clear understanding of the role of amniotic fluid and the amniotic sac in pregnancy. Option B, "Fetal nutrients are provided by the amniotic fluid," is the correct answer that indicates the need for further teaching. While amniotic fluid serves various functions, such as providing a cushion against impact and helping regulate fetal temperature, it does not serve as the primary source of fetal nutrients. Fetal nutrients are primarily derived from the placenta through the umbilical cord. Option A, "The amniotic fluid helps to dilate the cervix once labor begins," is incorrect because the amniotic fluid does not play a direct role in cervical dilation. Cervical dilation is primarily influenced by uterine contractions during labor. Option C, "Amniotic fluid provides a cushion against the impact of the abdominal wall," is incorrect because this statement is accurate. Amniotic fluid does act as a cushion, protecting the fetus from external pressure or impact. Option D, "The amniotic sac helps regulate fetal temperature," is incorrect as well. The amniotic sac helps to maintain a stable environment for the fetus by providing protection and space but does not play a significant role in regulating fetal temperature. In an educational context, it is essential to clarify misconceptions and provide accurate information to clients to support their understanding of the physiological processes during pregnancy. By addressing misunderstandings and reinforcing correct information, educators can empower clients to make informed decisions and feel confident in their knowledge about perinatal care.