A pregnant woman must have a glucose challenge test (GCT). Which of the following should be included in the preprocedure teaching?

Correct Answer: D

Rationale: The correct answer is D) The test should take one hour to complete. Rationale: The preprocedure teaching for a glucose challenge test (GCT) is crucial for the patient to understand what to expect during the test. The correct answer, D, is essential because it informs the pregnant woman about the expected duration of the test, which is approximately one hour. This information helps the patient plan accordingly and manage their time efficiently on the day of the test. Option A, fasting for 12 hours before the test, is incorrect because a GCT does not require fasting. In fact, fasting can affect the results of the test, leading to inaccurate findings. Option B, bringing a urine specimen to the laboratory on the day of the test, is also incorrect as a GCT does not involve testing urine. The test primarily involves blood samples to measure glucose levels. Option C, being prepared to have 4 blood specimens taken on the day of the test, is incorrect as well. Typically, a GCT requires only one or two blood samples to be drawn at specific time points during the test, not four. Educational context: Understanding the instructions for a GCT is vital for pregnant women as it helps in ensuring accurate test results and a smooth testing experience. By providing clear and accurate preprocedure teaching, healthcare providers can help alleviate anxiety, improve patient compliance, and enhance the overall quality of care provided to pregnant women undergoing this test.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Fundal height. During pregnancy, fundal height measurement is a crucial parameter to monitor fetal growth and development. In this case, the client's complaint of dyspnea when lying flat could be indicative of supine hypotensive syndrome, a condition where the weight of the uterus compresses the inferior vena cava when the mother is lying on her back, leading to decreased venous return and subsequent hypotension. Option A) Maternal hypertension is incorrect as dyspnea when lying flat is not a typical symptom of hypertension. Option C) Hydramnios refers to excessive amniotic fluid, which may present with other symptoms such as abdominal discomfort or rapid uterine growth, but not necessarily dyspnea when lying flat. Option D) Congestive heart failure is less likely in a 36-week pregnant client without a history of cardiac issues. Educationally, understanding the significance of fundal height measurement in monitoring fetal well-being and recognizing signs and symptoms of complications during pregnancy are essential skills for healthcare providers involved in maternity care. It is vital to differentiate between normal discomforts of pregnancy and potential warning signs that require prompt assessment and intervention to ensure the well-being of both the mother and baby.

Correct Answer: D

Rationale: The correct answer is D) How do you feel about having an episiotomy? During labor, it is crucial for the nurse to discuss interventions that may be necessary, such as an episiotomy, with the mother. An episiotomy is a surgical incision made during childbirth to enlarge the vaginal opening. This question is essential as it directly pertains to the woman's birthing experience and involves her in decision-making regarding her care. Option A) Do you plan to breastfeed your baby? While breastfeeding is important, this question is not directly relevant to monitoring the baby during labor. Option B) What do you plan to name the baby? Naming the baby is a personal decision that does not impact the monitoring of the baby during labor. Option C) Which pediatrician do you plan to use? Selecting a pediatrician is important but is not directly related to monitoring the baby during labor. In an educational context, this question highlights the importance of discussing interventions with the mother during labor to ensure her informed decision-making and involvement in her care. By addressing concerns like episiotomy, healthcare providers can provide individualized care and support to mothers during childbirth.

Correct Answer: A

Rationale: In the context of pharmacology and monitoring a baby during labor, the correct answer is A) Promote communication between the couple and health care professionals. This option is the most appropriate because it emphasizes the importance of open communication between the couple and their healthcare providers, which is crucial for ensuring a safe and informed birth experience. Option B) Enable the couple to learn about the types of pain medicine used in labor, while relevant to pharmacology, is not as comprehensive as option A. Knowing about pain medications is important, but effective communication with healthcare professionals encompasses a broader range of topics and considerations. Option C) Provide the couple with a list of items that they should take to the hospital for the labor and delivery, is important for preparedness but does not address the communication aspect highlighted in option A. Option D) Give the high-risk couple a sense of control over the likelihood of having a surgical delivery, while an important consideration for high-risk pregnancies, does not directly address the importance of communication in the birth planning process. Educationally, understanding the significance of effective communication in healthcare settings is essential for both healthcare professionals and patients. Encouraging communication can lead to better outcomes, increased patient satisfaction, and a more personalized approach to care. In the context of pharmacology, clear communication ensures that all parties are well-informed about medication options, potential risks, and benefits during labor and delivery.

Correct Answer: C

Rationale: In the context of monitoring a pregnant woman during labor, the nurse should highlight the presence of petechiae to the healthcare practitioner. Petechiae are small, pinpoint red or purple spots on the skin caused by minor bleeding under the skin's surface. In the context of pregnancy and labor, petechiae can be a sign of complications such as preeclampsia or other bleeding disorders, and therefore warrant immediate attention from the healthcare provider. Linea nigra (Option A) and melasma (Option B) are common skin changes that occur during pregnancy due to hormonal changes. These changes are typically benign and do not pose a direct threat to the health of the mother or baby during labor. Spider nevi (Option D) are also common in pregnancy but are usually harmless and not indicative of any serious underlying medical conditions. Educationally, it is crucial for nurses to understand the significance of different skin changes during pregnancy and labor to identify potential complications early and ensure appropriate interventions are implemented promptly. By highlighting the importance of petechiae as a potential indicator of underlying health issues, nurses can contribute to better maternal and fetal outcomes by facilitating timely medical evaluation and management.