A pregnant woman who is 24 weeks gestation is experiencing excessive vomiting and dehydration. Which of the following interventions should the nurse prioritize?

Correct Answer: C

Rationale: The correct answer is C, starting intravenous fluids to restore hydration and electrolytes. This is the priority intervention because dehydration during pregnancy can lead to serious complications for both the mother and the baby. By administering IV fluids, the nurse can quickly rehydrate the mother and replenish electrolytes to ensure the well-being of both. Choice A (Administer an antiemetic) may help control vomiting, but addressing dehydration is the primary concern. Choice B (Encourage rest) is important, but without addressing hydration first, rest alone will not resolve the issue. Choice D (Recommend smaller meals) may be helpful in managing nausea, but it does not address the immediate need for hydration and electrolyte balance.

Correct Answer: B

Rationale: The correct answer is B: Eat smaller, more frequent meals and avoid lying down after eating. This recommendation helps prevent acid reflux by reducing the pressure on the stomach and ensuring that the stomach is not overly full. Eating smaller meals more frequently prevents the stomach from becoming too full, which can trigger heartburn. Avoiding lying down after eating helps prevent stomach acid from flowing back into the esophagus. Options A, C, and D are incorrect. Taking antacids after every meal can lead to excessive intake and potential side effects. Drinking water immediately after meals may exacerbate heartburn by diluting stomach acid further. Increasing caffeine intake can worsen heartburn symptoms due to its ability to relax the lower esophageal sphincter.

Correct Answer: C

Rationale: The correct answer is C: to assess fetal heart rate accelerations. An NST is used to monitor the baby's heart rate and movement to ensure adequate oxygen supply. Fetal heart rate accelerations indicate a healthy, responsive baby. Assessing heart rate variability (A) is important but not the primary purpose. Evaluating fetal well-being (B) is broad and doesn't capture the specific focus on heart rate accelerations. Assessing maternal well-being (D) is not the purpose of an NST.

Correct Answer: A

Rationale: The correct answer is A because frequent, regular contractions every 10 minutes or less are a classic sign of preterm labor, indicating the need for immediate medical attention. Decreased fetal movement and back pain (choice B) are not specific signs of preterm labor. Mild cramping and occasional vaginal spotting (choice C) could be normal in pregnancy or may indicate other issues, but they are not definitive signs of preterm labor. Headaches and blurred vision (choice D) are more indicative of preeclampsia, a separate condition from preterm labor. Therefore, choice A is the most accurate and specific sign to include in the teaching plan for preterm labor.

Correct Answer: A

Rationale: The correct answer is A: The patient's blood pressure and hydration status should be assessed first because dizziness and lightheadedness can be indicative of hypotension or dehydration, common issues during pregnancy. Monitoring blood pressure will help determine if the symptoms are related to low blood pressure, and assessing hydration status can identify if the patient needs to increase fluid intake. Summary of other choices: B: Assessing fetal heart rate and activity is important but not the priority in this situation as the focus should be on the maternal health first. C: Checking hemoglobin and hematocrit levels is important for detecting anemia, but it is not the initial assessment for dizziness and lightheadedness. D: Monitoring weight gain and diet history are essential aspects of prenatal care but are not the immediate concerns when a pregnant patient is experiencing dizziness and lightheadedness.