At 0600 while admitting a woman for a scheduled repeat Caesarean section (C-section), the client tells the nurse that she drank a cup of coffee at 0400 because she wanted to avoid getting a headache. Which action should the nurse take first?

Correct Answer: C

Rationale: In this scenario, the correct action for the nurse to take first is to inform the anesthesia care provider (Option C). The client drinking coffee close to the scheduled C-section time is crucial information because caffeine can affect anesthesia. Anesthesia providers need to be aware of any substance consumption that can impact the anesthesia plan to ensure the client's safety during the procedure. Option A (Contact the client's obstetrician) is incorrect because the immediate concern is the impact of caffeine on anesthesia, which falls under the anesthesia provider's purview. Option B (Ensure preoperative lab results are available) is not the priority as the client's recent caffeine intake poses a more urgent issue. Option D (Start prescribed IV with Lactated Ringer's) is not the best initial action as addressing the caffeine intake's potential impact on anesthesia takes precedence. Educationally, this scenario highlights the importance of thorough preoperative assessments and the need to communicate pertinent information promptly to the appropriate members of the healthcare team. It also emphasizes the critical role nurses play in advocating for patient safety by ensuring all relevant details are shared with the anesthesia team for optimal patient outcomes.

Correct Answer: C

Rationale: The correct answer is C) Parental requests that infants be allowed to remain with them rather than in a nursery initiated the practice of family-centered care. Rationale: This statement is correct because the practice of family-centered maternity care was indeed initiated by parental requests for newborns to remain with them rather than being separated in a nursery. This shift in practice emphasized the importance of keeping families together and promoting bonding and attachment between newborns and parents right from the start. Option A is incorrect because the Sheppard-Towner Act of 1921 focused on maternal and infant health but did not specifically promote family-centered care. Option B is incorrect as changes in pharmacologic management of labor are not directly linked to the initiation of family-centered care. Option D is also incorrect as family-centered care was not primarily driven by demands from physicians but rather by the desires and needs of parents and families for greater involvement in maternity care. Educational context: It is important for nursing students to understand the historical context and evolution of family-centered maternity care to provide holistic and patient-centered care. By knowing the origins of this approach, students can appreciate the significance of involving families in the care process and understand the impact it has on maternal, newborn, and family outcomes. This knowledge also helps students to advocate for family-centered care practices in their future nursing roles.

Correct Answer: C

Rationale: The correct answer is C) The woman's support system is encouraged to stay until discharge. In the context of maternity care, having a labor, birth, recovery, and postpartum room where the woman's support system is encouraged to stay provides numerous advantages. This arrangement promotes family-centered care, which has been shown to improve maternal and infant outcomes by fostering emotional support, enhancing bonding, and increasing patient satisfaction. Having a loved one present during labor and birth can reduce anxiety and fear, leading to a more positive birth experience. Additionally, continuous support from a familiar person can help the mother cope with pain and make informed decisions during labor. Option A, stating that the family is in a familiar environment, is also important for promoting a sense of comfort and security during childbirth. However, the primary advantage of an LDRP room is the active involvement and support of the woman's chosen individuals. Option B, suggesting that LDRP rooms are less expensive than traditional hospital rooms, is incorrect as the cost of the room does not determine the quality of care or the benefits of having a support system present. Option D, implying that the infant is removed to the nursery to allow the mother to rest, goes against current best practices that emphasize rooming-in and promoting uninterrupted bonding and breastfeeding between the mother and baby. In conclusion, the correct answer highlights the importance of social support during childbirth, emphasizing the positive impact it can have on the birthing experience and outcomes for both the mother and baby.

Correct Answer: C

Rationale: The correct response, "What concerns you most about a cesarean birth?" (Option C), is the most therapeutic because it demonstrates active listening and empathy towards the patient's fears. By asking this question, the nurse encourages the patient to express their specific worries, enabling a deeper exploration of their concerns and providing a supportive environment for the patient to voice their emotions. This approach shows respect for the patient's feelings and helps build a trusting nurse-patient relationship. Option A ("Everything will be OK.") and Option B ("Don't worry about it. It will be over soon.") are both dismissive responses that invalidate the patient's fears and do not address the underlying concerns. This type of response can make the patient feel unheard and increase their anxiety. Option D ("The physician will be in later and you can talk to him.") does not directly address the patient's immediate fears and does not actively engage in exploring the patient's emotions. While it is important for the patient to speak to the physician, in this scenario, it is crucial for the nurse to address the patient's emotional needs and provide support during a vulnerable moment. In an educational context, it is essential for healthcare professionals to understand the significance of therapeutic communication in building rapport with patients. By actively listening, acknowledging emotions, and asking open-ended questions, nurses can create a supportive environment that promotes patient-centered care and enhances the overall patient experience.

Correct Answer: D

Rationale: The most appropriate goal for the collaborative problem of wound infection is option D, which states "Monitor the patient to detect therapeutic response to antibiotic therapy." This goal is the most suitable because it directly addresses the issue of wound infection by focusing on the effectiveness of the treatment being provided. Option A, "The patient will not exhibit further signs of infection," is not as specific or measurable as option D. It does not provide clear criteria for evaluating the patient's progress towards resolving the infection. Option B, "Maintain the patient's fluid intake at 1000 mL/8 hours," is important for overall patient care but does not directly address the specific issue of wound infection and its treatment. Option C, "The patient will have a temperature of 98.6°F within 2 days," is a specific goal related to fever resolution but may not necessarily reflect the overall resolution of the wound infection. Educationally, it is crucial to understand the importance of setting clear, specific, and measurable goals when addressing patient care issues. Monitoring the patient's response to antibiotic therapy is a critical aspect of managing wound infections to ensure that the treatment is effective and the patient is progressing towards recovery. By focusing on monitoring therapeutic response, healthcare providers can make informed decisions about adjusting treatment plans if necessary to achieve optimal outcomes for the patient.