The nurse is assisting with the preparation of a patient admitted for a planned cesarean birth. The patient has signed the consent form and discussed the elected regional anesthesia with the nurse anesthetist. Which is the most important action for the nurse related to anesthesia?

Correct Answer: A

Rationale: Step-by-step rationale for why answer A is correct: 1. NPO status is crucial to prevent aspiration during anesthesia administration. 2. Anesthesia guidelines typically require patients to be NPO for 6-8 hours. 3. Failure to verify NPO status can lead to serious complications. 4. Ensuring NPO status is a fundamental safety measure in anesthesia administration. Summary of why other choices are incorrect: B. Starting an IV and administering fluids are important but not as critical as verifying NPO status for anesthesia safety. C. Administering preoperative medications is important, but ensuring NPO status takes precedence to prevent aspiration. D. Obtaining a fetal heart rate monitor strip is important for monitoring the baby's well-being but does not directly impact anesthesia safety.

Correct Answer: B

Rationale: The correct answer is B because being NPO (nothing by mouth) for 6 to 8 hours before surgery helps prevent aspiration during anesthesia. Option A is incorrect because broad-spectrum antibiotics are typically used to cover a wider range of potential pathogens. Option C is not a medical-based preoperative intervention. Option D, while important, is more related to postoperative care rather than preoperative interventions.

Correct Answer: D

Rationale: Step-by-step rationale for why answer D is correct: 1. The deceleration pattern described, beginning near the acme of the contraction and extending beyond, is associated with uteroplacental insufficiency. 2. Uteroplacental insufficiency indicates a potential problem with oxygen and nutrient delivery to the fetus. 3. This situation requires immediate intervention to improve oxygenation to the fetus. 4. Monitoring alone is not sufficient; action is needed to address the underlying issue. 5. Therefore, the correct nursing action in this situation is to recognize the potential uteroplacental insufficiency and take appropriate measures to address it. Summary of why other choices are incorrect: A: This pattern reflects variable decelerations - Incorrect because the described pattern is not characteristic of variable decelerations. B: Document this Category I fetal heart rate pattern and decrease the rate of the - Incorrect because immediate action is needed in the presence of potential uteroplacental insufficiency.

Correct Answer: B

Rationale: The correct answer is B: Continuous electronic fetal monitoring. This method is most appropriate for a woman with a history of hypertension during pregnancy because it allows continuous monitoring of fetal heart rate patterns and uterine contractions, providing real-time data to detect any signs of fetal distress promptly. Continuous monitoring is crucial in high-risk pregnancies to ensure timely intervention if any issues arise. A: Continuous auscultation with a fetoscope is not ideal for a woman with a history of hypertension as it does not provide continuous monitoring and may miss subtle changes in fetal well-being. C: Intermittent assessment with a Doppler transducer does not offer continuous monitoring, which is essential in high-risk pregnancies like hypertension. D: Intermittent electronic fetal monitoring for 15 minutes each hour is not as effective as continuous monitoring in detecting changes in fetal well-being promptly, which is crucial in cases of hypertension during pregnancy.

Correct Answer: C

Rationale: Rationale for correct answer (C): Recording the normal pattern is indicated because the deceleration pattern mirroring uterine contractions is a reassuring sign of fetal well-being. It indicates a physiologic response to labor. Repositioning the patient (A) is unnecessary as the pattern is normal. Applying a fetal scalp electrode (B) is invasive and unnecessary in this scenario. Administering oxygen (D) is not indicated as the fetal heart rate pattern is normal.