The nurse is caring for a client in labor with meconium-stained amniotic fluid. What is the priority action?

Correct Answer: C

Rationale: In the scenario of a client in labor with meconium-stained amniotic fluid, the priority action is to prepare for potential neonatal resuscitation (Option C). Meconium-stained amniotic fluid indicates potential fetal distress due to the presence of meconium, which can lead to respiratory complications if aspirated by the newborn during delivery. Therefore, being prepared for immediate neonatal resuscitation is crucial to address any respiratory distress or complications that may arise in the newborn. Administering oxygen to the mother (Option A) may be beneficial, but the priority is the well-being of the newborn in this situation. Notifying the healthcare provider (Option B) is important, but immediate action to address potential neonatal complications takes precedence. Increasing IV fluid rate (Option D) is not the priority when dealing with meconium-stained amniotic fluid; the focus should be on the newborn's respiratory status and immediate interventions if needed. In an educational context, understanding the implications of meconium-stained amniotic fluid on the newborn's health and the need for prompt neonatal resuscitation can help nurses provide effective and timely care in labor and delivery settings. Prioritizing actions based on the potential risks to the newborn's health is essential in maternal newborn nursing practice.

Correct Answer: B

Rationale: In the context of pharmacology and maternal newborn nursing, proper management of heartburn during pregnancy is crucial for the well-being of both the mother and the developing fetus. The best advice to give to a client experiencing heartburn during pregnancy is to eat small, frequent meals (Option B). This recommendation helps prevent overeating, which can exacerbate heartburn symptoms by putting pressure on the stomach. By eating smaller meals more frequently, the stomach is not overly distended, reducing the likelihood of reflux and heartburn. Option A, lying down immediately after eating, is incorrect because it can worsen heartburn symptoms due to the horizontal position allowing stomach acid to flow back into the esophagus. Option C, drinking a glass of water with meals, may provide some temporary relief by diluting stomach acid, but it does not address the underlying issue of overeating or stomach distension. Option D, consuming spicy foods to aid digestion, is incorrect as spicy foods can actually trigger or worsen heartburn symptoms in many individuals. Educationally, it is important to emphasize to pregnant clients the significance of dietary modifications in managing common discomforts like heartburn. Teaching about appropriate meal sizes and frequency can empower clients to take control of their symptoms in a safe and effective manner, promoting a healthier pregnancy experience for both mother and baby.

Correct Answer: C

Rationale: In the context of managing gestational diabetes, the best recommendation for managing blood sugar levels is option C: Eat balanced meals and monitor blood sugar levels. This recommendation is crucial as it emphasizes a holistic approach to managing blood sugar levels during pregnancy. Eating balanced meals ensures that the client receives a mix of nutrients, including carbohydrates, which are essential for energy. Monitoring blood sugar levels allows the client to track how different foods affect their blood sugar and make necessary adjustments. This approach promotes stable blood sugar levels, which is vital for the health of both the mother and the baby. Option A, avoiding all carbohydrates, is not recommended as carbohydrates are an important source of energy and nutrients. Completely eliminating them can lead to nutritional deficiencies and is not sustainable in the long term. Option B, exercising for 60 minutes daily, is beneficial for overall health but may not be sufficient on its own to manage blood sugar levels in gestational diabetes. While exercise is important, dietary management and blood sugar monitoring play a more direct role in controlling blood sugar levels. Option D, only taking insulin when blood sugar is high, is not a comprehensive approach to managing gestational diabetes. Relying solely on insulin without addressing dietary factors and monitoring blood sugar levels may not provide optimal control and can lead to fluctuations in blood sugar levels. In an educational context, it is important for nurses to emphasize the importance of a balanced approach to managing gestational diabetes, including proper nutrition, regular monitoring, and, if needed, appropriate medication. Empowering clients with the knowledge and skills to manage their condition effectively can lead to better outcomes for both the mother and the baby.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Assess fetal heart rate and contraction pattern. The priority action for a client at 34 weeks' gestation experiencing regular uterine contractions is to assess the fetal well-being to determine if the contractions are affecting the baby. This assessment helps in identifying any signs of fetal distress or compromise. Option A) Encouraging ambulation may be beneficial in some situations to relieve discomfort, but it is not the priority when fetal well-being is at stake. Option B) Performing a sterile vaginal examination is invasive and not indicated as the initial action in this situation. It could potentially introduce infection or cause further irritation. Option D) Administering an analgesic without assessing the fetal status first could mask important signs of distress in the baby, which could be detrimental. Educationally, understanding the rationale behind the priority actions in maternal newborn nursing is crucial for providing safe and effective care to both the mother and the baby. Assessing fetal well-being in cases of maternal contractions is a fundamental aspect of monitoring and ensuring a positive outcome for both patients.

Correct Answer: B

Rationale: In the postpartum period, the finding that indicates a need for immediate intervention is option B) Lochia rubra with large clots. Lochia rubra is the normal vaginal discharge after childbirth, but the presence of large clots can indicate excessive bleeding or retained placental tissue, which are serious postpartum complications requiring immediate medical attention to prevent hemorrhage and infection. Option A) Fundus firm and midline is a normal finding indicating proper uterine involution, which is expected in the postpartum period. Option C) Perineal pain after delivery is common due to the trauma of childbirth and is managed with pain relief measures. Option D) Slight swelling of the feet can be a normal postpartum symptom due to fluid shifts, but it does not require immediate intervention unless it is severe and associated with other signs of preeclampsia. In an educational context, it is crucial for nurses working in maternal newborn care to recognize abnormal postpartum findings that require immediate intervention to ensure the well-being of the mother. Understanding normal postpartum changes and potential complications is essential in providing safe and effective care to postpartum clients. Regular assessment and early detection of abnormal findings can prevent serious postpartum complications and promote optimal recovery for the mother.