The nurse is monitoring a client at 36 weeks' gestation with suspected polyhydramnios. What complication is associated with this condition?

Correct Answer: C

Rationale: In the case of a client at 36 weeks' gestation with suspected polyhydramnios, the complication associated with this condition is cord prolapse (Option C). Polyhydramnios refers to an excess of amniotic fluid, which can increase the risk of cord prolapse during labor and delivery. Cord prolapse occurs when the umbilical cord slips through the cervix ahead of the baby, which can lead to compression of the cord and compromise fetal blood flow and oxygenation. Option A, preterm labor, is not directly associated with polyhydramnios. Preterm labor refers to the onset of labor before 37 weeks of gestation due to various reasons, but not specifically linked to polyhydramnios. Option B, placenta previa, involves the abnormal placement of the placenta over or near the cervical opening, causing bleeding during labor. While placenta previa is a potential complication in pregnancy, it is not directly related to polyhydramnios. Option D, gestational hypertension, is characterized by high blood pressure during pregnancy and can lead to complications such as preeclampsia. While gestational hypertension is a significant concern in pregnancy, it is not the primary complication associated with polyhydramnios. Educationally, understanding the complications of polyhydramnios is crucial for nurses caring for pregnant clients. Recognizing the risks associated with this condition allows for prompt intervention and management to ensure the best outcomes for both the mother and the baby. Monitoring for potential complications like cord prolapse in cases of polyhydramnios is essential for providing safe and effective care during labor and delivery.

Correct Answer: C

Rationale: In the context of preparing a client for induction of labor, the primary purpose of administering oxytocin is to strengthen uterine contractions (Option C). Oxytocin is a hormone that acts on the smooth muscle of the uterus, causing it to contract. This helps to initiate and progress labor by promoting regular and coordinated contractions, leading to cervical effacement and dilation, ultimately resulting in the delivery of the baby. Option A, enhancing cervical dilation, is not the primary purpose of administering oxytocin. While oxytocin can contribute to cervical dilation indirectly by promoting uterine contractions, its main role is to stimulate uterine muscle activity. Option B, increasing maternal blood pressure, is not a function of oxytocin in the context of labor induction. Oxytocin's effects are primarily focused on the uterus and its contractile activity. Option D, preventing postpartum hemorrhage, is not the primary purpose of administering oxytocin for labor induction. Oxytocin is commonly used after delivery to help prevent postpartum hemorrhage by promoting uterine contraction and controlling bleeding, but its main role during labor induction is to stimulate uterine contractions to initiate labor. Understanding the specific pharmacological actions of oxytocin in labor induction is crucial for nurses caring for women undergoing this process. It is important for nurses to be knowledgeable about the indications, actions, and potential side effects of medications used in obstetric care to ensure safe and effective management of labor and delivery.

Correct Answer: C

Rationale: In this scenario, the correct answer is option C: Pulmonary hypoplasia. Oligohydramnios, which is a condition characterized by a decreased amount of amniotic fluid surrounding the fetus, can lead to various complications. Pulmonary hypoplasia is a significant concern in cases of oligohydramnios because amniotic fluid plays a crucial role in fetal lung development. Adequate levels of amniotic fluid are necessary for the normal growth and expansion of the fetal lungs. When oligohydramnios is present, there is a risk of underdeveloped or hypoplastic lungs, which can result in respiratory distress for the newborn after birth. Now, let's discuss why the other options are incorrect: A) Fetal macrosomia: This condition refers to a large baby at birth, which is not directly associated with oligohydramnios. Fetal macrosomia is more commonly linked to maternal conditions like gestational diabetes. B) Cord prolapse: Cord prolapse occurs when the umbilical cord slips through the cervix ahead of the baby. While oligohydramnios can increase the risk of cord compression, it is not directly associated with cord prolapse. D) Placenta previa: Placenta previa is a condition where the placenta partially or completely covers the cervix, which can lead to bleeding during pregnancy. Oligohydramnios is not a typical complication of placenta previa. In an educational context, understanding the implications of oligohydramnios on fetal development is crucial for healthcare providers caring for pregnant women. This knowledge helps in identifying potential complications, providing appropriate interventions, and ensuring the best possible outcomes for both the mother and the baby. It underscores the importance of prenatal monitoring and timely interventions to address conditions that can impact fetal well-being.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Ensure signed informed consent is on file. The priority action before any procedure, especially a cesarean delivery, is to ensure that the patient has provided informed consent. This is crucial because it upholds the principles of autonomy and ensures that the patient is aware of the risks, benefits, and alternatives to the procedure. Option A) Obtain baseline maternal vital signs is important but not the priority when compared to ensuring informed consent. Vital signs can be obtained after ensuring the patient's readiness for the procedure. Option B) Assisting with positioning for spinal anesthesia is also important for the procedure but is not as critical as confirming informed consent. Option C) Verifying fetal heart tones before the procedure is essential, but it should not take precedence over ensuring informed consent. Educationally, this question highlights the significance of informed consent in healthcare practice. It emphasizes the nurse's role in advocating for the patient's right to make informed decisions about their care. By prioritizing informed consent, nurses demonstrate respect for the patient's autonomy and uphold ethical standards in healthcare delivery.

Correct Answer: B

Rationale: In caring for a client with gestational diabetes during labor, the nurse should monitor for the complication of macrosomia, which is the correct answer (B). Macrosomia refers to a condition where the baby is significantly larger than average, often due to excessive glucose crossing the placenta. This poses risks during labor, such as shoulder dystocia and birth injuries. Placental abruption (A) is a separation of the placenta from the uterine wall before delivery, which is not directly linked to gestational diabetes. Preterm labor (C) is premature contractions leading to early delivery, not specifically associated with gestational diabetes. Postpartum hemorrhage (D) is excessive bleeding after childbirth and can occur in any laboring woman, not solely those with gestational diabetes. Educationally, understanding the implications of gestational diabetes on labor and delivery outcomes is crucial for nurses caring for these clients. Monitoring for complications like macrosomia allows for timely interventions to ensure the safety of both the mother and the baby. Nurses need to be knowledgeable about the specific risks and complications associated with gestational diabetes to provide optimal care during labor and delivery.