The nurse is monitoring a pregnant client with suspected gestational hypertension. What finding confirms the diagnosis?

Correct Answer: B

Rationale: In the context of maternal newborn nursing and pharmacology, the correct answer to the question is option B: Blood pressure of 140/90 mmHg on two occasions. This finding confirms the diagnosis of gestational hypertension. Gestational hypertension is characterized by elevated blood pressure readings during pregnancy. A blood pressure reading of 140/90 mmHg or higher on two separate occasions after 20 weeks of gestation is indicative of gestational hypertension. Option A, proteinuria, is a symptom of preeclampsia, not gestational hypertension. While proteinuria can be present in some cases of gestational hypertension, it is not the defining diagnostic criterion for this condition. Option C, edema of the hands and feet, is a common symptom in pregnancy but is not specific to gestational hypertension. Edema alone is not sufficient to confirm the diagnosis of gestational hypertension. Option D, elevated blood glucose levels, is more indicative of gestational diabetes rather than gestational hypertension. Gestational diabetes is a separate condition characterized by high blood sugar levels during pregnancy. It is essential for nurses caring for pregnant clients to understand the diagnostic criteria for gestational hypertension to provide timely and appropriate care. Monitoring blood pressure levels regularly, especially after 20 weeks of gestation, is crucial in identifying and managing gestational hypertension to prevent adverse outcomes for both the mother and the baby.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) This is common due to fetal descent. Rationale: - Lower abdominal pressure and frequent urination at 36 weeks are common symptoms due to the descent of the fetal head into the pelvis, known as engagement or lightening. This physiological process occurs as the baby prepares for birth. - Preterm labor (Option A) typically presents with regular contractions, lower back pain, and sometimes vaginal bleeding. It is crucial to differentiate between normal signs of pregnancy progression and potential signs of preterm labor to ensure appropriate interventions and monitoring. - Urinary tract infections (Option B) may present with symptoms like burning sensation during urination, cloudy urine, and strong-smelling urine. While pregnant women are more susceptible to UTIs, the symptoms described in the question are more related to fetal descent. - Braxton Hicks contractions (Option D) are irregular, painless contractions that can occur throughout pregnancy. While they may cause some discomfort, they are not typically associated with lower abdominal pressure and frequent urination at 36 weeks. Educational context: Understanding the physiological changes that occur during late pregnancy is crucial for maternal newborn nurses to provide accurate information, support, and care to pregnant clients. Educating clients about common signs and symptoms of pregnancy progression versus potential complications like preterm labor or infections empowers them to make informed decisions about their health and well-being.

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.