What factor is known to increase the risk of gestational DM?

Correct Answer: D

Rationale: A previous diagnosis of type 2 diabetes is a known risk factor for developing gestational diabetes mellitus (GDM). Women who have had diabetes prior to pregnancy are more likely to develop GDM due to pre-existing insulin resistance. This increased risk is why healthcare providers closely monitor pregnant women with a history of type 2 diabetes. It is important for these women to manage their blood sugar levels carefully during pregnancy to reduce the risk of complications for both the mother and the baby.

Correct Answer: B

Rationale: Based on the information provided, the patient is experiencing regular contractions 2 minutes apart lasting 60 seconds, and she had a bloody show earlier in the morning. These signs in a multiparous patient with 6 hours of labor indicate she is most likely in the transition phase of labor. The transition phase is characterized by intense contractions that are closer together, typically 2-3 minutes apart, and lasting longer, usually around 60-90 seconds. This stage signifies the progression towards the final stages of labor, leading up to the pushing stage and delivery. Therefore, the correct answer is B, Transition phase.

Correct Answer: A

Rationale: In the scenario presented, the nurse's priority action should be to call for emergent medical assistance. A woman with a rupture during a nursing assessment could be experiencing a serious complication known as umbilical cord prolapse. This occurs when the umbilical cord slips through the cervix ahead of the baby, which can lead to compression of the cord and a serious decrease in oxygen supply to the baby. It is a medical emergency that requires immediate intervention by the healthcare team, which may include moving the mother into a knee-chest position or performing a cesarean section. Therefore, the priority action for the nurse is to ensure prompt medical intervention to protect the well-being of both the mother and the baby.

Correct Answer: A

Rationale: Narcotic analgesia, when administered to a laboring patient, can cross the placenta and affect the infant. It can cause neonatal respiratory depression in the newborn after delivery. This is because the medication can depress the respiratory drive of the infant, leading to potentially serious breathing problems. It is important for the healthcare provider to closely monitor and assess the newborn for signs of respiratory distress in such cases.

Correct Answer: A

Rationale: The correct statement explaining how a newly delivered baby initiates respiration is "Chemical thermal and mechanical factors." When a baby is born, various factors come into play to stimulate the baby's first breath. Chemically, the baby senses a decrease in oxygen and an increase in carbon dioxide levels, triggering the respiratory centers in the brain to start the breathing process. Thermally, exposure to the cooler air outside the womb stimulates the baby's skin receptors, encouraging the baby to take a breath. Mechanically, the pressure changes during delivery and the physical stimulation of the baby's face and body also play a role in initiating respiration. Overall, it is the combined effect of these chemical, thermal, and mechanical factors that help a newly delivered baby begin breathing independently.