Which will indicate a concealed hemorrhage in an abruptio placenta?

Correct Answer: A

Rationale: A concealed hemorrhage in abruptio placentae, also known as a concealed retroplacental hematoma, can cause rapid, significant bleeding behind the placenta with limited visible external bleeding. This internal bleeding can lead to significant blood loss and can cause the uterus to become tense and firm, resulting in a hard board-like abdomen upon palpation. This clinical sign is a key indicator of a concealed hemorrhage in abruptio placentae and should prompt immediate medical attention to prevent maternal and fetal complications. The other choices, such as decreased fundal height, bradycardia, and decreased abdominal pain, are not typically associated with a concealed hemorrhage in abruptio placentae.

Correct Answer: A

Rationale: The correct first action when a delivering patient's water breaks is to check the fetal heart tone. This is important to assess the well-being of the baby and ensure there are no signs of distress. Once the fetal heart tone is confirmed, the nurse can proceed with notifying the physician, changing bed linen, and encouraging the mother to go for a walk as needed. But the priority should always be to assess the fetal well-being in such a situation.

Correct Answer: A

Rationale: The most important nursing action to undertake at this time is obtaining a fetal heart rate (FHR) assessment. Monitoring the FHR is crucial during labor to assess the well-being of the baby and detect any signs of fetal distress. This information helps guide the healthcare team in determining the appropriate course of action to ensure the safety of both the mother and baby. It takes precedence over other tasks such as completing a sterile vaginal exam, assessing the odor of amniotic fluid, performing Leopold's maneuver, or obtaining pain medication orders. Monitoring the FHR should be the immediate priority in this situation.

Correct Answer: A

Rationale: In the context of newborn care, understanding the modes of heat loss in infants is crucial for maintaining their thermoregulation and preventing complications. Radiation is the transfer of heat from the baby to a cooler surface without direct contact. This mode of heat loss is significant in newborns due to their large body surface area to mass ratio. Conduction involves the transfer of heat from the baby to a cooler surface through direct contact. This can occur when placing the baby on a cold surface without adequate insulation. Convection is the loss of heat from the baby to the surrounding air. Air movement can enhance this process, leading to increased heat loss. Perspiration, as mentioned in option D, is not a significant mode of heat loss in newborns. Newborns have immature sweat glands and do not sweat effectively for thermoregulation. Educationally, understanding these modes of heat loss is essential for healthcare providers working with newborns to implement appropriate interventions to maintain their body temperature within a normal range, which is crucial for their overall well-being.

Correct Answer: B

Rationale: In pharmacology, understanding the ACC/AHA guidelines for assessing cardiovascular risk is crucial for providing safe and effective care, especially in maternal newborn settings. Option B is correct because it includes comprehensive factors recommended by the guidelines. Age, sex, race, cholesterol levels, blood pressure, medication use, diabetes status, and smoking status are all key determinants of cardiovascular risk. Option A is incorrect as it lacks crucial indicators like cholesterol levels and medication use. Option C is also incorrect as it focuses only on a few factors, omitting key variables like cholesterol levels and medication use. Option D is incorrect as it excludes important risk factors such as cholesterol levels, blood pressure, and diabetes status. Educationally, this question highlights the importance of a holistic approach to assessing cardiovascular risk, especially in vulnerable populations like pregnant individuals. Understanding these guidelines is essential for pharmacology students and healthcare professionals to make informed decisions regarding cardiovascular health and medication management in maternal newborn care.