A mom is 11 weeks pregnant and affords for her first prenatal care visit. Which take a look at is
the maximum appropriate?
1. Hemoglobin A1c
2. Triple screen
three. Coombs Test
four. Amniocentesis - ANS-1. Hemoglobin A1c
Hemoglobin A1C test monitors for gestational diabetes. This take a look at is recommended for
all pregnant girls at the primary prenatal check. Triple display screen is a blood look at
accomplished among 15 & 20 weeks gestation that detects chromosomal abnormalities. The
indirect Coombs take a look at displays maternal blood for anti-RBC antibodies. Amniocentesis
is needle aspiration of fluid from the sac to come across fetal abnormalities.
A nurse gives fentanyl 50 mcg IV for a patient in exertions. Which fetal coronary heart rate
pattern have to the nurse assume?
1. Decreased variability
2. Variable decelerations
three. Late decelerations
four. Early decelerations - ANS-1. Decreased variability
Rationale: Fentanyl may purpose reduced fluctuations inside the baseline fetal heart charge;
Fentanyl crosses the placenta and is a CNS depressant. Early decelerations have an onset
before the peak of the contraction and result from fetal head compression.
A nurse is worrying for a affected person undergoing augmentation of labor. The nurse notes 3
consecutive late decelerations on the fetal display. Which motion must the nurse take?
1. Increase infusion of lactated ringer's solution
2. O2 mask at 10 L
3. Place affected person on left facet
four. Turn off infusion of oxytocin (Pitocin) - ANS-4. Turn off infusion of oxytocin (Pitocin)
Rationale: Fetal hypoxia is treated with measures to boom oxygen waft to fetus, consisting of
increasing fluids, oxygen, turning off pitocin, and placing the mother within the left lying function.
A nurse is caring for patients on the postpartum unit. Which patient is highest hazard for
postpartum hemorrhage?
1. Patient who received fundal rub down
2. Patient with engorged breasts
three. Patient who offers oxytocin
4. Patient with a distended bladder - ANS-4. Patient with a distended bladder
Rationale: A distended bladder will displace uterus to left or proper and may prevent the uterus
from fully contracting. An episiotomy can reason pain however isn't always a danger factor for
hemorrhage. Fundal rubdown helps lessen postpartum bleeding.
, A nurse is instructing a patient on signs and signs of hard work. Teaching was powerful if the
affected person says which?
1. I will name my health practitioner after I experience accelerated pelvic stress.
2. I will name my medical doctor after I bypass my mucous plug.
Three. I will call my health practitioner while my contractions arise each five minutes for an hour.
4. I will call my physician when I have bloody display. - ANS-three. I will name my physician
when my contractions arise every five minutes for 1 hour.
Rationale: Contractions that arise often for an hour suggest the onset of labor. True hard work
causes contractions which can be everyday with decreasing intervals among contractions,
contractions boom in intensity and length, and the cervix dilates and effaces. Contractions every
three to four minutes are a sign of active exertions. Blood show happens 24-forty eight hours
before the onset of labor. Lightening happens when the fetus settles into the pelvic inlet and
generally happens 2 weeks earlier than exertions.
A nurse is reviewing her assignments. Which affected person must she assess first?
1. A 12-hour infant who is small for gestational age.
2. Four hour toddler with a cardiac disorder.
Three. Nine hour vintage infant who has no longer voided
four. Three day vintage little one expecting discharge - ANS-2. Four hour infant with a cardiac
defect
Rationale: The infant with a cardiac disorder is at the maximum chance for complications and
must be assessed first.
A nurse notes that a time period affected person in labor is having past due decelerations. Why
have to the nurse notify the doctor?
1. Utero-placental insufficiency
2. Fetal distress
3. Impending delivery
four. Cord Compression - ANS-1. Utero-placental insufficiency
Rationale: Late decelerations are due to uteroplacental insufficiency. Cord compression reasons
variable decelerations. Impending transport is signaled by using crowning of the fetal head.
A patient has meconium-stained amniotic fluid. Fetal scalp sampling indicates a blood pH of
seven.12 and fetal bradycardia is present. Based on those findings, the nurse should take which
action?
1. Administer amnioinfusion.
2. Prepare for cesarean phase.
3. Reposition the patient.
4. Start IV as prescribed. - ANS-2. Prepare for cesarean segment.
Rationale: Infants with meconium-stained amniotic fluid may additionally have respiratory
problems and bradycardia at start. Based in this evaluation, fetal metabolic acidosis is gift.
These findings pose a first-rate threat to the new child's properly-being. A cesarean section is
needed. Amnioinfusion is an infusion of sterile isotonic solution into the uterine hollow space
throughout labor to lessen umbilical wire compression. This is likewise achieved to dilute