ATI Maternal Newborn 2019 B

ATI Maternal Newborn 2019 B A nurse is caring for a client who is at 32 weeks of gestation and is experiencing preterm labor. Which of the following medications should the nurse plan to administer? Betamethasone Rationale: The nurse should plan to administer betamethasone IM, a glucocorticoid, to stimulate fetal lung maturity and thereby prevent respiratory depression. a diet teaching for hyperemesis gravidarum "I will eat foods that taste good instead of balancing my meals." "I will avoid having a snack before I go to bed each night." "I will have a cup of hot tea with each meal." "I will eliminate products that contain dairy from my diet." "I will eat foods that taste good instead of balancing my meals." Clients who have hyperemesis gravidarum should eat foods they like in order to avoid nausea, rather than trying to consume a well-balanced diet. hyperemesis gravidarum should avoid going to bed with an empty stomach. The nurse should instruct the client to eat a healthy snack before going to bed. should alternate liquids and solids every 2 to 3 hr to avoid an empty stomach and over filling at each meal. do not need to eliminate dairy products from their diet. The client should be encouraged to consume dairy products, because they are less likely to cause nausea than other foods. performing Leopold maneuvers steps? The first step- palpate the client's fundus to identify the FETAL part. Second, determine the location of the fetal BACK. Third, palpate for the fetal part presenting at the INLET. Finally, the nurse should palpate the cephalic prominence to identify the attitude of the head. A nurse is reviewing the medical record of a newly admitted client who is at 32 weeks of gestation. Which of the following conditions is an indication for fetal assessment using electronic fetal monitoring? Oligohydramnios Hyperemesis gravidarum Leukorrhea Periodic tingling of the fingers Oligohydramnios The nurse should identify that oligohydramnios requires further fetal assessment using electronic fetal monitoring. Other conditions that require further assessment include hypertension, diabetes, intrauterine growth restriction, renal disease, decreased fetal movement, previous fetal death, post-term pregnancy, systemic lupus erythematosus, and intrahepatic cholestasis. Hyperemesis gravidarum is not an indication for further fetal assessment using electronic fetal monitoring unless complications occur. Leukorrhea is a common finding during pregnancy and is not an indication for further fetal assessment using electronic fetal monitoring unless complications occur. Periodic tingling of the fingers is a common finding during pregnancy and is not an indication for further fetal assessment using electronic fetal monitoring. assessing a pregnant is at the end of the first trimester. Place the Doppler ultrasound stethoscope in which of the following locations to begin assessing for the fetal heart tones FHT? Just above the umbilicus Just above the symphysis pubis The right lower quadrant The left lower quadrant Just above the symphysis pubis At the end of the first trimester of pregnancy, the client's uterus is approximately the size of a grapefruit and is positioned low in the pelvis slightly above the symphysis pubis. Therefore, the nurse should begin assessing for FHT just above the symphysis pubis. Therefore, the nurse might not hear FHT in the right or left lower quadrant. The nurse should assess FHT using the Doppler stethoscope just above the umbilicus if the fetus is in a transverse or breech presentation and the client is at a minimum of 22 weeks of gestation. A nurse is caring for a client who is at 35 weeks of gestation and is experiencing placenta previa. Which should take? Perform a vaginal exam to determine cervical dilation every 2 hr. Instruct the client to ambulate in the hallway once every 4 hr. Administer betamethasone to the client via IM injection. Initiate continuous external fetal monitoring. Initiate continuous external fetal monitoring. The nurse should identify that a client who has a placenta previa and is actively bleeding is at an increased risk for preterm labor and hemorrhage. The nurse should initiate interventions such as bed rest, pelvic rest, and continuous fetal heart monitoring, which assesses fetal well-being and the presence of contractions. The nurse should obtain IV access and monitor laboratory values. Also, the nurse should implement interventions to prepare for an emergency birth. Betamethasone is given to enhance fetal lung maturity for clients who are experiencing preterm labor. It is given to clients between 24 and 34 weeks of gestation. A client who has a placenta previa and is actively bleeding is at an increased risk for preterm labor and hemorrhage. Ambulating frequently could potentially stimulate labor and increase vaginal bleeding. Therefore, the nurse should place the client on bed rest with bathroom privileges. A client who has a placenta previa and is actively bleeding is at an increased risk for preterm labor and hemorrhage. The nurse should place the client on pelvic rest and should not perform vaginal or rectal examinations. A nurse at a prenatal clinic is caring for a client who suspects she may be pregnant and asks the nurse how the provider will confirm her pregnancy. The nurse should inform the client that which of the following laboratory tests will be used to confirm her pregnancy? A urine test for the presence of human chorionic gonadotropin Rationale: Human chorionic gonadotropin is excreted by the placenta and promotes the excretion of progesterone and estrogen. This hormone is the basis for pregnancy testing. A nurse is caring for a client who believes she may be pregnant. Which of the following findings should the nurse identify as a positive sign of pregnancy? Palpable fetal movement rationale: Palpable fetal movements are a positive sign of pregnancy. Quickening, the client's report of fetal movement, is a presumptive sign of pregnancy. Chadwick's sign A nurse is caring for a client who has oligohydramnios. Which of the following fetal anomalies should the nurse expect? Renal agenesis Rationale: Oligohydramnios is a volume of amniotic fluid less than 300 mL during the third trimester of pregnancy and occurs when there is a renal system dysfunction or obstructive uropathy. Absence of fetal kidneys will cause oligohydramnios. A nurse is assessing a client who is at 37 weeks of gestation and has suspected pelvic fracture due to blunt abdominal trauma. Which of the following findings should the nurse expect? Uterine contractions Rationale: The nurse should expect the client to be experiencing uterine contractions due to abdominal trauma. A nurse is assessing a client who is at 12 weeks of gestation and has hyatidiform mole. Which of the following findings should the nurse expect? Dark brown vaginal discharge Rationale: A hydatidiform mole, or a molar pregnancy, is a benign proliferative growth of the chorionic villi, which gives rise to multiple cysts. The products of conception transform into a large number of edematous, fluid-filled vesicles. As cells slough off the uterine wall, vaginal discharge is usually dark brown and can contain grapelike clusters. A nurse is assessing a client who is at 35 weeks of gestation and has preeclampsia without severe features. Which of the following findings should the nurse identify as the priority? 480 mL urine output in 24 hr Rationale: When using the urgent vs. nonurgent approach to client care, the nurse should determine that the priority finding is 480 mL of urine output in 24 hr because the minimum acceptable urine output in an adult client is 30 mL/hr. This can indicate progression of preeclampsia to preeclampsia with severe features, which requires immediate intervention. Therefore, this is the priority finding. 00:0201:44 A nurse is teaching a client who is at 12 weeks of gestation and has HIV. Which of the following statements should the nurse include in the teaching? "You should continue to take zidovudine throughout the pregnancy." Rationale: The nurse should inform the client that taking prescription antiviral medication every day decreases the risk of transmission of HIV to her newborn. A nurse is providing teaching to a client who is at 8 weeks of gestation about the manifestations to report to the provider during pregnancy. Which of the following information should the nurse include in the teaching? Blurred or double vision Rationale: A client who is pregnant should report experiencing blurred or double vision as these could be a manifestation of gestation hypertension or pre-eclampsia. A nurse is caring for a client who is in the latent phase of labor and is receiving oxytocin via continuous IV infusion. The nurse notes that the client is having contractions every 2 min which last 100 t o 110 seconds and that the fetal heart rate (FHR) is reassuring. Which of the following actions should the nurse take? Decrease the dose of oxytocin by half.