ATI MATERNAL NEWBORN WITH BEST EXPLANATIONS

ATI MATERNAL NEWBORN WITH BEST EXPLANATIONS
A nurse is assessing aclient whois at 37 weeks of gestation and has suspected pelvic
fracture duetoblunt abdominal trauma. Which of the following findings should the nurse
expect? - Uterine contractions
Rationale:
The nurse should expect the client to beexperiencing 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 thefollowing 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, whichgives 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 outputin 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 anadult client is 30 mL/hr. This can indicate progression of
preeclampsia to preeclampsia with severe features, whichrequires immediate
intervention. Therefore, this is thepriority finding.
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 zidovudinethroughout the pregnancy."
Rationale:
The nurse should inform the client that taking prescription antiviral medication every day
decreases therisk of transmission of HIV to her newborn.
A nurse is caring for a client who is at 32 weeks of gestation and is experiencing preterm
labor. Which ofthe following medications should the nurseplan to administer? -
Betamethasone
Rationale:
The nurse should plan to administer betamethasone IM, a glucocorticoid, to stimulate
fetal lungmaturity and thereby prevent respiratory depression.
adiet teaching for hyperemesis gravidarum
"I will eat foods that taste good instead of balancing my
meals.""I will avoid having a snackbeforeI goto bed
each night."
"I will have acup ofhot tea with each meal."
"I will eliminate products that contain dairy from my diet." - "I will eat foods that taste
good instead ofbalancing my meals."
Clients who have hyperemesis gravidarum should eat foods they like in order to avoid
nausea, ratherthan trying to consumea well-balanced diet.
hyperemesis gravidarum should avoid going to bed with an empty stomach. The nurse
should instructtheclient 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 eachmeal.
do not need toeliminate dairy products from theirdiet. Theclientshould beencouraged to
consumedairy products, because they are less likely to cause nausea than other foods.
performing Leopold maneuvers steps?
- The first step-palpate the client's fundus toidentify the FETAL part.
Second, determine thelocation of thefetal BACK. Third, palpate for the fetal part
presenting at theINLET.
Finally, the nurse should palpate thecephalic prominence to identify the attitude of thehead.
A nurse is reviewing the medical record of a newly admitted client who is at 32 weeks of
gestation. Which of the followingconditions is anindication for fetal assessment using
electronic fetal monitoring?
Oligohydramnios
Hyperemesis
gravidarum
Leukorrhea
Periodic tingling of thefingers - Oligohydramnios
The nurse should identify that oligohydramnios requires further fetal assessment using
electronic fetalmonitoring. 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 fetalmonitoring unless complications occur.
Leukorrhea is a common finding during pregnancy and is not an indication for further fetal
assessmentusing electronic fetal monitoring unless complications occur.
Periodic tingling of the fingers is a common finding during pregnancy and is not an
indication for furtherfetal assessment using electronic fetal monitoring.