NUR 418 - MATERNITY- STUDY GUIDE with rationales correctly explained 2024/2025

NUR 418 - MATERNITY- STUDY GUIDE with rationales correctly explained 2024/2025

NUR 418 maternity 02
1-When making assignments in the obstetrical unit, the charge nurse should assign the most
experienced staff nurse to which client?
1. G1P0 reporting a small amount of pink vaginal discharge
2. G2P1 reporting rupture of membranes with greenish fluid
3. G3P2 at 7 cm dilation, 100% effacement
4. G4P2 with bilateral +1 pitting ankle edema
Explanation:
If a client reports green amniotic fluid, the nurse should suspect meconium-stained amniotic fluid.
Meconium is the fetal gastrointestinal contents, including toxins and waste, accumulated during
pregnancy. Green or yellow amniotic fluid indicates that the fetus has passed the first stool
(meconium) in utero.
Meconium is toxic to the lungs, and its presence in the amniotic fluid places the newborn at high risk
for meconium aspiration syndrome, a type of aspiration pneumonia. Birth will require a neonatal
resuscitation team capable of endotracheal intubation and suctioning. Endotracheal suctioning is
indicated if the baby has depressed respirations, decreased muscle tone, or heart rate <100/min.
(Option 1) Bloody show is usually pink and is described as "sticky" due to its mucoid nature. It is an
expected finding with labor progression. Light
spotting or brownish discharge may also be an
expected finding following vaginal examination or
recent intercourse due to cervical trauma.
However, spontaneous bright red bleeding is not
normal.
(Option 3) Cervical dilation and effacement are
signs of labor progression. This client does not
exhibit any concerning signs of potential
complications.
(Option 4) Dependent edema is an expected
finding in pregnant clients. Edema is no longer
included in the definition of preeclampsia due to
its prevalence in healthy pregnancies. Defining
characteristics include increased blood pressure
after 20 weeks gestation with proteinuria in a
previously normotensive client.
Educational objective:
Green amniotic fluid indicates the presence of
meconium. Meconium aspiration is considered
an obstetrical emergency requiring a skilled
neonatal resuscitation team.
2-A neonate is born with exstrophy of the bladder. Which intervention would be appropriate for the
nurse to complete first?
1. Cover the bladder with petroleum jelly gauze
2. Insert a urinary catheter into the bladder
NUR 418 maternity 02
3. Place a protective film over the bladder
NUR 418 maternity 02
4. Prepare the neonate for immediate surgery
Explanation:
Bladder exstrophy is a congenital disorder in which the bladder was not developed in the abdominal
cavity during fusion in the embryo and is exposed externally. The priority before surgical repair is to
prevent injury. Placing a protective film of plastic (Saran wrap) over the exposed bladder will keep
the tissue moist and help prevent infection.
(Option 1) Petroleum jelly in the gauze may be irritating to the delicate bladder tissue and should be
avoided.
(Option 2) Inserting a urinary catheter is not an