26 Questions
What emergency intervention should the nurse implement when signs of umbilical cord compression are present, and a portion of the cord can be felt in the vagina?
Place a gloved hand in the vagina and put upward pressure on the presenting part to keep it off the cord
What intervention is most important when caring for a client with confirmed breech presentation by ultrasound?
Continuing to monitor maternal and fetal status
If a woman with a history of crack cocaine use disorder experiences sudden fetal bradycardia, an irregular abdominal wall contour, and acute continuous abdominal pain, what condition would the nurse suspect?
Uterine rupture
What is the purpose of counting fetal movements beginning at 28 weeks' gestation?
To assess the baby's readiness for birth
If a mother who just delivered via cesarean has a history of controlled atrial fibrillation, which assessment finding should the nurse prioritize?
Jugular distention
What can cause anemia in pregnancy that is most commonly encountered?
Iron-deficiency anemia
If a 32-year-old woman with epilepsy wants to have children, what should be prioritized in her care?
Adjusting her epilepsy medications
What procedure might be needed during the third trimester to assess fetal lung maturity?
Amniocentesis
In what situation might a mother delivering a large baby via cesarean be at risk of needing this type of birth?
If she has gestational diabetes
What is the primary concern with marijuana use during pregnancy?
It could impact fetal neurologic development
For a pregnant client with a disability, what should be the nurse's initial action?
Explore the impact of the disability on lifestyle
What aspect of care should a nurse emphasize when reviewing a prenatal visit report for a 41-year-old client?
Genetic testing options
Which statement best reflects the potential risks of marijuana use during pregnancy?
It can impair fetal neurodevelopment
What is the nurse's most appropriate response to a pregnant client considering using marijuana for nausea?
"Marijuana use is not recommended due to fetal risks"
For a pregnant client with multiple sexual partners and HIV, what should be the nurse's immediate focus?
Facilitating access to HIV medication
What is the most common cause of miscarriage in the first trimester?
Chromosomal defects in the fetus
Which medication is typically prescribed for an unruptured ectopic pregnancy?
Methotrexate
What advice would a nurse give to a woman experiencing bleeding during pregnancy?
Please come in now for an evaluation by your health care provider
What should a woman do if she has been in labor at 34 weeks gestation?
Immediately rush to the hospital for medical attention
In a spontaneous abortion at 10 weeks' gestation, what would not be a likely cause?
Advanced maternal age
What is the most appropriate action for the nurse to take when the doctor states that the cord is palpable during a vaginal examination?
Call for help and prepare the client for an emergency cesarean birth
Which statement about maternal risks and benefits of cesarean birth would not be accurate to include in counseling?
"A surgical incision may be made at the perineum to enlarge the vagina just before the birth of the baby"
Which complication is NOT typically associated with a cesarean birth?
Shoulder dystocia
If a client expresses feelings of failure after needing a cesarean birth due to cephalopelvic disproportion, how should the nurse respond?
"Cesarean births are common and necessary in some situations. Your baby's well-being is what matters the most"
What would be the correct intervention if a pregnant client is 9 cm dilated with a 100% effaced cervix and a -3 station fetus, and the cord becomes palpable during examination?
Prepare for an imminent vacuum-assisted delivery
During a cesarean birth, what maternal complication is more likely to require a hysterectomy?
Severe hemorrhage
Study Notes
Umbilical Cord Compression
- In case of umbilical cord compression, the nurse should place a gloved hand in the vagina and apply upward pressure on the presenting part to keep it off the cord.
- This emergency intervention helps to relieve cord compression and prevent fetal distress.
Breech Presentation
- When caring for a client with a breech presentation, it is essential to continue monitoring maternal and fetal status.
- The nurse should also consider applying suprapubic pressure against the fetal back to help facilitate a successful vaginal birth.
Fetal Distress
- Sudden onset of fetal bradycardia, irregular abdominal wall contour, and continuous abdominal pain may indicate uterine rupture.
Diabetes in Pregnancy
- Elevated blood sugars in the mother do not necessarily promote faster lung maturation in the fetus.
- Amniocentesis may be necessary during the third trimester to assess fetal lung maturity.
Postpartum Care
- After a cesarean delivery, the nurse should prioritize assessing the mother for nausea, vomiting, urinary retention, and jugular distension.
- Abdominal cramps are a common postpartum complaint, but the nurse should be aware of potential complications.
Anemia in Pregnancy
- Iron-deficiency anemia is the most common cause of anemia in pregnancy.
Epilepsy and Pregnancy
- Women with epilepsy can have a healthy pregnancy with proper planning and medication adjustments.
- The nurse should emphasize the importance of folate-rich foods in the diet to prevent birth defects.
Marijuana Use in Pregnancy
- Marijuana use during pregnancy is not recommended due to potential risks to fetal neurologic development.
Prenatal Care for Clients with Disabilities
- The nurse should prioritize establishing an open communication channel and offering guidance on care measures during pregnancy.
Bleeding in Pregnancy
- Vaginal bleeding during pregnancy can be caused by various factors, some of which may be harmless.
- The nurse should reassure the client that the bleeding may not be caused by anything she did or did not do.
Spontaneous Abortion
- Chromosomal defects in the fetus are the most common cause of miscarriage in the first trimester.
Preeclampsia
- Clients with preeclampsia should be instructed to report symptoms such as blurred vision, dizziness, and sinus headaches to their healthcare provider.
Ectopic Pregnancy
- Methotrexate is commonly prescribed to treat unruptured ectopic pregnancies.
Labor and Delivery
- If the umbilical cord is palpable during labor, the nurse should prepare for an emergency cesarean birth.
- Clients who experience a cesarean birth should be counseled on the risks and benefits, including potential complications such as infection and hemorrhage.
Cesarean Birth
- A surgical incision may not be made at the perineum to enlarge the vagina during a cesarean birth.
Emotional Support
- The nurse should provide emotional support to clients who may feel like they have failed if their birth plan does not go as expected.
Test your knowledge on postpartum assessment and care with a focus on maternal and neonatal well-being. This quiz includes questions about monitoring baby's lung development, potential complications such as large birth weight, timing of procedures like amniocentesis, and postpartum care after cesarean delivery.
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