Maternal Childs

What type of respirations does the nurse expect to identify in a healthy newborn?

Answer: Rationale:

Which statement made by a pregnant client to a nurse indicates that the client does not understand the teaching about fetal growth and development?

Answer: "The baby gets food from the amniotic fluid." Rationale: The amniotic fluid serves as a protective environment; the fetus depends on the placenta, along with the umbilical blood vessels, for nutrients and oxygen. "The baby is smaller if the mother smokes," "The baby's oxygen is provided by the mother," and "The baby's umbilical cord has two arteries and one vein" are all true statements, and further teaching would not be required.

A nurse is caring for a client with preeclampsia who is receiving intravenous magnesium sulfate therapy. What antidote should the nurse have readily available?

Answer: Calcium gluconate Rationale: Calcium gluconate is the antidote for magnesium sulfate toxicity. Adrenaline is a vasoconstrictor and is not used as an antidote for magnesium sulfate toxicity. Hydrocortisone is a steroid and is not used to counteract magnesium sulfate toxicity. Potassium iodide is not the antidote for magnesium sulfate toxicity. Potassium iodide inhibits the secretion of thyroid hormone and decreases the vascularity of the thyroid gland.

While a mother is inspecting her newborn she expresses concern that her baby's eyes are crossed. How should the nurse respond?

Answer: "This is expected. Your baby is trying to focus." Rationale: Newborns' eye movements are uncoordinated, and the eyes may appear crossed as they try to focus. As the eye muscles mature, the apparent strabismus disappears. Stating that the baby's eyes seem fine discounts the mother's concern and is demeaning. Although it is true that the baby's eyes are crossed, the mother should be given an explanation for the apparent strabismus. Telling the mother that she is right and that the health care provider must be contacted is misinformation that will increase the mother's anxiety.

A nurse in the clinic determines that a 4-day-old neonate who was born at home has a purulent discharge from the eyes. What condition does the nurse suspect?

Answer: Chlamydia trachomatis infection Rationale: Chlamydia trachomatis infection occurs 3 to 4 days after birth; if it is not treated prophylactically with an antibiotic at birth or within 3 days, chronic follicular conjunctivitis with conjunctival scarring will occur. HIV infection in the newborn does not manifest with conjunctivitis. The high oxygen concentrations given to severely compromised preterm infants cause vasoconstriction of retinal capillaries, which can lead to blindness; there are no data to indicate that this infant was preterm, severely compromised, or received oxygen. A chemical conjunctivitis occurs within the first 48 hours and is not purulent.

A married 35-year-old client is to undergo a tubal ligation. The factor in the history that contributes most to the healthy resolution of any emotional problem associated with sterilization is that the client:

Answer: Has a son and daughter and feels that her family is complete. Rationale:Many couples in their 30s who are happy with their families and feel that they are complete choose sterilization as their method of contraception. Sterilization by means of tubal ligation should have no effect on dysmenorrhea, because the hormonal influence does not change. The decision to undergo sterilization should not be made by others, only by the woman herself. Decisions regarding sterilization should not be made during pregnancy or in the immediate postpartum period, especially if the client is stressed.

A mother is concerned that her newborn will be exposed to communicable diseases when she goes home. While teaching the mother ways to decrease the risk of Infection; what type of immunity should the nurse explain was transferred to her baby through the placenta?

Answer: Passive Natural Rationale: Passive natural immunity is developed from an antigen-antibody response in the mother that is transmitted to the fetus. Active natural immunity is acquired by an individual in response to a disease or an infection. Active artificial immunity is acquired by an individual in response to small amounts of antigenic material (e.g., vaccination). Passive artificial immunity is conferred by the injection of antibodies prepared in another host.

A client in her 30th week of gestation is in preterm labor, and the practitioner prescribes betamethasone (Celestone). The client asks the nurse why she is being given this drug. As a basis for the response the nurse takes into consideration that it:

Answer: Promotes neonatal pulmonary maturity Rationale: Betamethasone (Celestone), a corticosteroid, accelerates lung maturity and reduces intravascular hemorrhage and necrotizing enterocolitis in the preterm neonate if given 24 hours before birth. Chorioamnionitis is treated with antibiotic therapy; this problem may occur if the membranes rupture prematurely and birth does not occur within 24 hours. Corticosteroids do not have an effect on uteroplacental exchange. Respiratory distress syndrome (RDS) develops in the neonate, not the fetus; if betamethasone is given to the mother 24 hours before a preterm birth, the severity and incidence of RDS in the neonate should decrease.

A client is to undergo amniocentesis at 38 weeks' gestation to determine fetal lung maturity. What lecithin/sphingomyelin ratio (L/S ratio) is adequate for the nurse to conclude that the fetus' lungs are mature enough to sustain extrauterine life?

Answer: The lecithin concentration increases abruptly at 35 weeks, reaching a level that is twice the amount of sphingomyelin, which decreases concurrently. At 30 to 32 weeks' gestation, the amounts of lecithin and sphingomyelin are equal, indicating lung immaturity. A ratio of 1:4 does not reflect fetal lung maturity; nor does a ratio of 3:4. Rationale: The lecithin concentration increases abruptly at 35 weeks, reaching a level that is twice the amount of sphingomyelin, which decreases concurrently. At 30 to 32 weeks' gestation, the amounts of lecithin and sphingomyelin are equal, indicating lung immaturity. A ratio of 1:4 does not reflect fetal lung maturity; nor does a ratio of 3:4.

A nurse places a newly admitted client with worsening preeclampsia in a private room. Why is it important for this client to be in a nonstimulating environment?

Answer: The probability of tonic-clonic seizures is reduced. Rationale: Even minimal sensory stimuli can trigger an exaggerated cerebral response such as seizures; therefore a nonstimulating environment is most therapeutic. Women with preeclampsia do not have respiratory problems. Although respiration may become depressed with magnesium sulfate therapy, a quiet environment will have no effect on respiration. A nonstimulating environment does not reduce the severity of headaches resulting from hypertension and has no relationship to the effects of antihypertensive drugs.