A 33-year-old woman is in active labor. What should the nurse's next action be if the client's white blood cell (WBC) count is 25,000/mm3?
Normal WBC Range: 5,000-10,000/mm3
Immediately inform the health care provider
Repeat CBC STAT
Immediately begin antibiotic therapy
Recognize that this count is an acceptable range for labor and continue to monitor
The Correct Answer is D
A. Informing the healthcare provider immediately is not necessary in this case because the elevated WBC count is expected during active labor. Although WBC counts are normally 5,000–10,000/mm³, physiological leukocytosis occurs in pregnancy and especially in labor, often reaching 20,000–30,000/mm³ due to stress and the inflammatory response.
B. Repeating a CBC STAT is not required unless there are other signs of infection or clinical deterioration. A WBC of 25,000/mm³ alone, in the absence of fever, foul-smelling discharge, or other symptoms, is typically a normal labor-related change.
C. Beginning antibiotic therapy immediately is unnecessary without evidence of infection such as fever, uterine tenderness, or positive cultures. Administering antibiotics based solely on leukocytosis could lead to unnecessary medication exposure.
D. Recognizing that this count is an acceptable range for labor and continuing to monitor is correct. Physiologic leukocytosis during active labor can elevate WBC counts to 25,000–30,000/mm³. The nurse should continue routine assessment and monitor for any signs of infection, but no immediate intervention is needed solely for this laboratory value.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","D","E"]
Explanation
A. Maintain euglycemia is the most important preconception recommendation for women with pregestational diabetes. Achieving optimal blood glucose control before conception and during early pregnancy significantly reduces the risk of congenital anomalies, spontaneous abortion, and other maternal-fetal complications.
B. Increasing weight by 45 pounds is incorrect. Excessive weight gain is not recommended prior to conception. Weight should be optimized based on BMI and individual health status, not arbitrary high gain. Overweight or obesity can worsen insulin resistance and increase pregnancy risks.
C. Weight loss of at least 40% is unrealistic and unnecessary. Modest, goal-directed weight loss before conception may improve glycemic control, but an extreme reduction like 40% of body weight is unsafe and not recommended.
D. Workout at least 3 times a week is recommended to improve insulin sensitivity, maintain a healthy weight, and support cardiovascular health. Physical activity is a safe and effective strategy for preconception glycemic management unless contraindicated.
E. Dietary management is critical in diabetes care. A balanced, individualized nutrition plan helps maintain euglycemia, prevent excessive weight gain, and ensure adequate nutrient intake for maternal and fetal health.
Correct Answer is C
Explanation
A. Induction is not dependent on cervical dilation alone. Even if the client were dilated, the defining factor for induction is that labor has not started spontaneously. Therefore, this option is incorrect.
B. Augmentation refers to stimulating or enhancing labor that has already begun, often using oxytocin or other interventions. Cervical ripening is typically done before induction, so this is not augmentation.
C. Induction of labor is the process of initiating labor artificially in a client who is not in labor, often due to post-term pregnancy, medical complications, or other indications. In this scenario, the client is at 41 weeks gestation and labor has not begun naturally, and cervical ripening medication is being used to prepare the cervix for labor before administering oxytocin to stimulate contractions. This clearly represents labor induction.
D. Augmentation refers specifically to strengthening or regulating contractions in labor that has already started, not initiating labor in a client who is not in labor. Since this client is not in labor yet, augmentation does not apply.
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