A nurse is caring for a client at 35 weeks of gestation who has preeclampsia with severe features and is scheduled for an immediate induction of labor after the manifestations worsened. The client is upset because the provider has disregarded their birth plan. Which of the following considerations should the nurse implement for the client?
Antenatal steroid administration
Expectant management protocols
Method of birth
Shared decision-making
The Correct Answer is D
A. Antenatal steroid administration: Antenatal steroids (e.g., betamethasone) are used to enhance fetal lung maturity in preterm pregnancies (<34 weeks). At 35 weeks, steroids are generally not indicated.
B. Expectant management protocols: Expectant management (delaying delivery with close monitoring) is considered in mild preeclampsia but is not appropriate in severe preeclampsia due to the risk of maternal and fetal complications.
C. Method of birth: The method of birth (vaginal vs. C-section) is determined based on maternal and fetal conditions. While important, it is not the key consideration in addressing the client's concern about their birth plan.
D. Shared decision-making: Shared decision-making ensures that the client feels heard and involved in their care plan, even in urgent situations. The nurse should acknowledge the client's concerns, explain the rationale for induction, and explore possible accommodations for their birth plan.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C"]
Explanation
A. Fetal breathing: Fetal breathing movements are assessed as part of the BPP, which evaluates fetal well-being.
B. Fetal motion: Fetal movements, including limb and body movements, are an essential component of the BPP.
C. Amniotic fluid volume: The amount of amniotic fluid is measured to assess fetal hydration and placental function.
D. Fetal gender: The BPP does not assess fetal gender; it focuses on fetal well-being rather than genetic characteristics.
E. Fetal neck translucency: Nuchal translucency (fetal neck thickness) is assessed during first-trimester ultrasound screening for chromosomal abnormalities, not during a BPP.
Correct Answer is D
Explanation
A. Number of previous pregnancies: While previous pregnancies can influence labor speed (multiparous clients often progress faster), it is not the most critical factor in assessing labor progression.
B. Maternal age: Advanced maternal age may increase labor complications, but it does not directly determine labor progression.
C. Gestational weight gain: Excessive weight gain can impact fetal size, but it is not the primary factor affecting labor progression.
D. Fetal size: Fetal size plays a significant role in labor progression. A large fetus may cause cephalopelvic disproportion (CPD), leading to slow or arrested labor, whereas a smaller fetus may allow for quicker labor progression.
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