A nurse is caring for a client following a vaginal delivery of a term fetal demise. Which of the following statements should the nurse make?
"You can bathe and dress your baby if you'd like to."
"You should name the baby so she can have an identity."
"I'm sure you will be able to have another baby when you're ready."
"If you don't hold the baby, it will make letting go much harder."
The Correct Answer is A
A. "You can bathe and dress your baby if you'd like to."
This statement gives the client the option to spend time with their baby if they wish to do so. It respects the client's autonomy and choice in how they want to handle this difficult situation.
B. Telling the client to name the baby may put unnecessary pressure on them during a challenging time.
C. Assuring the client that they can have another baby in the future might not be comforting at this moment, as they are grieving the loss of their current pregnancy.
D. Pressuring the client to hold the baby may not be appropriate, as everyone's grief process is different, and the client should be allowed to make their own choices regarding physical contact with the baby.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. "Moderate variability of the fetal heart rate" is a reassuring sign, indicating that the fetus is tolerating labor well. It does not warrant discontinuing oxytocin.
B. "Nonrepetitive early decelerations" are also a reassuring sign and are typically not an indication to discontinue oxytocin. Early decelerations are typically benign and related to head compression during contractions.
C. "Six contractions in 10 min" may be within the acceptable range for uterine activity during labor. However, it's important to assess the duration and intensity of these contractions as well.
D. "Contractions last 60 seconds" on their own may not be an indication to discontinue oxytocin. The nurse should also assess the frequency and intensity of contractions to determine if they are causing uterine hyperstimulation. Uterine Hyperstimulation Occurs: Uterine hyperstimulation is defined by an excessive frequency, duration, or intensity of contractions. Generally, contractions that occur more frequently than 5 contractions in 10 minutes (one every 2 minutes) or contractions that last longer than 60-90 seconds can be concerning.
Correct Answer is B
Explanation
A. Transient circumoral cyanosis: This is a common finding in newborns and typically resolves without treatment.
B. The nurse should report the finding of "Single palmar creases" to the provider. Single palmar creases, also known as a single transverse palmar crease or simian crease, are associated with certain genetic syndromes like Down syndrome. It can be a significant clinical finding that warrants further evaluation and potential genetic testing to rule out any underlying conditions.
C. Rust-stained urine: This can occur due to the breakdown of red blood cells in the newborn's body during the first few days of life. It's usually benign and resolves on its own.
D. Subconjunctival hemorrhage: This is a common finding caused by pressure during childbirth and is typically benign, resolving without intervention.
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