A nurse is caring for a client in active labor who has meconium staining of the amniotic fluid. The nurse notes a reassuring fetal heart rate (FHR) tracing from the external fetal monitor. Which of the following actions should the nurse perform?

Prepare equipment needed for newborn resuscitation

Perform endotracheal suctioning as soon as the fetal head is delivered

Prepare the client for an ultrasound examination

Prepare the client for an emergency cesarean birth

Answer and Explanation

The Correct Answer is A

A. Prepare equipment needed for newborn resuscitation.

A. Preparing equipment needed for newborn resuscitation is the correct action.

Meconium-stained amniotic fluid can increase the risk of meconium aspiration syndrome in the newborn. While the fetal heart rate is reassuring, being prepared for potential newborn resuscitation is prudent given the meconium staining.

B. Performing endotracheal suctioning as soon as the fetal head is delivered is not the current standard of care. The American Academy of Pediatrics (AAP) no longer recommends routine suctioning of meconium-stained infants unless they show signs of respiratory distress, poor muscle tone, or a depressed heart rate.

C. Preparing the client for an ultrasound examination is not the immediate priority. Meconium-stained amniotic fluid may be associated with fetal distress, but the focus should be on the current labor and delivery situation.

D. Preparing the client for an emergency cesarean birth is not the first action.

The presence of meconium staining alone does not necessarily indicate the need for an emergency cesarean birth, especially if the fetal heart rate is reassuring.

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Correct Answer is A

Explanation

Nägele's rule is a method used to estimate the expected date of delivery (EDD) for a pregnant woman. To use Nägele's rule, you start with the first day of the last menstrual period (LMP), add one year, subtract three months, and add seven days.

In this case:

LMP: November 27th

Add one year: November 27th of the following year

Subtract three months: August 27th

Add seven days: September 3rd

Therefore, according to Nägele's rule, the expected date of birth is September 3rd

A. Brownish vaginal discharge B. Contractions occurring every 4 to 5 minutes C. Pink mucoid vaginal discharge D. Contractions lasting 100 seconds

Correct Answer is D

Explanation

A. Brownish vaginal discharge may indicate the presence of old blood or mucus and is not necessarily a cause for concern in the absence of other signs or symptoms.

B. Contractions occurring every 4 to 5 minutes are within the normal frequency range during the first stage of labor.

C. Pink mucoid vaginal discharge, also known as the "bloody show," is a common occurrence in early labor and is not typically a cause for immediate concern.

D. Contractions lasting 100 seconds are excessively long and are a cause for concern.

Prolonged contractions can lead to decreased uterine blood flow, impacting fetal oxygenation. Such prolonged contractions should be assessed and addressed promptly.

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A nurse is caring for a client in active labor who has meconium staining of the amniotic fluid. The nurse notes a reassuring fetal heart rate (FHR) tracing from the external fetal monitor. Which of the following actions should the nurse perform?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is calculating a client's expected date of birth using Nägele's rule. The client tells the nurse that her last menstrual cycle started on November 27th. Which of the following dates is the client's expected date of birth?

Correct Answer is A

Explanation

A nurse is caring for a client who is in the first stage of labor. Which of the following findings should the nurse identify as a cause for concern?

Correct Answer is D

Explanation

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