A pregnant woman initiated prenatal care at 12 weeks’ gestation.
At that time, her hemoglobin and hematocrit were 13 gm/dL and 36%, respectively.
Review her following prenatal labs at 28 weeks’ gestation: Hgb: 10.5 gm/dL Hct: 32% Blood type: B GBS: Positive Based on this data, what is the appropriate nursing action?
Administer a Rhogam injection.
Teach about iron-rich foods in her diet.
Notify the midwife to start PO antibiotics to treat the GBS.
Teach about avoiding exposure to rubella.
The Correct Answer is B
Choice A rationale
Administering a Rhogam injection is not indicated because the patient is Rh-positive (blood type B) and Rhogam is for Rh-negative individuals to prevent sensitization.
Choice B rationale
Teaching about iron-rich foods is appropriate, given her hemoglobin level of 10.5 gm/dL and hematocrit of 32%, indicating mild anemia; iron-rich foods help increase hemoglobin.
Choice C rationale
Starting PO antibiotics for GBS is unnecessary at this stage; antibiotics are administered during labor to prevent neonatal infection, not during prenatal care.
Choice D rationale
Avoiding exposure to rubella is important, but there is no indication in her current prenatal labs that she needs immediate teaching about this infection.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is True
Explanation
Choice A rationale
Starting Pitocin at a low dose minimizes the risk of uterine hyperstimulation, which can cause fetal distress. Gradually increasing the dose allows careful monitoring of the mother’s and fetus’s responses for optimal contraction rate.
Choice B rationale
Administering Pitocin without starting at a low dose increases the risk of uterine tachysystole, leading to potential complications like uterine rupture or placental abruption. A gradual increase ensures safer labor progression.
Correct Answer is ["A","B"]
Explanation
Choice A rationale
Calling for help and notifying the care provider ensures that expert medical assistance is available promptly for any emergency interventions required.
Choice B rationale
Getting help and preparing the operating room ensures readiness for an immediate cesarean section if fetal distress persists and the situation does not improve rapidly.
Choice C rationale
Starting Pitocin is inappropriate during fetal distress as it may further stress the fetus by increasing contraction frequency and intensity, potentially worsening the situation.
Choice D rationale
Inserting a Foley catheter does not address the immediate concern of fetal distress and would not provide immediate benefit in improving fetal heart rate.
Choice E rationale
Repeating uterine resuscitation measures (e.g., repositioning, oxygen, IV fluids) is essential, but if they are ineffective, additional interventions, such as preparing for possible surgical delivery, are needed.
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