A pregnant woman was admitted for induction of labor at 43 weeks of gestation with sure dates. A nonstress test (NST) in the obstetrician's office revealed a nonreactive tracing. On artificial rupture of membranes, thick meconium-stained fluid was noted. What should the nurse caring for the infant after birth anticipate?
Meconium aspiration, hypoglycemia, and dry, cracked skin
Hyperglycemia, hyperthermia, and an alert, wide-eyed appearance
Excessive vernix caseosa covering the skin, lethargy, and RDS
Golden yellow to green-stained skin and nails, absence of scalp hair, and an increased amount of subcutaneous fat
The Correct Answer is A
Choice A reason: This statement is correct, as these are the common complications of post-term infants, who are born after 42 weeks of gestation. Meconium aspiration can occur when the fetus passes meconium in utero and inhales it into the lungs, causing respiratory distress, inflammation, and infection. Hypoglycemia can occur due to the depletion of glycogen stores and the increased metabolic demands. Dry, cracked skin can occur due to the loss of vernix caseosa and the reduced amniotic fluid.
Choice B reason: This statement is incorrect, as these are the signs of neonatal hypocalcemia, which is a low level of calcium in the blood. Neonatal hypocalcemia can occur due to maternal diabetes, prematurity, or asphyxia, and can cause jitteriness, seizures, or tetany.
Choice C reason: This statement is incorrect, as these are the characteristics of preterm infants, who are born before 37 weeks of gestation. Excessive vernix caseosa covering the skin is a protective coating that prevents heat and water loss. Lethargy and RDS are signs of immaturity and underdevelopment of the central nervous system and the lungs.
Choice D reason: This statement is incorrect, as these are the features of infants with erythroblastosis fetalis, which is a hemolytic disease caused by the incompatibility of the Rh factor or the ABO blood group between the mother and the fetus. Golden yellow to green-stained skin and nails are due to the accumulation of bilirubin, which is a breakdown product of red blood cells. Absence of scalp hair and an increased amount of subcutaneous fat are due to the chronic hypoxia and edema.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: "I'll basically follow the same diet that I was following before I became pregnant." is an incorrect statement, because it indicates that the client does not understand the need for dietary changes during pregnancy. The client should follow a diet that is individualized, balanced, and consistent in carbohydrate intake, and that meets the nutritional needs of pregnancy.
Choice B reason: "Because I need extra protein, I'll have to increase my intake of milk and meat." is an incorrect statement, because it indicates that the client does not understand the role of protein in diabetes management. The client should consume adequate but not excessive amounts of protein, and choose lean sources of protein, such as poultry, fish, eggs, and legumes.
Choice C reason: "I'll adjust my diet and insulin based on the results of my urine tests for glucose." is an incorrect statement, because it indicates that the client does not understand the limitations of urine tests for glucose. The client should monitor her blood glucose levels regularly, and adjust her diet and insulin accordingly, under the guidance of the provider. Urine tests for glucose are not accurate or reliable indicators of blood glucose levels.
Choice D reason: "Pregnancy affects insulin production, so I'll need to make adjustments in my diet." is a correct statement, because it indicates that the client understands the impact of pregnancy on diabetes. The client should be aware that pregnancy can cause insulin resistance, especially in the second and third trimesters, and that her diet may need to be modified to achieve optimal glycemic control.
Correct Answer is B
Explanation
Choice A reason: Misoprostol is not the first line medication for postpartum hemorrhage, as it is a prostaglandin E1 analog that causes uterine contractions and cervical ripening. Misoprostol is used for the prevention and treatment of postpartum hemorrhage, but it is less effective and more side effects than oxytocin, which is the first line medication.
Choice B reason: Pitocin is the first line medication for postpartum hemorrhage, as it is a synthetic form of oxytocin, which is a hormone that stimulates uterine contractions and retraction. Pitocin is used for the induction and augmentation of labor, and the prevention and treatment of postpartum hemorrhage, as it reduces blood loss and enhances hemostasis.
Choice C reason: Hemabate is not the first line medication for postpartum hemorrhage, as it is a prostaglandin F2 alpha analog that causes uterine contractions and vasoconstriction. Hemabate is used for the treatment of postpartum hemorrhage, but it is contraindicated in clients with asthma, hypertension, or cardiac disease, as it can cause bronchospasm, hypertension, or cardiac arrhythmias.
Choice D reason: Methergine is not the first line medication for postpartum hemorrhage, as it is an ergot alkaloid that causes sustained uterine contractions and vasoconstriction. Methergine is used for the treatment of postpartum hemorrhage, but it is contraindicated in clients with hypertension, preeclampsia, or cardiac disease, as it can cause severe hypertension, cerebrovascular accidents, or myocardial infarction.
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