A woman had spinal anesthesia for delivery. Now she complains of a pounding headache rated 7/10. What action by the nurse is most appropriate?

Assist the client to turn onto her side. This is the correct answer because turning the client onto her side can improve blood flow to the placenta and increase fetal oxygenation. Hypotension is a common cause of decreased uteroplacental perfusion, which can lead to fetal distress and late decelerations on the fetal monitor. The nurse should also administer oxygen, increase IV fluids, and notify the provider. • Choice B reason:

Prepare for an immediate vaginal delivery. This is not the correct answer because there is no indication that the client is ready for delivery. The client has 6 cm of cervical dilation, which means she is still in the active phase of labor. The second stage of labor begins when the cervix is fully dilated (10 cm) and ends with delivery of the baby. Preparing for an immediate vaginal delivery would not address the cause of hypotension or improve fetal oxygenation. • Choice C reason:

Prepare for a cesarean birth. This is not the correct answer because there is no indication that the client needs a cesarean birth. A cesarean birth may be indicated if there are signs of fetal compromise, such as severe variable or late decelerations, or maternal complications, such as placenta previa or cord prolapse. However, these conditions are not present in this scenario. Preparing for a cesarean birth would not address the cause of hypotension or improve fetal oxygenation. • Choice D reason:

Assist the client to an upright position. This is not the correct answer because placing the client in an upright position can worsen hypotension and decrease uteroplacental perfusion. An upright position can increase pressure on the inferior vena cava and reduce venous return to the heart. This can lower cardiac output.

The correct answer is: a. Hyperbilirubinemia.

Choice A: Hyperbilirubinemia

Reason: Hyperbilirubinemia in newborns is often caused by the increased breakdown of red blood cells, which have a shorter lifespan in neonates. This breakdown produces bilirubin, a yellow pigment that can accumulate in the blood, leading to jaundice. The liver of a newborn is not fully mature and may not be able to process and excrete bilirubin efficiently, resulting in hyperbilirubinemia.

Choice B: Respiratory Distress Syndrome

Reason: Respiratory Distress Syndrome (RDS) is primarily caused by a deficiency of surfactant in the lungs, which is more common in premature infants. It is not directly related to the lifespan of red blood cells. Symptoms include rapid, shallow breathing and a bluish color due to lack of oxygen.

Choice C: Polycythemia

Reason: Polycythemia is characterized by an abnormally high concentration of red blood cells. It is often due to factors like delayed cord clamping or maternal diabetes, rather than the decreased lifespan of red blood cells. Polycythemia can lead to increased blood viscosity and complications such as sluggish blood flow.

Choice D: Transient Tachypnea

Reason: Transient Tachypnea of the Newborn (TTN) is a respiratory condition caused by delayed clearance of fetal lung fluid. It typically resolves within a few days and is not related to the lifespan of red blood cells. Symptoms include rapid breathing and grunting.