During the oliguric phase of acute renal failure, which of the following occurs?

Choice A rationale:

Fetal heart rate of 90 beats per minute is a sign of fetal bradycardia, which is a serious and potentially life-threatening condition. It indicates that the fetus is not getting enough oxygen, and it can lead to fetal distress, brain damage, or even death.

Oxytocin can cause uterine hyperstimulation, which can reduce blood flow to the placenta and cause fetal bradycardia. Therefore, if the nurse observes a fetal heart rate of 90 beats per minute, it is essential to discontinue the oxytocin infusion immediately and notify the healthcare provider.

Choice B rationale:

Increased urinary output is not a direct contraindication to oxytocin administration. In fact, oxytocin can sometimes cause a decrease in urinary output due to its antidiuretic effects.

While a significant increase in urinary output could be a sign of fluid overload, it would not necessarily indicate that the oxytocin infusion needs to be discontinued. The nurse would need to assess the patient's overall fluid status and other clinical indicators to make this determination.

Choice C rationale:

Three contractions occurring within a 10-minute period is considered a normal contraction pattern during labor. It is not a sign of uterine hyperstimulation or fetal distress.

In fact, the goal of oxytocin administration is to achieve regular contractions that are occurring every 2-3 minutes and lasting 40-60 seconds. Therefore, this finding would not indicate that the oxytocin infusion needs to be discontinued.

Choice D rationale:

Adequate resting tone of the uterus palpated between contractions is a normal finding during labor. It indicates that the uterus is contracting effectively and is not at risk for uterine atony (lack of muscle tone).

This finding would not be a reason to discontinue the oxytocin infusion.

Choice A rationale:

This statement is incorrect. The risk factor for a genetic disorder can vary depending on the specific disorder and the family history. For example, the risk of having a child with an autosomal recessive disorder is higher if there is a history of the disorder in the family.

Additionally, some genetic disorders have a higher risk of recurrence than others. For example, the risk of having a child with cystic fibrosis is 25% if both parents are carriers of the gene.

It's crucial for nurses to be aware of the varying risk factors associated with different genetic disorders to provide accurate information and counseling to families.

Choice C rationale:

This statement is also incorrect. The risk of a disorder involving maternal ingestion of drugs being repeated in the second child depends on several factors, including the specific drug, the dose, and the timing of exposure.

It cannot be generalized to a one in four chance for all drug-related disorders. Nurses should consult with appropriate resources and specialists to determine the specific risks associated with different drugs and exposures.

Choice D rationale:

This statement is incorrect for autosomal dominant disorders. With an autosomal dominant disorder, the likelihood of the second child also having the condition is 50%, not 100%. Each child has a 50% chance of inheriting the affected gene from the affected parent.

It's essential for nurses to understand the inheritance patterns of different genetic disorders to provide accurate information and support to families.

Choice B rationale:

This statement is correct. An autosomal recessive disease carries a one in eight risk of the second child also having the disorder. This is because both parents must be carriers of the affected gene for a child to inherit the disorder.

If both parents are carriers, there is a 25% chance that each child will inherit two copies of the affected gene and have the disorder. However, there is also a 50% chance that each child will inherit only one copy of the affected gene and be a carrier, and a 25% chance that each child will inherit two normal copies of the gene and not be affected.