A nurse is caring for a 24-year-old pregnant woman in the prenatal clinic. She is gravida 2, para 1 (G2P1), and her mother has a history of type 2 diabetes mellitus.

Exhibits:

Exhibits

Which is likely causing this client's increased blood glucose at 28 weeks? Select all that apply.

Fetal health problems

Decreased cortisol

Increased insulin needs

Placental infection

Normal weight gain of pregnancy

Fetus with macrosomia

Answer and Explanation

Correct Answer : C,E,F

Choice A rationale: Fetal health problems are not directly linked to maternal blood glucose levels. The fetus relies on maternal glucose, but fetal health issues do not cause maternal hyperglycemia.

Choice B rationale: Decreased cortisol is unlikely to cause increased blood glucose levels. Cortisol typically raises blood glucose by promoting gluconeogenesis and decreasing glucose uptake by cells.

Choice C rationale: Increased insulin needs during pregnancy are due to insulin resistance caused by placental hormones. This physiological change ensures adequate glucose supply to the fetus, leading to higher maternal blood glucose levels.

Choice D rationale: Placental infection can cause inflammation and other complications but is not a common cause of increased blood glucose levels. Infections typically present with fever and other systemic symptoms.

Choice E rationale: Normal weight gain during pregnancy can contribute to insulin resistance. Increased adipose tissue leads to higher levels of circulating free fatty acids, which impair insulin signaling and glucose uptake.

Choice F rationale: A fetus with macrosomia is often associated with maternal hyperglycemia. Excess glucose crosses the placenta, stimulating fetal insulin production and growth, leading to larger fetal size.

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Correct Answer is C

Explanation

Choice A rationale

Administering acetaminophen is not indicated as the temperature of 100.4° F (38° C) is within the normal postpartum range, often due to dehydration or breast engorgement. Acetaminophen should be used cautiously and only if necessary.

Choice B rationale

Assessing perineum for excessive lochia is unnecessary here, as the current vital signs do not indicate hemorrhage. Normal postpartum bleeding gradually decreases in amount and should be monitored accordingly but not prompted by these vitals.

Choice C rationale

Documentation of vital signs is essential to maintain accurate medical records and track any changes in the patient's condition. Accurate records help in identifying trends and making informed decisions about patient care.

Choice D rationale

Reporting a heart rate of 58 beats/minute is unnecessary because bradycardia can be normal in postpartum women, especially if they have good cardiovascular fitness. It is important to monitor for other symptoms before taking further action.

A. Notify the nursery about the client’s response. B. Restart oxytocin infusion rate per protocol. C. Stop oxygen per cannula. D. Check for clonus in both feet.

Correct Answer is B

Explanation

Choice A rationale

Notifying the nursery about the client’s response is not an immediate intervention. It is more important to manage uterine contractions and fetal oxygenation before informing other departments about the client's condition.

Choice B rationale

Restarting the oxytocin infusion rate per protocol is necessary to resume labor induction. Oxytocin increases uterine contractions, promoting cervical dilation and progression of labor. Continuous monitoring is required to adjust the dosage.

Choice C rationale

Stopping oxygen per cannula is not recommended if fetal distress is present. Oxygen supplementation ensures adequate fetal oxygenation during uterine contractions, reducing the risk of hypoxia and related complications.

Choice D rationale

Checking for clonus in both feet is not relevant to the current scenario. Clonus is a neurological sign indicating hyperreflexia, often unrelated to labor management. The focus should be on managing uterine contractions and fetal well-being.

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A nurse is caring for a 24-year-old pregnant woman in the prenatal clinic. She is gravida 2, para 1 (G2P1), and her mother has a history of type 2 diabetes mellitus. Exhibits: Exhibits Which is likely causing this client's increased blood glucose at 28 weeks? Select all that apply.

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Naxlex Comprehensive Predictor Exams

The current vital signs for a primipara who delivered vaginally during the previous shift are: temperature 100.4° F (38° C), heart rate 58 beats/minute, respiratory rate 16 breaths/minute, and blood pressure 130/74 mm Hg. Which action should the nurse implement?

Correct Answer is C

Explanation

Correct Answer is B

Explanation

A nurse is caring for a 24-year-old pregnant woman in the prenatal clinic. She is gravida 2, para 1 (G2P1), and her mother has a history of type 2 diabetes mellitus. Exhibits: Exhibits Which is likely causing this client's increased blood glucose at 28 weeks? Select all that apply.

Which action should the nurse take?

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A client whose labor is being augmented with an oxytocin infusion requests an epidural for pain control. Findings of the last vaginal exam, performed 1 hour ago, were 3 cm cervical dilation, 60% effacement, and a -2 station. Which action should the nurse implement first?

A nurse is caring for a 24-year-old pregnant woman in the prenatal clinic. She is gravida 2, para 1 (G2P1), and her mother has a history of type 2 diabetes mellitus.

Exhibits:

Exhibits

Which is likely causing this client's increased blood glucose at 28 weeks? Select all that apply.