The provider orders a Heparin infusion to run 950 units/hr. The medication is supplied as 25,000 units/250 mL NSS.

At what rate would the infusion pump be set at?

Choice A rationale

Applying a fetal scalp electrode is an invasive procedure that provides a more accurate assessment of fetal heart rate. However, late decelerations indicate uteroplacental insufficiency requiring immediate interventions to improve fetal oxygenation before considering invasive monitoring.

Choice B rationale

Performing a vaginal exam can assess labor progress and rule out cord prolapse or other issues. While important, it is not the immediate priority when late decelerations indicate acute fetal hypoxemia; improving oxygenation to the fetus is paramount.

Choice C rationale

Inserting an intravenous catheter is essential for administering fluids or medications. However, the most immediate intervention for late decelerations is to improve uterine blood flow and fetal oxygenation, which is achieved through maternal repositioning as the first step.

Choice D rationale

Late decelerations indicate uteroplacental insufficiency, meaning reduced blood flow and oxygen to the fetus. Repositioning the client to the left-lateral position relieves pressure on the vena cava, improving venous return to the heart, thus increasing uterine blood flow and fetal oxygenation by optimizing placental perfusion.

Choice A rationale

Allowing a new mother to hold her stillborn infant demonstrates the ethical principle of beneficence and respect for autonomy. Beneficence involves acting in the best interest of the client, providing comfort and emotional support during a profound loss. Respect for autonomy allows the mother to make choices regarding her grief process and bonding, acknowledging her inherent right to self-determination even in tragedy.

Choice B rationale

Confirming a signed consent form aligns with the ethical principle of autonomy and fidelity. Autonomy ensures the client's right to self-determination and informed decision-making regarding their healthcare. Fidelity involves upholding professional promises and commitments, which includes ensuring all legal and ethical prerequisites for procedures, like informed consent, are meticulously fulfilled prior to intervention.

Choice C rationale

Refusing to disclose client information to the media exemplifies the ethical principle of confidentiality, which is a facet of fidelity. Confidentiality protects sensitive client data, safeguarding their privacy and fostering trust within the therapeutic relationship. Fidelity mandates honoring commitments to privacy and acting as a trustworthy steward of patient information, even under external pressure.

Choice D rationale

Keeping an appointment with a client directly demonstrates the ethical principle of fidelity. Fidelity refers to the commitment to honor promises and maintain loyalty. By consistently attending scheduled appointments, the nurse upholds their professional obligations and builds trust with the client, demonstrating reliability and dedication to the therapeutic relationship. This action directly reflects trustworthiness.