Review ATI RN MATERNAL NEWBORN 2023 (2024)

Providing a stimulating environment would not be appropriate for an infant with NAS, as excessive stimulation can exacerbate symptoms such as irritability and tremors. A calm and quiet environment is preferable.

Monitoring blood glucose levels every hour is not a routine practice for managing neonatal abstinence syndrome. While NAS can cause feeding difficulties, hypoglycemia is not typically a primary concern unless the infant is exhibiting specific symptoms.

"Your previous deliveries were all negative for GBS." This response is incorrect because GBS status can change between pregnancies. A negative result in previous pregnancies does not guarantee a negative result in subsequent pregnancies. Screening closer to the delivery date is necessary to determine the current GBS status.

"There was no indication of GBS in your earlier prenatal testing." This response is incorrect because routine prenatal testing typically does not include GBS screening unless there are specific risk factors or symptoms present. GBS screening is specifically done closer to delivery to determine colonization status at that time.

"We need to know if you are positive for GBS at the time of delivery." This response is appropriate. Group B streptococcus (GBS) screening is typically performed around the 35th to 37th week of pregnancy because colonization status can change over time. A negative result earlier in the pregnancy does not necessarily mean that the client will remain negative at the time of delivery. Therefore, it is essential to screen closer to delivery to determine if the client is colonized with GBS and if prophylactic measures are needed to reduce the risk of transmission to the newborn during labor and delivery.

Urinary frequency is not a typical symptom of trichom*oniasis. However, some individuals may experience mild urinary symptoms such as burning or discomfort during urination.

Thick, white vagin*l discharge is more indicative of a yeast infection (such as candidiasis) rather than trichom*oniasis. Trichom*oniasis typically presents with a frothy, yellow-green, or gray vagin*l discharge.

Informing the client that the law requires them to name the fetus is incorrect. There is no legal requirement to name a stillborn fetus. Naming the fetus is a personal decision that should be left to the parents. Pressuring them to name the fetus may cause additional distress.

Limit the amount of time the fetus is in the client's room. This is not an appropriate action. Allowing the parents time to grieve and bond with their stillborn child is important for their emotional healing process. They should be given the opportunity to spend time with the baby if they desire.

Instructing the client that an autopsy should be performed within 24 hours is incorrect. While autopsies can sometimes provide valuable information about the cause of stillbirth, it is not necessary to perform one within 24 hours. The decision to have an autopsy should be discussed with the parents, and the timing can vary depending on their wishes and circ*mstances.

Protective environment precautions, also known as reverse isolation, are used to protect immunocompromised clients from acquiring infections from others. This includes clients who have undergone organ transplantation or chemotherapy. MRSA is not an indication for protective environment precautions because it is not typically transmitted via the air or by casual contact.

Airborne precautions are used for infectious agents that remain infectious over long distances when suspended in the air. Diseases requiring airborne precautions include tuberculosis, measles, and chickenpox. MRSA is not transmitted through the airborne route but rather through direct or indirect contact with contaminated surfaces or skin.

Contact precautions are used for infectious agents that are transmitted by direct or indirect contact with the client or their environment. MRSA is primarily transmitted through direct contact with infected skin or wounds, making contact precautions the appropriate choice. These precautions include wearing gloves and gowns when entering the client's room, performing proper hand hygiene, and ensuring that contaminated items and surfaces are cleaned and disinfected appropriately to prevent the spread of infection to others.

Delaying treatment to wait for signs of infection could worsen the condition if present. Early intervention is crucial for preventing ophthalmia neonatorum.

The newborn was delivered via cesarean birth. Delivery via cesarean section is not typically a reason to delay the instillation of antibiotic ophthalmic ointment. The risk of neonatal conjunctivitis from maternal infection remains, regardless of the mode of delivery.

A client who is at 36 weeks of gestation and reports back pain following intercourse is incorrect. While back pain following intercourse can be uncomfortable, it is not typically considered an urgent or severe symptom. This client's assessment can be prioritized after addressing more urgent concerns.

A client who is at 8 weeks of gestation and reports severe vomiting is incorrect. Severe vomiting in early pregnancy can be indicative of hyperemesis gravidarum, a condition characterized by excessive nausea and vomiting that can lead to dehydration and electrolyte imbalances. While this is a concerning symptom, it is not typically as urgent as potential symptoms of preeclampsia.

A client who is at 10 weeks of gestation and reports frequent urination. Frequent urination is a common symptom in early pregnancy and is not typically indicative of an urgent or severe condition.

Administering oxygen via nonrebreather mask at 8 L/min is incorrect. While oxygen administration is important in cases of fetal distress, covering the umbilical cord to prevent compression takes precedence in the scenario of umbilical cord prolapse.

Performing a vagin*l examination may exacerbate the situation by further displacing the cord and compromising blood flow to the fetus. This action is contraindicated in cases of umbilical cord prolapse.

Initiating an infusion of IV fluids for the client is incorrect. While maintaining hydration is important, it is not the immediate priority in the scenario of umbilical cord prolapse with fetal bradycardia. The focus should be on relieving cord compression and improving fetal oxygenation.

"Are you feeling relief from your pelvic pressure?" This question is relevant to assessing the effectiveness of the hands-and-knees position. Occipitoposterior position can cause increased pressure on the pelvic area, and relieving this pressure is one of the goals of positioning maneuvers. Therefore, this is a suitable question to evaluate the intervention.

"Has your back labor improved?" Occipitoposterior position often results in increased back pain during labor (back labor). While improving back pain is an important aspect of care, it may not directly indicate the effectiveness of the hands-and-knees position in rotating the baby. This question is somewhat relevant but does not directly address the intervention.

"Does that lessen your suprapubic pain?" Suprapubic pain may occur due to pressure on the bladder or pelvic structures during labor. While relieving suprapubic pain is a valid concern, it may not directly indicate the effectiveness of the hands-and-knees position in rotating the baby. This question is somewhat relevant but does not directly address the intervention.

Administering IV fluids may be appropriate if the client is hypovolemic or experiencing dehydration, but it is not a specific treatment for peripartum cardiomyopathy. IV fluid administration should be based on the client's fluid status and clinical assessment.

Assessing blood pressure is important in monitoring the client's cardiovascular status, but assessing it twice daily may not be sufficient for a client with peripartum cardiomyopathy, especially in the acute postpartum period. Blood pressure should be monitored more frequently, and any significant changes should be promptly addressed.

Obtaining a prescription for misoprostol is incorrect. Misoprostol is a medication used for various purposes, including the prevention and treatment of postpartum hemorrhage. However, it is not a specific treatment for peripartum cardiomyopathy. The focus in peripartum cardiomyopathy management is on cardiac support and stabilization.