A nurse in a provider’s office is collecting data from a client who is at 34 weeks of gestation and reports having a sudden gush of vaginal fluid.Which of the following manifestations is the priority?
Amniotic fluid with meconium noted.
Maternal temperature 38.3°C (101°F).
Foul smelling vaginal discharge.
Fetal heart tones 98/min.
The Correct Answer is D
Choice A rationale
Amniotic fluid with meconium noted can indicate fetal distress, but it is not the most immediate priority compared to fetal heart tones.
Choice B rationale
A maternal temperature of 38.3°C (101°F) can indicate infection, but it is not the most immediate priority compared to fetal heart tones.
Choice C rationale
Foul-smelling vaginal discharge can indicate infection, but it is not the most immediate priority compared to fetal heart tones.
Choice D rationale
Fetal heart tones of 98/min indicate fetal bradycardia, which is a sign of fetal distress and requires immediate intervention to ensure the well-being of the fetus.
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Correct Answer is D
Explanation
Choice A rationale
Home palliative services are typically provided for patients with terminal illnesses or those requiring end-of-life care. A molar pregnancy, while serious, does not usually necessitate palliative care. Instead, the focus is on monitoring and follow-up to ensure complete removal of molar tissue and to detect any potential complications, such as gestational trophoblastic neoplasia.
Choice B rationale
Amniocentesis is a procedure used to diagnose chromosomal abnormalities and fetal infections, typically performed during the second trimester of pregnancy. It is not relevant for a patient recovering from a molar pregnancy, as there is no viable fetus involved.
Choice C rationale
Chemotherapy may be required if there is evidence of persistent gestational trophoblastic disease or choriocarcinoma, but it is not an immediate requirement for all patients recovering from a molar pregnancy. The need for chemotherapy would be determined based on follow-up hCG levels and other diagnostic tests.
Choice D rationale
Attending a support group is an important aspect of emotional and psychological recovery after a molar pregnancy. Support groups provide a space for patients to share their experiences, receive emotional support, and gain information about their condition and recovery process.
Correct Answer is D
Explanation
Choice A rationale
Placing a newborn in the right lateral position is not recommended as it increases the risk of suffocation and sudden infant death syndrome (SIDS)4.
Choice B rationale
Placing a newborn in the left lateral position is also not recommended for the same reasons as the right lateral position.
Choice C rationale
Placing a newborn in the prone position (on their stomach) significantly increases the risk of SIDS and is not recommended.
Choice D rationale
Placing a newborn in the supine position (on their back) is the safest position for sleep and is recommended to reduce the risk of SIDS4.