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
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.
Correct Answer is B
Explanation
Choice A rationale
Diazepam is a benzodiazepine used primarily for anxiety, muscle spasms, and seizures. It is not recommended for opioid use disorder during pregnancy due to potential risks to the fetus, including withdrawal symptoms and developmental issues.
Choice B rationale
Methadone is a long-acting opioid agonist used to treat opioid use disorder. It helps reduce withdrawal symptoms and cravings without producing the euphoria associated with opioid abuse. Methadone is considered safe for use during pregnancy and can improve maternal and fetal outcomes.
Choice C rationale
Naloxone is an opioid antagonist used to reverse opioid overdose. While it is crucial to have naloxone readily available for individuals with opioid use disorder to prevent overdose deaths, it is not a primary treatment for opioid use disorder during pregnancy.
Choice D rationale
Buprenorphine is a partial opioid agonist used to treat opioid use disorder. It is considered safe for use during pregnancy and can reduce withdrawal symptoms and cravings. However, methadone is often preferred due to its longer history of use and more extensive research on its safety during pregnancy.