A nurse is collecting data from a client who is at 23 weeks of gestation.Which of the following client statements should the nurse identify as a potential psychosocial concern?
“I’ve started to purchase furniture for the baby’s room.”.
“I’m not sure if I want an epidural during labor.”.
“My partner is planning to attend birthing classes with me.”.
“I’m not sure my older child will accept the new baby.”.
The Correct Answer is D
Choice A rationale
Purchasing furniture for the baby’s room is a common and healthy behavior during pregnancy. It indicates that the client is preparing for the baby’s arrival and is excited about the new addition to the family. This behavior is generally seen as positive and supportive of the pregnancy.
Choice B rationale
Being unsure about wanting an epidural during labor is a normal concern for many pregnant individuals. It reflects the client’s consideration of pain management options and their desire to make an informed decision. This is not typically seen as a psychosocial concern.
Choice C rationale
The partner planning to attend birthing classes with the client is a positive sign of support and involvement in the pregnancy. It indicates that the partner is engaged and willing to participate in the childbirth process, which can be beneficial for the client’s emotional well-being.
Choice D rationale
Expressing uncertainty about whether an older child will accept the new baby can indicate underlying anxiety or stress about family dynamics and the impact of the new baby on existing relationships. This concern may require further exploration and support to ensure the client’s emotional health.
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Correct Answer is C
Explanation
Choice A rationale
Placing the client in the knee-chest position is not appropriate for managing hypotension caused by an epidural infusion. This position does not effectively improve blood pressure.
Choice B rationale
Administering methylergonovine IM is not appropriate for managing hypotension caused by an epidural infusion. Methylergonovine is used to manage postpartum hemorrhage, not hypotension.
Choice C rationale
Giving a bolus of lactated Ringer’s is the appropriate action to manage hypotension caused by an epidural infusion. This helps to increase blood volume and improve blood pressure.
Choice D rationale
Assisting the client to empty her bladder is important, but it is not the immediate priority in managing hypotension caused by an epidural infusion.
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.