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A nurse is triaging four clients on the labor and delivery unit.
Which of the following actions should be a priority for nursing care?

A.

Check the blood sugar of a gestational diabetic.

B.

Assess the vaginal blood loss of a client who is recovering from a spontaneous abortion.

C.

Assess the patellar reflexes of a client with pre-eclampsia without severe features.

D.

Check the fetal heart rate of a client whose membranes just ruptured.

Answer and Explanation

The Correct Answer is D

Choice A rationale

Checking blood sugar is important in gestational diabetes but isn't immediate priority in a triage setting compared to assessing urgent conditions that could harm the fetus or mother immediately.

 

Choice B rationale

Assessing vaginal blood loss post-abortion is crucial, but in the presence of ruptured membranes, fetal heart rate checks take precedence to ensure the fetus's immediate well-being.

 

Choice C rationale

Assessing patellar reflexes in pre-eclampsia management is significant, but immediate priority in labor and delivery triage goes to ensuring fetal safety after membrane rupture.

 

Choice D rationale

Checking the fetal heart rate after membrane rupture is a priority because it provides immediate information about the fetus's status and any potential complications like cord prolapse or distress.


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Correct Answer is A

Explanation

Choice A rationale

Blood pressure of 160/110 indicates severe preeclampsia and warrants immediate intervention to prevent complications. Stopping oxytocin is part of the management of severe

preeclampsia to avoid exacerbating the condition.

Choice B rationale

Frequency of contractions every 3 minutes is within the normal range during labor induction and does not warrant stopping the infusion unless there are other concerns.

Choice C rationale

A fetal heart rate of 155 bpm with early decelerations may require close monitoring but does not necessarily warrant stopping the oxytocin infusion. Early decelerations are typically a

normal physiological response.

Choice D rationale

Frequency of contractions every 3 minutes is expected during active labor and is generally not a cause to stop the oxytocin infusion. The nurse should continue to monitor the labor

progression closely.

Correct Answer is B

Explanation

Choice A rationale

Checking for ketones in urine is related to metabolic conditions like diabetic ketoacidosis, not directly relevant to the immediate care of an eclamptic client.

Choice B rationale

Padding the bed rails and headboard helps prevent injury during seizures, which is crucial in managing a client with eclampsia.

Choice C rationale

Providing visual and auditory stimulation can increase the risk of further seizures in an eclamptic client. Reducing stimulation is usually recommended.

Choice D rationale

Placing the bed in the high Fowler's position is not appropriate for managing a client post-seizure. The priority is ensuring airway patency and preventing injury.

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