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During preconception counseling, the nurse explains that during the first 8 weeks the fetus is most vulnerable to the effects of teratogens.
What is occurring during the first 8 weeks of gestation?

A nurse in the labor and delivery unit is caring for a 31-year-old pregnant female client who is at 31 weeks of gestation.

History and Physical: The client is a Gravida 4 Para 3. She reports cramping and low back pain that started last night.

Vital Signs:

0900:

• Temperature: 36.9°C (98.4°F)
• Pulse rate: 87/min
• Respiratory rate: 20/min
• Blood Pressure: 129/70 mm Hg
• Oxygen saturation: 98%

1000:

• Pulse rate: 86/min
• Respiratory rate: 18/min
• Blood Pressure: 130/76 mm Hg
• Oxygen saturation: 97%

Nurses Notes: At 0900, the client was placed on a fetal monitor, and the fetal heart tones (FHT) were recorded at 160/min. The client reported pain as a 6 on a 0 to 10 scale and requested pain medication. Vaginal examination showed 2 cm dilation, 80% effacement, and -1 station. At 1000, uterine contractions were observed every 2 to 4 minutes, lasting 60 to 80 seconds, with an FHT of 155/min. Provider was notified of the client's status and assessment, and new orders were received.

Medical History: The client has a history of three previous pregnancies (Gravida 4 Para 3).Querry: The nurse is contacting the primary health care provider regarding the client's status.

Which of the following interventions should the nurse anticipate? Select the 3 interventions the nurse should anticipate.

A nurse is conducting screening assessments in an OBGYN clinic.
Which of the following clients has risk factors for cervical cancer?

A nurse is caring for a 28-year-old female client in the fourth stage of labor after a vaginal delivery in the labor and delivery unit.
 

History and Physical: The client is a Gravida 3 Para 2 (T2P0A0L2) with chronic hypertension. She was admitted for medical induction of labor due to gestational diabetes with a Bishop score of 9 on admission. The plan was to induce labor with oxytocin.

Vital Signs:

1130:

• Blood Pressure: 144/92 mmHg
• Pulse: 99 bpm
• Respirations: 17/min
• Temperature: 100.4°F (38.0°C)
• Pulse Ox: 97%

Nurses Notes: At 1040, the client underwent a vacuum-assisted vaginal delivery of a viable female infant weighing 4215 grams. The placenta was manually extracted at 1035, appearing intact. At 1130, the fundus was boggy, midline, and at the umbilicus. Lochia rubra was heavy with small clots noted. The IV was patent and currently infusing ordered oxytocin.

Diagnostic Tests:

• Hemoglobin: 11g/dL (9.5-11 g/dL)
• Hematocrit: 33% (28-33%)
• White Blood Cell Count: 12,000/mm³ (5,600-17,000/mm³)
• Platelets: 151,000/mm³ (140,000-400,000/mm³)
• Protein Creatinine Ratio: 0.01 (less than 0.3)
• HbA1c: 8.9% (less than 5.7%)

Querry: Which of the following assessment findings require follow-up? Select All That Apply.

A nurse is walking by a client's room and can hear the fetal heart rate dropping.
The nurse observes the heartbeat and interprets the monitor strip as indicating which of the following?

A nurse is caring for a 28-year-old postpartum female client in the postpartum unit.

Medical History:

The client is on postpartum day 1. She is breastfeeding her newborn every 4 to 5 hours for 30 to 40 minutes each time. She reports some nipple discomfort during the feedings. The nurse assisted the client with positioning and latch and recommended the client awaken the newborn to feed every 3 hours during the day. The newborn voided twice and passed two meconium stools in the past 24 hours.

Vital Signs:

Blood Pressure: 120/80 mmHg

Pulse: 80 bpm

Respirations: 16/min

Temperature: 36.8°C (98.2°F)

Pulse Ox: 99%

Nurses Notes: On postpartum day 2, the client reports breastfeeding every 3 to 4 hours and experiencing nipple discomfort during some feedings. No physical findings of nipple trauma are noted, and the breasts are soft. The client denies feelings of fullness. The newborn voided twice and passed three meconium stools in the second 24 hours of life. Discharge teaching was provided to the client regarding breastfeeding.

Querry: Which of the following statements by the client indicates an understanding of the discharge teaching? Click to highlight the client statements that indicate an understanding of the discharge teaching.

A nurse is assisting a teenage client with breastfeeding.
The client asks, "How will I know when to feed my baby?" The nurse educates the client on infant feeding cues. Which of the following is a newborn feeding cue?

A nurse is caring for a client who experienced a cesarean birth due to dysfunctional labor. The client states that she is disappointed that she did not have natural childbirth. Which of the following responses should the nurse make?
A. "It sounds like you are feeling sad that things didn't go as planned.”.

A nurse is caring for a 25-year-old postpartum female client who had a spontaneous vaginal birth at 39 weeks of gestation in the postpartum unit.

Medical History: The client is a Gravida 1, Para 1. She is currently breastfeeding.

Vital Signs:

• Blood Pressure: 120/80 mmHg
• Pulse: 80 bpm
• Respirations: 16/min
• Temperature: 36.8°C (98.2°F)
• Pulse Ox: 99%

Nurses Notes: The client reports feeling well overall. She is breastfeeding her newborn and has expressed concerns about her baby’s weight loss. The client’s breasts are full, warm, and slightly tender, indicating that her milk is coming in. She has been educated on breastfeeding and the expected changes in her baby's stool color. The client appears attentive and responsive to her baby’s needs. She is utilizing correct breastfeeding techniques and has been encouraged to continue feeding 8 to 12 times per day and on demand. The client has also been advised on the importance of monitoring her newborn's weight and intake.

Newborn Daily Weights:

• Birth weight: 3,515 gm (7 lb 12 oz)
• Weight after 24 hr: 3,410 gm (7 lb 8 oz) (3% weight loss)
• Weight after 48 hr: 3,345 gm (7 lb 4 oz) (5% weight loss)

Querry: Which of the following statements by the client indicates an understanding of the discharge teaching? Click to highlight the client statements that indicate an understanding of the discharge teaching.

A nurse is caring for a newborn with hyperbilirubinemia and is being treated with phototherapy.
For each of the following nursing actions, specify if it is indicated or contraindicated with phototherapy treatment.

A nurse on the labor and delivery unit is caring for a patient who is having induction of labor with oxytocin administered through a secondary IV line. Uterine contractions occur every 2 minutes, last 90 seconds each, and are strong to palpation. The baseline fetal heart rate is 150/min, with uniform decelerations beginning at the peak of the contraction, nadir after the peak of the contraction, and a return to baseline after the contraction is over.
Which of the following actions should the nurse take?