NUR 325 Nursing Services Childbearing Family

NUR 325 Nursing Services Childbearing Family

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Free NUR 325 Nursing Services Childbearing Family Questions

1. 78. In caring for an immediate postpartum client, you note petechiae and oozing from her IV site. What information in her history would make you suspect Disseminated Intravascular Coagulation Disorder (DIC)?
  • A. She experienced an abruptio placenta and pre-eclampsia with her labor.
  • B. She had a 4100 gm baby.
  • C. This is her 5th child.
  • D. She had hyperemesis gravidarum her first trimester.

Explanation

Disseminated Intravascular Coagulation (DIC) is a life-threatening condition that may develop as a complication of abruptio placentae, pre-eclampsia, or retained dead fetus syndrome. These conditions trigger widespread activation of the clotting cascade, leading to consumption of platelets and clotting factors. As a result, bleeding occurs from sites such as IV punctures, mucous membranes, and surgical incisions. The presence of petechiae and oozing in a patient with these risk factors strongly indicates possible DIC and requires immediate intervention.
2. Vital Signs
BP 128/70 mmHg
HR 88 bpm
RR 16/min
Temp 98.6 ((O)
Sp02 98% on RA
FHR 155 with minimal variability

Diagnostic Results
WBC: 7,000/mm3 (5000 to 10,000/mm3)
Hgb: 14 mg/dL (12 to 18 g/dL)
Hct: 39% (37% to 52%)
Platelets: 160,000/mm3 (150,000 to 400,000/mm3)
Blood type: O
Rh: Negative

Beta Strep Vaginal Culture Negative

Nurses Notes
A patient, G2P1, 34 weeks gestation arrives in L&D with contractions every 3-5 minutes. The patient denies any vaginal bleeding or leaking of fluid. Pain is described as 5/10 radiating from the back to the front.
Vaginal exam is 2cm/70%/-3. You call the doctor and give an ISBARR.

Which of the following will you recommend for this patient? (Select all that apply.)
  • A. Brethine (Terbutaline)
  • B. Pitocin 20 u in 500cc LR to run at 125 mL per hour
  • C. Misoprostol (Cytotec)
  • D. Betamethasone
  • E. Oxytocin (Pitocin)
  • F. IV Fluids

Explanation

A. Brethine (Terbutaline):
Terbutaline is a tocolytic medication used to stop or slow preterm labor contractions. Since this patient is 34 weeks and contracting regularly, Terbutaline can help relax the uterine muscles and prevent further cervical dilation to allow time for fetal lung maturation.
D. Betamethasone:
This corticosteroid is administered to accelerate fetal lung maturity by stimulating surfactant production. It is most effective when given between 24–34 weeks gestation and helps reduce the risk of respiratory distress syndrome if preterm delivery occurs.
F. IV Fluids:
Hydration can sometimes reduce uterine irritability and contractions in preterm labor. Providing IV fluids supports maternal circulation and may help decrease contractions, especially if dehydration is contributing to uterine activity.
3.

 A nurse is developing a care plan for a patient with a medical diagnosis of endometriosis. Based upon her predicted symptoms, what is the priority nursing diagnosis

  • Infection: At risk for.

  • Alteration in comfort: dysmenorrhea

  • Incontinence: Functional urinary

  • Constipation: At risk for

Explanation

Correct Answer B: Alteration in comfort: dysmenorrhea

Explanation:

B. Alteration in comfort: dysmenorrhea

Dysmenorrhea (painful menstruation) is the most common and significant symptom of endometriosis, caused by ectopic endometrial tissue responding to hormonal changes. Pain management is often a priority focus in the nursing care plan for these patients.

Why the Other Options Are Incorrect:

A. Infection: At risk for.

Endometriosis is not an infectious condition, and there's no immediate risk of infection unless there is a complication like post-surgical infection.

C. Incontinence: Functional urinary

Urinary incontinence is not a typical symptom of endometriosis. Although pelvic pain may indirectly affect bladder function, it's not a primary concern.

D. Constipation: At risk for

While pelvic adhesions from endometriosis can cause some bowel symptoms, constipation is not the primary or most urgent symptom in this diagnosis.


4.

A woman who is gravida 3 para 2 enters the intrapartum unit. The most important initial nursing assessments are

  • If she has had prenatal care.

  • Membrane status and her EDD/EDC.

  • Time of last food intake and fasting blood sugar.

  • Pain level and birth plan.

Explanation

Correct Answer B: Membrane status and her EDD/EDC

B. Membrane status and her EDD/EDC

When a woman presents in labor, the most critical initial assessments include whether her membranes have ruptured and her estimated due date (EDD/EDC). Membrane status is essential for assessing infection risk and potential labor progression, while the EDD helps determine gestational age, influencing care decisions (e.g., term vs. preterm protocols).

Why the Other Options Are Incorrect:

A. If she has had prenatal care.

While important for background information, it is not the most immediate priority during labor admission. Urgent clinical data comes first.

C. Time of last food intake and fasting blood sugar.

This is relevant if anesthesia or surgery is anticipated but is not a top initial priority upon arrival to the intrapartum unit.

D. Pain level and birth plan.

Pain assessment and understanding the birth plan are important for ongoing care and patient-centered management, but they do not supersede determining membrane status and gestational age.


5. 68. A multiparous woman has been in labor for 8 hours. Her membranes have just ruptured. The nurse's initial response should be:
  • A. Prepare the patient for immediate birth
  • B. Check the fluid with nitrazine paper
  • C. Note the color and consistency of the fluid
  • D. Assess the FHR

Explanation

When the membranes rupture, the priority nursing action is to assess the fetal heart rate (FHR). This ensures that the umbilical cord has not prolapsed or become compressed, which could compromise fetal oxygenation. Prompt evaluation of the FHR after membrane rupture helps identify any signs of fetal distress early so that immediate interventions can be initiated if necessary, ensuring both maternal and fetal safety.
6. 74. The nurse is providing care for a woman with Type 1 Diabetes. Which of the following is true for the laboratory test for Glycosylated Hemoglobin A1c:
  • A. An A1c shows the amount of hemoglobin the liver can absorb.
  • B. An A1c provides current glucose levels in the blood.
  • C. An A1c would be considered good diabetic control with results of <6%.
  • D. An A1c is done between 24 to 28 weeks on all pregnant women.

Explanation

The glycosylated hemoglobin (A1c) test measures the percentage of hemoglobin molecules coated with glucose, reflecting average blood glucose control over the previous 2–3 months. For diabetic patients, an A1c level below 6% indicates good glycemic control and reduces the risk of complications such as neuropathy, nephropathy, and retinopathy. Unlike daily glucose readings, this test gives a long-term view of how well blood sugar levels are being managed.
7. 84. A G1 P0 39-week gestation patient presents in active labor. She is GBS positive at 36 weeks. What medication does the nurse anticipate giving?
  • A. Pitocin
  • B. Azithromycin
  • C. Penicillin G
  • D. Magnesium Sulfate

Explanation

Group B Streptococcus (GBS) is a bacterial infection that can be transmitted to the newborn during vaginal delivery, leading to serious infections such as sepsis, pneumonia, or meningitis. The recommended treatment for GBS-positive mothers in labor is intravenous Penicillin G, administered at the onset of labor or rupture of membranes, and continued every 4 hours until delivery. This prophylactic therapy effectively reduces neonatal infection risk.
8.

 The doctor writes an order for Terbutaline to be given SQ. Which assessment finding will cause the nurse to question this order

  • BP 94/60

  • P 132

  • UC's are q 10 minutes

  • FHR is category 1

Explanation

Correct Answer B: P 132

Explanation:

B: P 132

Terbutaline is a beta-adrenergic agonist used as a tocolytic to stop preterm labor. One of its common side effects is tachycardia, and it is contraindicated if the maternal pulse is greater than 120 bpm. A pulse of 132 is too high, and administering Terbutaline could worsen the tachycardia, leading to serious cardiovascular effects.

Why the Other Options Are Incorrect:

A. BP 94/60

While this is on the lower end of normal, it is not a contraindication for Terbutaline. Hypotension should be monitored, but it does not automatically rule out use.

C. UC's are q 10 minutes

Uterine contractions every 10 minutes are infrequent, but Terbutaline may still be considered to space them further if labor suppression is needed. This finding does not contraindicate use.

D. FHR is category 1

A Category 1 fetal heart rate tracing is normal and reassuring, and it does not prevent the administration of Terbutaline.


9. 59. A woman who did not receive any prenatal care is more likely to experience which of the following conditions?
  • A. IUGR/ Small for gestational age
  • B. LGA - Large for gestational age
  • C. Molar Pregnancy
  • D. Cervical Insufficiency

Explanation

A woman who receives no prenatal care is at higher risk for having an infant who is intrauterine growth restricted (IUGR) or small for gestational age. Lack of prenatal care may result in unrecognized maternal conditions such as hypertension, malnutrition, or placental insufficiency, all of which can impair fetal growth. Early detection and management during prenatal visits are critical in preventing IUGR and improving fetal outcomes.
10. 92. The doctor writes an order for Terbutaline to be given SQ. Which assessment finding will cause the nurse to question this order?
  • A. BP 94/60
  • B. P 132
  • C. UCs are q 10 minutes
  • D. FHR is Category 1

Explanation

Terbutaline is a beta-adrenergic agonist used as a tocolytic to relax uterine muscles and stop preterm contractions. However, it has cardiac side effects, including tachycardia. A pulse greater than 120 bpm is a contraindication because the medication can further increase heart rate, leading to arrhythmias or cardiac distress.
A blood pressure of 94/60 is low but not critically so, contractions every 10 minutes are mild, and a Category 1 FHR is normal — none of these would prevent giving Terbutaline.

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