Need Help with these OB Questions Please

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Hi Everyone,

Our group needs help on answering these questions and could really use some input to see if we are on right track since we all have to come to agreement on the answers. Thanks in advance.

A 17-year-old primigravida is 28 weeks gestation and has gained 6 pounds since 4 weeks ago at her last prenatal visit. The most important nursing action is to:

  • Caution her to avoid salty foods and return in 2 weeks
  • Advise to cut down on fast foods that are high in fat
  • Recommend she stay home from school for a few days to reduce stress
  • Assess blood pressure, presence of edema, and urine for protein.

The most dangerous effect on the fetus of a mother who smokes cigarettes while pregnant is: (Choose all that apply)

  • Stillbirth
  • Behavioral problems
  • Fetal addiction to the substance inhaled
  • Intauterine growth retardation

Intrapartum High Risk

A woman who has had a previous cesarean birth is in active labor, when suddenly complains of pain between her scapulae. Which of the following actions should the nurse take? (Select all that apply)

  • Assess the patient's vital signs for tachycardia, and falling blood pressure.
  • Observe for abnormally high uterine resting tone
  • Assist the client into a supine position
  • Notify the physician immediately

As a group we are split between: # 1 A or D for the answer We all agree this is possible preeclampsia.

#2 A lot of us feel it's A B & D only Others feel it's all A, B, C, & D

#3 A for sure with D? Is the symptom of "pain between her scapulae" a symptom of Uterine Rupture or is it possibly a symptom of something else?

Thanks in advance

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Specializes in med/surg, telemetry, IV therapy, mgmt.

a 17-year-old primigravida is 28 weeks gestation and has gained 6 pounds since 4 weeks ago at her last prenatal visit. the most important nursing action is to:

  • caution her to avoid salty foods and return in 2 weeks
  • advise to cut down on fast foods that are high in fat
  • recommend she stay home from school for a few days to reduce stress
  • assess blood pressure, presence of edema, and urine for protein.

the most dangerous effect on the fetus of a mother who smokes cigarettes while pregnant is: (choose all that apply)

  • stillbirth
  • behavioral problems
  • fetal addiction to the substance inhaled
  • intauterine growth retardation

intrapartum high risk

a woman who has had a previous cesarean birth is in active labor, when suddenly complains of pain between her scapulae. which of the following actions should the nurse take? (select all that apply)

  • assess the patient's vital signs for tachycardia, and falling blood pressure.
  • observe for abnormally high uterine resting tone
  • assist the client into a supine position
  • notify the physician immediately

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a 17-year-old primigravida is 28 weeks gestation and has gained 6 pounds since 4 weeks ago at her last prenatal visit. the most important nursing action is to:

  • caution her to avoid salty foods and return in 2 weeks
  • advise to cut down on fast foods that are high in fat
  • recommend she stay home from school for a few days to reduce stress
  • assess blood pressure, presence of edema, and urine for protein.

the most dangerous effect on the fetus of a mother who smokes cigarettes while pregnant is: (choose all that apply)

  • stillbirth
  • behavioral problems
  • fetal addiction to the substance inhaled
  • intauterine growth retardation

intrapartum high risk

a woman who has had a previous cesarean birth is in active labor, when suddenly complains of pain between her scapulae. which of the following actions should the nurse take? (select all that apply)

  • assess the patient's vital signs for tachycardia, and falling blood pressure.
  • observe for abnormally high uterine resting tone
  • assist the client into a supine position
  • notify the physician immediately

thanks daytonite.......i don't mean to sound stupid but are the answers in red? reason i ask is # 1 is not select all that apply and only one answer is needed for #1 #2 is select all that apply

2catlover

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Specializes in med/surg, telemetry, IV therapy, mgmt.

answers are in red. i made an error on question #1.

a 17-year-old primigravida is 28 weeks gestation and has gained 6 pounds since 4 weeks ago at her last prenatal visit. the most important nursing action is to:

  • caution her to avoid salty foods and return in 2 weeks
  • advise to cut down on fast foods that are high in fat
  • recommend she stay home from school for a few days to reduce stress
  • assess blood pressure, presence of edema, and urine for protein.

the reference that i checked did not list stillbirth, behavioral problems or fetal addiction to the substance inhaled as an effect of smoking on a fetus, but it was very clear about uterine growth retardation.

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Thanks Daytonite What source did you use? Can you explain #3 as to how an abnormally high uterine resting tone would also be an answer. Is the condition the woman is presenting is this Uterine Rupture?

2CatLover

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Specializes in med/surg, telemetry, IV therapy, mgmt.

foundations of maternal-newborn nursing, 4th edition, clinical companion, by sharon smith murray and emily slone mckinney.

is the condition the woman is presenting with in question #3 uterine rupture?

yes. contractions slow down or stop when the uterus ruptures.

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thanks so much daytonite for clarifying your answers to my questions. i and my group member sometimes have trouble "reading into the question" which states "the most dangerous effect" not effects and then choose all that apply. it appears there is only one answer since effect is not plural. just like the way question #2 is written

our main textbook is also foundations of maternal-newborn nursing, 4th edition, by sharon smith murray and emily slone mckinney and on page 601 table 24-2 for tobacco and fetal or neonatal effects it states: prematurity, lbw, fetal demise (stillbirth right? ) developmental delays, increased incidence of sids, neurologic problems ( behavorial problems right? )

the most dangerous effect on the fetus of a mother who smokes cigarettes while pregnant is: (choose all that apply) stillbirth behavioral problems fetal addiction to the substance inhaled intauterine growth retardation

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thanks daytonite for clarifying your answers and assisting our group. our class textbook is foundations of nursing 4e by murray and mckinney. one reason why we had problems in answering question #2 is the way the question is worded. it states the most dangerous effect not effects and then choose all that apply.

the most dangerous effect on the fetus of a mother who smokes cigarettes while pregnant is: (choose all that apply)

  • stillbirth
  • behavioral problems
  • fetal addiction to the substance inhaled
  • intauterine growth retardation

in the textbook on page 601 table 24-2 for tobacco and fetal or neonatal effects it lists: prematurity, fetal demise (stillbirth correct?) developmental delays (growth retardation - agree) increased incidence of sids, neurologic problems (behavorial problems correct?) so you can see why alot of us were confused as to how to answer this so, do you think intauterine growth retardation is still the only answer based on the additional info given? help help

2catlover

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Oops Sorry I double posted

2CatLover

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Specializes in Medical.

Not a midwife so take this with a pinch of salt but neurological problems are not the same as behavioural problems. Unless your text or another reliable reference specifically mentions behavioural issues I would be really careful about including this one.

There is certainly an increased risk of stillbirth or miscarriage associated with smoking, though it is small and usually related to the heaviness of tobacco use. Low birth weight and prematurity are more common.

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Specializes in med/surg, telemetry, IV therapy, mgmt.

Wow! Well, I'd go on what your textbook says. Stillbirth (fetal death) would be the most dangerous effect based on how the question is worded. But since the question tells you to choose all that apply I would also include intrauterine growth retardation. Both of these happen in utero.

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