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A nurse in an antepartum unit is caring for a client.

Exhibits
Which of the following actions should the nurse take? Select all that apply.

Administer oxygen at 10L/min via nonrebreather face mask.

Request a prescription for hydralazine.

Initiate a bolus of IV fluid.

Assist the client to the left lateral position.

Request a prescription for oxytocin.

Notify the provider of the client's condition.

Prepare to administer an amnioinfusion.

Answer and Explanation

Correct Answer : A,C,D,F,G

A. Administer oxygen at 10 L/min via nonrebreather face mask. The fetal heart rate (FHR) is 168/min with minimal variability, which indicates potential fetal distress or hypoxia. Providing oxygen can improve fetal oxygenation.

B. Request a prescription for hydralazine. Hydralazine is used for severe hypertension in pregnancy (BP ≥160/110 mm Hg). The client’s BP is 132/84 mm Hg, which does not indicate a need for antihypertensive medication at this time.

C. Initiate a bolus of IV fluid. IV fluid bolus can improve placental perfusion, increase maternal blood pressure (if hypotension is a concern), and correct fetal heart rate abnormalities. This is especially important with minimal variability.

D. Assist the client to the left lateral position. Repositioning to the left lateral position improves uteroplacental blood flow and may help correct FHR abnormalities.

E. Request a prescription for oxytocin. Oxytocin is used to augment labor. However, the priority here is managing fetal distress, not increasing contractions. Oxytocin may worsen fetal distress, so it is not appropriate at this time.

F. Notify the provider of the client's condition. The combination of tachycardia (FHR 168/min), minimal variability, and meconium-stained fluid indicates possible fetal distress. The provider must be notified immediately to determine further interventions.

G. Prepare to administer an amnioinfusion. Meconium-stained fluid increases the risk of meconium aspiration syndrome. An amnioinfusion (infusion of sterile fluid into the amniotic sac via an intrauterine catheter) can help dilute thick meconium and improve fetal well-being.

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Correct Answer is D

Explanation

A. Antibiotic therapy. This is incorrect because there is no indication of an infection. The WBC count is within the normal range, and there are no symptoms suggestive of a bacterial infection.
B. Protective environment. This is incorrect because a protective environment is used for immunocompromised clients, such as those undergoing chemotherapy or with severe neutropenia, which is not the case here.
C. Blood transfusion. This is incorrect because although the hemoglobin level is low (8.1 g/dL), it is not critically low enough to require a transfusion. Instead, iron supplementation is the preferred treatment.
D. Iron supplementation. This is correct because the child’s hemoglobin and hematocrit levels indicate mild anemia, likely due to excessive cow’s milk intake, which can lead to iron deficiency anemia in toddlers. Iron supplementation will help correct the deficiency.

A. Ask the child to complete homework in an area with minimal distractions. B. Have the child write assignments by hand instead of using a computer. C. Vary the child's scheduled activities each day. D. Encourage the child to read a book during an outdoor school activity period.

Correct Answer is A

Explanation

A. Minimizing distractions helps children with ADHD focus better and improves concentration.
B. Writing by hand does not necessarily enhance concentration and may actually increase frustration for some children with ADHD.
C. A structured and predictable routine is beneficial for children with ADHD, so varying activities daily may be counterproductive.
D. Encouraging a child to read during an outdoor activity period may limit needed physical movement, which can help manage ADHD symptoms.

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A nurse in an antepartum unit is caring for a client.

Exhibits
Which of the following actions should the nurse take? Select all that apply.