A nurse is caring for a 26-year-old gravida 2 para 1 client in the labor and delivery unit.

Exhibits
Click to indicate which interventions the nurse would include in the plan of care to support the expected outcomes of adequate epidural anesthesia on the mother and the fetus. Each column must have at least one response selected.

Assisting with pushing efforts

Administering bolus fluids

Monitoring blood pressure

Administering IV fluids

Side positioning

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"A,B"},"D":{"answers":"A"},"E":{"answers":"A,B"}}

Interventions	Support Epidural Anesthesia for Mother	Support Epidural Anesthesia for Fetus
Assisting with pushing efforts	✓
Administering bolus fluids	✓
Monitoring blood pressure	✓	✓
Administering IV fluids	✓
Side positioning	✓	✓

Assisting with pushing efforts:

Goal: Support Epidural Anesthesia for Mother
Reason: Epidural anesthesia can diminish the mother's ability to feel the urge to push during labor. Assisting with pushing efforts helps ensure effective delivery and supports the mother's ability to participate actively in the birthing process.

Administering bolus fluids:

Goal: Support Epidural Anesthesia for Mother
Reason: Administering bolus fluids can help prevent hypotension, a common side effect of epidural anesthesia. Ensuring adequate fluid volume maintains blood pressure and supports overall maternal hemodynamic stability.

Monitoring blood pressure:

Goal: Support Epidural Anesthesia for Mother and Fetus
Reason: Continuous monitoring of blood pressure is essential to detect and manage hypotension, ensuring both maternal and fetal well-being. It helps maintain adequate blood flow to the uterus and placenta, optimizing fetal perfusion.

Administering IV fluids:

Goal: Support Epidural Anesthesia for Mother
Reason: Administering IV fluids helps maintain hydration and blood pressure, counteracting the potential hypotensive effects of epidural anesthesia. It supports the mother's hemodynamic stability during labor.

Side positioning:

Goal: Support Epidural Anesthesia for Mother and Fetus
Reason: Side positioning optimizes uteroplacental blood flow and reduces the risk of aortocaval compression by the gravid uterus. It ensures better fetal perfusion and maternal comfort while receiving epidural anesthesia.

Nursing Test Bank

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Free Nursing Study Resources

Correct Answer is ["A","C","D","E"]

Explanation

Choice A rationale

Assisting the client to void before walking can prevent potential incontinence episodes, which might be embarrassing for the client. Additionally, a full bladder can increase the risk of falls due to discomfort or urgency to get to the restroom quickly.

Choice B rationale

While instructing the client about signs of orthostatic hypotension is important, it is not within the scope of practice for an unlicensed assistive personnel (UAP) to provide such instructions. This task falls under the responsibility of a licensed nurse.

Choice C rationale

Measuring the client's vital signs before walking helps to assess the client's baseline status and ensures that the client is stable enough to engage in physical activity. Any abnormal readings could indicate the need to postpone or modify the activity.

Choice D rationale

Reporting the onset of any dizziness or light-headedness is crucial for ensuring the client's safety during activity. These symptoms could indicate underlying issues such as orthostatic hypotension or other cardiovascular problems that need to be addressed promptly.

Choice E rationale

Determining if a gait belt is needed ensures that the client receives appropriate support while walking. A gait belt can provide additional stability and help prevent falls, especially for clients with limited tolerance for activity.

A. Mixed berries. B. Low-fat yogurt. C. Carrots. D. Beets.

Correct Answer is B

Explanation

Choice A rationale

Mixed berries are rich in antioxidants and nutrients, but they do not specifically provide the calcium and vitamin D necessary to support bone health in postmenopausal women, who are at increased risk for osteoporosis.

Choice B rationale

Low-fat yogurt is a good source of calcium and vitamin D, which are vital for maintaining bone density and preventing osteoporosis in postmenopausal women. These nutrients are crucial as estrogen levels drop, increasing the risk of bone loss.

Choice C rationale

Carrots are high in beta-carotene and fiber but do not significantly contribute to calcium and vitamin D intake. While beneficial for overall health, they are not the primary focus for bone health in postmenopausal women.

Choice D rationale

Beets offer various vitamins and minerals but lack substantial amounts of calcium and vitamin D. They are not emphasized for bone health in postmenopausal women, who need to prioritize nutrients that support bone density.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with limited tolerance for activity needs to walk in the hallway with assistance. Which instruction(s) should the nurse give to the unlicensed assistive personnel (UAP) who is assisting with the client's care? Select all that apply.

Correct Answer is ["A","C","D","E"]

Explanation

The nurse is providing a nutrition class to a group of postmenopausal clients. Which food should the nurse emphasize to this group?

Correct Answer is B

Explanation

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