A nurse is caring for a client following an amniocentesis.
The nurse should observe the client for which of the following complications?
Hyperemesis.
Proteinuria.
Hemorrhage.
Hypoxia.
The Correct Answer is C
Choice A rationale
Hyperemesis gravidarum is severe nausea and vomiting during pregnancy, typically occurring in the first trimester. Amniocentesis is a procedure performed later in pregnancy, so hyperemesis is not a direct complication of the procedure.
Choice B rationale
Proteinuria is the presence of protein in the urine, which can be a sign of preeclampsia during pregnancy. While amniocentesis carries a small risk of complications, proteinuria is not a direct expected complication of the procedure itself.
Choice C rationale
Hemorrhage, or excessive bleeding, is a potential complication of amniocentesis because the procedure involves inserting a needle through the abdominal wall and uterus to withdraw amniotic fluid. This can potentially damage blood vessels, leading to bleeding at the insertion site or internally.
Choice D rationale
Hypoxia is a condition in which the body or a region of the body is deprived of adequate oxygen supply at the tissue level. While fetal well-being is monitored during and after amniocentesis, hypoxia is not a direct complication for the mother.
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Correct Answer is D
Explanation
Choice A rationale
A urinary output of 30 mL/hr is within the normal range for an adult, indicating adequate kidney perfusion and hydration status postpartum. Normal urine output is typically considered to be greater than 30 mL/hr.
Choice B rationale
Headache pain rated a 6 on a scale of 0 to 10 is a common complaint postpartum, especially after spinal anesthesia. While it requires assessment and management, it is not necessarily a sign of immediate life-threatening complication. Postpartum headaches can be related to hormonal shifts, dehydration, or the spinal anesthesia itself.
Choice C rationale
A blood pressure of 100/70 mm Hg is within the normal postpartum range for many women. While a decrease from pre-pregnancy levels can occur, this reading does not indicate an immediate critical issue. Normal postpartum blood pressure generally stabilizes around pre-pregnancy levels within a few days.
Choice D rationale
A respiratory rate of 10 breaths per minute is below the normal adult range of 12 to 20 breaths per minute. This bradypnea could indicate respiratory depression, a potential complication of spinal anesthesia, especially if opioid analgesics have been administered. Immediate intervention is required to assess the cause and ensure adequate oxygenation.
Correct Answer is C
Explanation
Choice A rationale
Encouraging a hands-and-knees position can help rotate a fetus in an occiput posterior position or relieve back pain during labor. However, in hypotonic uterine dysfunction where contractions are weak and ineffective, this positional change alone is unlikely to augment labor significantly.
Choice B rationale
Providing a comfortable environment with dim lighting can reduce anxiety and promote relaxation, which might indirectly support labor progress. However, it does not directly address the issue of weak and ineffective uterine contractions characteristic of hypotonic dysfunction.
Choice C rationale
Administering oxytocin is the typical intervention for hypotonic uterine dysfunction after ruling out fetopelvic disproportion. Oxytocin is a synthetic hormone that stimulates uterine contractions, increasing their frequency, duration, and intensity to facilitate labor progress. It acts on the oxytocin receptors in the uterus, leading to smooth muscle contraction.
Choice D rationale
Preparing for an amniotomy (artificial rupture of membranes) might be considered to augment labor if the membranes are intact. However, since the woman's membranes have already ruptured, this intervention is not applicable in this situation. Amniotomy can sometimes stimulate or augment labor by releasing prostaglandins.
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