A nurse is completing discharge teaching to a client in her 35th week of pregnancy who has mild preeclampsia. Which of the following information about nutrition should be included in the teaching?

Drink 48 to 64 ounces of water daily.

Avoid salting foods during cooking.

Consume 40 to 50 g of protein daily.

Limit intake of whole grains, raw fruits, and vegetables.

Answer and Explanation

The Correct Answer is A

Choice a reason:
Hydration is crucial during pregnancy, especially for those with preeclampsia. Adequate water intake helps maintain blood volume and reduce blood viscosity, which can help manage blood pressure levels. Drinking 48 to 64 ounces of water daily is recommended to support the increased blood volume needed during pregnancy and to help prevent dehydration, which can exacerbate preeclampsia symptoms.

Choice b reason:
While reducing salt intake can be beneficial for managing blood pressure, it is not necessary to completely avoid salting foods during cooking. Instead, moderation is key. Excessive salt can lead to water retention, which can worsen preeclampsia, but some salt is needed for electrolyte balance and proper body function.

Choice c reason:
Protein is an essential nutrient for fetal growth and the repair and maintenance of maternal tissues. A daily intake of 40 to 50 grams of protein is generally recommended during pregnancy. However, for those with preeclampsia, protein needs may be higher due to potential protein loss in the urine. It's important to monitor protein intake and adjust as needed under medical guidance.

Choice d reason:
Limiting the intake of whole grains, raw fruits, and vegetables is not recommended. These foods provide essential nutrients, fiber, and antioxidants that are beneficial for both maternal and fetal health. They should be included as part of a balanced diet unless there are specific dietary restrictions advised by a healthcare provider.

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Correct Answer is C

Explanation

Choice A reason:
Inserting an indwelling urinary catheter can be helpful in measuring urine output and reducing bladder distention, which may impede uterine contractions. However, it is not the immediate next step in managing postpartum hemorrhage.

Choice B reason:
Administering oxytocin by continuous IV infusion is a standard intervention to promote uterine contractions after delivery, which helps to control bleeding. However, before starting an oxytocin infusion, it is important to ensure that there are no retained placental fragments and that the uterus is not already well-contracted.

Choice C reason:
Massaging the client's fundus is the priority action because it can stimulate uterine contractions, which are essential for controlling postpartum bleeding. A firm, contracted uterus helps to compress the blood vessels and prevent excessive bleeding.

Choice D reason:
Tilting the client onto her right side with her legs elevated can help improve venous return and may be part of the management for shock. However, the immediate concern in a postpartum client with excessive bleeding is to manage the bleeding by promoting uterine contractions.

A. Observe for meconium in respiratory secretions. B. Monitor for hyperglycemia. C. Monitor for hyperthermia. D. Identify manifestations of anemia.

Correct Answer is A

Explanation

Choice a reason:
Observing for meconium in respiratory secretions is crucial for SGA newborns because they are at increased risk for meconium aspiration syndrome (MAS). MAS occurs when a newborn breathes in meconium-stained amniotic fluid into their lungs, which can cause respiratory distress. It is more common in full-term or post-term babies, and early detection and treatment are vital for improving outcomes.

Choice b reason:
Monitoring for hyperglycemia is important as SGA newborns are at risk for blood sugar imbalances. Hyperglycemia in newborns can be due to various factors, including stress, and requires careful management to prevent complications. However, it is not the primary concern immediately post-delivery for SGA newborns compared to the risk of MAS.

Choice c reason:
Monitoring for hyperthermia is less commonly a primary concern for SGA newborns immediately after birth. Hyperthermia can lead to dehydration and increase metabolic demands, which can be harmful to newborns. However, the immediate risk of hyperthermia is not as high as the risk of MAS for SGA newborns.

Choice d reason:
Identifying manifestations of anemia is important in newborn care. Anemia in newborns can present as pale skin, irritability, and a fast heart rate. While it is a condition that requires attention, the immediate post-delivery concern for SGA newborns is typically the risk of MAS rather than anemia.

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A nurse is completing discharge teaching to a client in her 35th week of pregnancy who has mild preeclampsia. Which of the following information about nutrition should be included in the teaching?

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Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

A nurse is caring for a client who is at 40 weeks of gestation and is in labor. The client's ultrasound examination indicates that the fetus is small for gestational age (SGA). Which of the following interventions should be included in the newborn's plan of care?

Correct Answer is A

Explanation

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