A nurse is reinforcing teaching with a client who is in labor about why epidural anesthesia is not initiated until a good labor pattern has been established. Which of the following explanations should the nurse include?

"Given too soon, epidural anesthesia will delay rupture of fetal membranes.".

"Given too soon, epidural anesthesia can prolong labor.".

"Given too soon, epidural anesthesia can cause fetal depression.".

"Given too soon, epidural anesthesia can cause maternal hypertension.".

Answer and Explanation

The Correct Answer is B

Choice A reason:
Initiating epidural anesthesia too soon may delay rupture of fetal membranes. This statement is not accurate. Epidural anesthesia itself does not have a direct impact on the rupture of fetal membranes. The timing of rupturing membranes is determined based on the progress of labor and other clinical indications. There is no causal relationship between epidural anesthesia and the timing of membrane rupture.

Choice B reason:
Initiating epidural anesthesia too soon can prolong labor. This statement is correct. Epidural anesthesia, while providing pain relief during labor, can also cause some degree of motor blockage and decrease the woman's ability to push effectively. This can potentially lead to a lengthening of the labor process. It is generally recommended to wait until a good labor pattern has been established to avoid unnecessary prolongation of labor.

Choice C reason:
Initiating epidural anesthesia too soon can cause fetal depression. This statement is not entirely accurate. Epidural anesthesia can cross the placenta and reach the fetus, but the effect on the baby is usually minimal. However, fetal monitoring is essential during labor to ensure the baby's well-being, regardless of whether epidural anesthesia is used or not.

Choice D reason:
Initiating epidural anesthesia too soon can cause maternal hypertension. This statement is not supported by evidence. Epidural anesthesia does not typically cause maternal hypertension. It can, however, lead to a decrease in blood pressure in some cases, which is why careful monitoring of maternal blood pressure is necessary during and after the administration of epidural anesthesia.

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Correct Answer is B

Explanation

Choice A rationale:

If the client is Rh positive and the newborn is Rh negative, there is no indication for administering Rho(D) immune globulin. Rho(D) immune globulin is only given when the Rh-negative mother gives birth to an Rh-positive baby.

Choice B rationale:

This is the correct choice for administering Rho(D) immune globulin. When the mother is Rh negative and the newborn is Rh positive, there is a risk of Rh incompatibility. If the fetal blood enters the mother's circulation during delivery, her immune system may produce antibodies against Rh-positive blood cells, which can be harmful to future Rh-positive pregnancies. To prevent this, Rho(D) immune globulin is administered to the Rh-negative mother shortly after delivery.

Choice C rationale:

If both the mother and the newborn are Rh-negative, there is no risk of Rh incompatibility. Rho(D) immune globulin is not required in this situation.

Choice D rationale:

If both the mother and the newborn are Rh-positive, there is no risk of Rh incompatibility. Rho(D) immune globulin is not indicated in this case.

A. Hypercalcemia. B. Hypobilirubinemia. C. Hypoglycemia. D. Decreased RBC.

Correct Answer is C

Explanation

Choice A rationale :

Hypercalcemia - The nurse does not need to monitor for hypercalcemia in this scenario. Hypercalcemia refers to high levels of calcium in the blood, and it is not directly related to the newborn's weight or the mother's diabetes mellitus.

Choice B rationale

Hypobilirubinemia - Hypobilirubinemia is low levels of bilirubin in the blood and is not a major concern for a newborn's weight or the mother's diabetes mellitus. Although jaundice (high bilirubin levels) can be a concern in newborns, it is not the focus in this case.

Choice C rationale

Hypoglycemia - This is the correct choice. Newborns of diabetic mothers are at risk of developing hypoglycemia, which is low blood sugar levels. The baby receives excess glucose from the mother during pregnancy, and after birth, insulin production may be higher than needed, leading to low blood sugar levels. Monitoring for hypoglycemia is crucial to prevent potential complications.

Choice D rationale

Decreased RBC - The nurse does not need to monitor for decreased red blood cells (RBC) specifically related to the newborn's weight or the mother's diabetes mellitus. Monitoring RBC levels is important for other conditions, but it is not the primary concern in this case.

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A nurse is reinforcing teaching with a client who is in labor about why epidural anesthesia is not initiated until a good labor pattern has been established. Which of the following explanations should the nurse include?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is postpartum. Which of the following findings is an indication for the nurse to administer Rho(D) immune globulin?

Correct Answer is B

Explanation

A nurse is collecting data from a newborn who weighs 5,160 g (11 lb, 6 oz) and whose mother has diabetes mellitus. For which of the following data should the nurse monitor?

Correct Answer is C

Explanation

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