A nursery nurse is attending the birth of a post-term infant.

Exhibits
Upon review of the medical record, the infant newborn is at risk for developing which of the following symptoms? Select all that apply

Meconium aspiration syndrome

macrosomia

intraventricular hemorrhage

bronchopulmonary dysplasia

Answer and Explanation

Correct Answer : A,B

Rationale for Correct Choices

• Meconium aspiration syndrome: The presence of thick green amniotic fluid indicates meconium-stained fluid, which the post-term infant may aspirate during delivery. Meconium aspiration can obstruct the airways, cause chemical pneumonitis, and lead to respiratory distress requiring immediate intervention and supportive care.

• Macrosomia: Post-term infants are at increased risk of macrosomia due to prolonged gestation and continued growth in utero. Macrosomic infants face complications such as difficult labor, shoulder dystocia, and birth injuries, necessitating careful monitoring and potential interventions during delivery.

Rationale for Incorrect Choices

• Intraventricular hemorrhage: This condition is primarily associated with preterm infants due to fragile germinal matrix vasculature. The post-term infant in this scenario is less likely to develop intraventricular hemorrhage.

• Bronchopulmonary dysplasia: Chronic lung disease usually develops in preterm infants who have required prolonged mechanical ventilation or oxygen therapy. The term post-term infant is not at high risk for this condition immediately after birth.

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Correct Answer is D

Explanation

Rationale:
A. "Dehydration is caused by a decreased hemoglobin and hematocrit.": Dehydration typically results in increased, not decreased, hemoglobin and hematocrit values because fluid loss concentrates red blood cells. Low values would suggest anemia or blood loss rather than dehydration.

B. "Dehydration is associated with gastroesophageal reflux.": While dehydration may worsen nausea or fatigue, it is not directly linked to gastroesophageal reflux. GERD in pregnancy is usually caused by hormonal relaxation of the lower esophageal sphincter and increased intra-abdominal pressure from the enlarging uterus.

C. "Dehydration is treated with calcium supplements.": Calcium supplements are unrelated to treating dehydration. Management focuses on restoring fluid balance through oral or intravenous hydration to maintain uteroplacental perfusion and reduce uterine irritability.

D. "Dehydration can increase the risk for preterm labor.": Dehydration leads to increased secretion of antidiuretic hormone (ADH), which can stimulate oxytocin release and uterine contractions. Correcting dehydration helps reduce uterine activity and lowers the risk of preterm labor in pregnant clients.

A. Perform a vaginal examination every 12 hr. B. Administer betamethasone. C. Provide a low-stimulation environment. D. Maintain bed rest. E. Obtain a 24-hr urine specimen. F. Give antihypertensive medication. G. Monitor intake and output hourly.

Correct Answer is ["B","C","D","E","F","G"]

Explanation

Rationale

A. Perform a vaginal examination every 12 hr: Vaginal examinations should be avoided in a client with severe preeclampsia unless delivery is imminent, as they can stimulate uterine activity and increase the risk of placental abruption. Continuous monitoring and noninvasive assessments are prioritized instead.

B. Administer betamethasone: Betamethasone promotes fetal lung maturity by stimulating surfactant production when preterm delivery before 34 weeks is anticipated. This reduces the risk of neonatal respiratory distress syndrome and intraventricular hemorrhage.

C. Provide a low-stimulation environment: A quiet, dimly lit environment helps minimize CNS stimulation, reducing the risk of seizure activity in clients with severe preeclampsia. Environmental stressors such as bright lights and loud noises should be avoided.

D. Maintain bed rest: Bed rest, particularly in the left lateral position, improves uteroplacental perfusion and reduces blood pressure by minimizing pressure on the vena cava. It also helps limit activity that could elevate BP further.

E. Obtain a 24-hr urine specimen: Collecting a 24-hour urine specimen allows accurate assessment of total protein excretion, which confirms the severity of preeclampsia. Proteinuria greater than 300 mg/24 hr indicates significant renal involvement.

F. Give antihypertensive medication: Antihypertensives such as labetalol or hydralazine help prevent maternal complications like stroke or heart failure from sustained severe hypertension while avoiding excessive BP reduction that could impair uteroplacental blood flow.

G. Monitor intake and output hourly: Close monitoring of intake and output detects early signs of renal compromise or fluid overload, which are common in preeclampsia. Accurate measurement helps guide safe fluid management and prevent pulmonary edema.

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A nursery nurse is attending the birth of a post-term infant. Exhibits Upon review of the medical record, the infant newborn is at risk for developing which of the following symptoms? Select all that apply

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing teaching to a client who is experiencing preterm contractions and dehydration. Which of the following statements should the nurse make?

Correct Answer is D

Explanation

The nurse is continuing to care for the client. Exhibits The nurse is initiating the client's plan of care. Which of the following interventions should the nurse plan to implement? Select all that apply.

Correct Answer is ["B","C","D","E","F","G"]

Explanation

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A nursery nurse is attending the birth of a post-term infant.

Exhibits
Upon review of the medical record, the infant newborn is at risk for developing which of the following symptoms? Select all that apply