The nurse is assessing a woman in early labor.
While positioning her for a vaginal exam, she complains of dizziness and nausea and appears pale.
Her blood pressure has dropped slightly.
What is the appropriate initial nursing action?
Call the healthcare provider.
Elevate the head of the bed.
Encourage deep breathing.
Turn her to her side.
The Correct Answer is D
Choice A rationale
Calling the healthcare provider delays immediate intervention needed to alleviate the client's symptoms of dizziness and nausea due to supine hypotensive syndrome. Quick repositioning is crucial to improve venous return and alleviate the symptoms.
Choice B rationale
Elevating the head of the bed will not relieve the pressure on the inferior vena cava caused by the supine position. This intervention does not address the underlying cause of the client's symptoms.
Choice C rationale
Encouraging deep breathing is unlikely to resolve the symptoms of supine hypotensive syndrome, which is caused by the compression of the vena cava by the gravid uterus when lying supine. This intervention does not address the physiological cause.
Choice D rationale
Turning her to her side relieves the pressure on the inferior vena cava, improving venous return and increasing blood pressure. This is the correct initial action to address the symptoms of supine hypotensive syndrome.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["July 27"]
Explanation
Step 1 is to identify the first day of the last menstrual period (LMP), which is October 20.
Step 2 is to count back 3 months from October 20, resulting in July 20.
Step 3 is to add 1 year to July 20, resulting in July 20 of the following year.
Step 4 is to add 7 days to July 20, resulting in July 27.
Final calculated answer: July 27 of the following year.
Correct Answer is B
Explanation
Choice A rationale
Maintaining a folic acid intake of 4 mcg per day is not sufficient. The recommended dose for pregnant women is 400-800 mcg to help prevent neural tube defects, but it is not specifically related to reducing the risk of preterm labor.
Choice B rationale
Increasing fluid intake to 8-10 (8 oz) glasses per day is recommended as it helps to maintain hydration, which is crucial in preventing preterm labor. Dehydration can cause uterine contractions, which can lead to preterm labor.
Choice C rationale
Consuming the recommended daily allowance of vitamin C (85 mg) is important for immune function and overall health but does not directly affect the risk of preterm labor.
Choice D rationale
Increasing caloric intake by 500 calories per day is typically recommended for breastfeeding mothers, not for preventing preterm labor during pregnancy. Proper nutrition is important, but overconsumption can lead to excessive weight gain.
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