The nurse receives a newborn within the first minutes after a vaginal delivery and intervenes to establish adequate respirations.
What priority issue should the nurse address to ensure the newborn’s survival?

Choice A rationale

Cervical dilation is a sign of labor, but a dilation of 1 cm alone does not confirm active labor. It could be the early phase of labor or false labor.

Choice B rationale

Contractions that decrease with walking are typically associated with false labor. In true labor, contractions usually get stronger regardless of activity level.

Choice C rationale

While 2+ pitting edema in the lower extremities can be seen in pregnancy, it is not a reliable indicator of labor. It could be due to fluid retention or other conditions.

Choice D rationale

The status of the membranes (intact or ruptured) does not necessarily indicate whether a woman is in labor. Some women may experience membrane rupture before labor begins.

Choice A rationale

In the context of a fetus weighing an estimated 8 pounds at 36-weeks gestation in a client with gestational diabetes, an amniocentesis would most likely be performed to assess the maturity of the fetal lungs. This is because babies of mothers with gestational diabetes are at risk for

respiratory distress syndrome if delivered early, and the baby’s size may indicate that early delivery could be beneficial.

Choice B rationale

While amniocentesis can be used to detect neural tube defects, these are usually diagnosed earlier in pregnancy. Furthermore, there is no specific link between gestational diabetes, fetal weight, and neural tube defects that would make this the primary reason for performing an amniocentesis in this scenario.

Choice C rationale

Amniocentesis can be used to detect chromosomal abnormalities. However, these are typically screened for earlier in pregnancy and would not be directly related to the mother’s gestational diabetes or the estimated fetal weight.

Choice D rationale

The gender of the fetus can be determined through amniocentesis, but it can also be determined more simply through ultrasound. Therefore, it is unlikely that an amniocentesis would be performed for this purpose, especially considering the mother’s gestational diabetes and the baby’s size.