Which of the following provider prescriptions should the nurse plan to implement? Select the 3 actions the nurse should plan to take.
Which of the following provider prescriptions should the nurse plan to implement? Select the 3 actions the nurse should plan to take.
Conduct a non-stress test twice per week.
Monitor blood glucose level once daily.
Refer the client to a dietitian for nutritional counseling.
Instruct the client to refrain from physical activity.
Correct Answer : A,B,C
Choice A rationale: Conducting a non-stress test twice per week is a common practice for pregnant women who are at high risk, and this client is considered high risk due to her history of gestational diabetes and the fact that her two previous newborns weighed over
4.5 kg. A non-stress test is a simple, noninvasive test that checks the baby’s heart rate and response to movement. It’s called a “non- stress” test because it causes no stress to the baby. The test usually takes about 20 to 30 minutes. The mother lies on her left side, and a belt with a sensor that can detect the baby’s heartbeat is placed around her abdomen. The baby’s heart rate is expected to increase with each movement, and this is a sign that the baby is healthy and getting enough oxygen. If the baby’s heart rate does not increase with movement, it may mean that the baby is not getting enough oxygen, which could be a sign of a problem.
Choice B rationale: Monitoring blood glucose levels once daily is crucial for this client due to her history of gestational diabetes and current elevated fasting blood glucose level. Gestational diabetes is a condition in which a woman without diabetes develops high blood sugar levels during pregnancy. It may precede development of type 2 DM. Self-monitoring of blood glucose levels in gestational diabetes is considered a cornerstone of management to improve maternal and neonatal prognosis. It allows pregnant women to evaluate their individual response to therapy and assess whether glycemic targets are being achieved. This can help prevent complications related to gestational diabetes, such as macrosomia (a high birth weight), hypoglycemia in the newborn, and pre- eclampsia in the mother.
Choice C rationale: Referring the client to a dietitian for nutritional counseling is an important step in managing her gestational diabetes. Diet plays a crucial role in managing blood glucose levels during pregnancy. A dietitian can provide a personalized meal plan that includes the right amount of carbohydrates, protein, and fat for the client. The meal plan will also take into account the client’s food preferences, lifestyle, and weight gain goals during pregnancy. Nutritional counseling can help the client understand how different foods affect her blood glucose levels and how to make healthy food choices that will benefit both her and her baby.
Choice D rationale: Instructing the client to refrain from physical activity is not a recommended action. Physical activity is generally beneficial for pregnant women, including those with gestational diabetes. Regular physical activity can help lower blood glucose levels, reduce insulin resistance, and manage weight gain during pregnancy. However, the type and intensity of physical activity should be appropriate for the client’s fitness level and pregnancy stage, and any physical activity should be done under the guidance of a healthcare provider.
Choice E rationale: Increasing caloric intake to support fetal growth is not necessarily a recommended action for this client. While it’s true that pregnant women need additional calories to support fetal growth, this must be balanced with the need to manage blood glucose levels in the case of gestational diabetes. Consuming too many calories, particularly in the form of carbohydrates, can lead to high blood glucose levels. Instead, the focus should be on consuming a balanced diet that includes a variety of nutrients to support fetal growth.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
While changes in an infant’s sleep patterns can be a sign of many issues, they are not a specific indicator of a food allergy.
Choice B rationale
Rice cereals are typically one of the first foods introduced to infants and are usually well- tolerated. They are not known to cause problems during lactation.
Choice C rationale
The foods a mother eats can affect breast milk, but they do not typically cause food allergies. Most babies can tolerate a variety of foods in a mother’s diet without any problems.
Choice D rationale
If there is a strong family history of peanut allergies, the mother might want to avoid eating peanuts while breastfeeding. However, current research suggests that early exposure to potential allergens may actually decrease the risk of developing allergies.
Correct Answer is C
Explanation
The correct answer is choiceC. Respiratory rate.
Choice A rationale:
Monitoring the fetal heart rate (FHR) is crucial during labor to assess the well-being of the fetus.However, when administering magnesium sulfate, the primary concern is the mother’s respiratory status due to the risk of respiratory depression, which can be a side effect of the medication.
Choice B rationale:
While bowel sounds are an important part of a comprehensive assessment, they are not the primary concern when administering magnesium sulfate.Magnesium sulfate primarily affects the neuromuscular and respiratory systems.
Choice C rationale:
Respiratory rate is the primary nursing assessment for a client receiving magnesium sulfate IV.Magnesium sulfate can cause respiratory depression, so it is essential to monitor the client’s respiratory status closely to detect any signs of respiratory compromise early.
Choice D rationale:
Monitoring temperature is important in any clinical setting, but it is not the primary concern when administering magnesium sulfate.The primary focus should be on the respiratory rate due to the potential for respiratory depression.
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