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 B
Explanation
The correct answer is choiceB. Expressions of excitement.
Choice A rationale:
Eagerness to learn newborn care skills is more characteristic of the “taking-hold” phase, which follows the “taking-in” phase.During the taking-hold phase, the mother becomes more independent and starts to take an active role in caring for her newborn.
Choice B rationale:
Expressions of excitement are typical during the “taking-in” phase. This phase occurs in the first 1-2 days postpartum, where the mother is primarily focused on herself and her birth experience.She may be excited and talkative about the birth process.
Choice C rationale:
Focus on the family unit and its members is more aligned with the “letting-go” phase, which is the final phase of maternal postpartum adjustment.In this phase, the mother starts to integrate the newborn into the family and adjusts to her new role.
Choice D rationale:
Lack of appetite can occur during the “taking-in” phase due to exhaustion and the physical demands of labor, but it is not a defining characteristic of this phase.
Correct Answer is C
Explanation
Choice A rationale
Ceftriaxone (Rocephin) is an antibiotic that is often used to treat bacterial infections, but it is not typically the first line of treatment for herpes.
Choice B rationale
Penicillin G intravenously is a type of antibiotic that is often used to treat bacterial infections. However, herpes is a viral infection, and antibiotics are not effective against viruses.
Choice C rationale
Acyclovir is an antiviral medication that is commonly used to treat herpes infections. It works by slowing the growth and spread of the herpes virus in the body. This would be the most appropriate treatment for a patient presenting with symptoms of a herpes outbreak.
Choice D rationale
Betamethasone is a type of corticosteroid that is often used to reduce inflammation. While it might help to reduce some of the inflammation and discomfort associated with herpes lesions, it would not address the underlying viral infection.
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