The nurse in the obstetrical clinic is setting appointments for ...

[vinney12]

The nurse in the obstetrical clinic is setting appointments for clients seeking preconceptual care. Which client should be seen first?
 
  1. 36-year-old, has never been pregnant, takes medication for a seizure disorder
  2. 15-year-old, smokes one pack per day, had a miscarriage four months ago
  3. 22-year-old, runs long distances, has been on the pill for six years
  4. 29-year-old, has had two abortions, takes a multiple-vitamin supplement

Question 2

The nurse is caring for an infant born at 37 weeks that weighs 1,750 g (3 pounds, 10 ounces). The head circumference and length are at the 25th percentile. What statement would the nurse expect to find in the chart?
 
  1. Preterm appropriate for gestational age, symmetrical IUGR
  2. Term small for gestational age, symmetrical IUGR
  3. Preterm small for gestational age, asymmetrical IUGR
  4. Preterm appropriate for gestational age, asymmetrical IUGR

[britb2u]

Answer to Question 1

1
Rationale:
1. This client is the top priority because she has multiple risk factors: She is over the age of 35 and therefore is at risk for trisomies; some medications are teratogenic, and are contraindicated during pregnancy; and pregnancy is not recommended for women with some conditions. This client needs to see the specialist who prescribes her anti-seizure medication, as well with an obstetric provider to discuss the risks her age present to a possible pregnancy.
2. Although this client has the risks of being young and a smoker, she is not the highest priority.
3. The only risk factor this client has is a need to increase folic acid intake due to being on the pill for six years.
4. This client has no risk factors for pregnancy. A history of more than three abortions increases the risks of preterm labor and infertility, but this client has only had two abortions.

Answer to Question 2

3
Rationale:
1. The infant is preterm at 37 weeks. Because the weight is below the 10th percentile, the infant is not appropriate for gestational age, but is considered small for gestational age. Head circumference and length between the 10th and 90th percentiles indicate asymmetrical IUGR. Symmetrical IUGR would have head circumference below the 10th percentile.
2. The infant is preterm at 37 weeks. Because the weight is below the 10th percentile, the infant is small for gestational age. Head circumference and length between the 10th and 90th percentiles indicate asymmetrical IUGR. Symmetrical IUGR would have head circumference below the 10th percentile.
3. The infant is preterm at 37 weeks. Because the weight is below the 10th percentile, the infant is small for gestational age. Head circumference and length between the 10th and 90th percentiles indicate asymmetrical IUGR.
4. The infant is preterm at 37 weeks. Because the weight is below the 10th percentile, the infant is not appropriate for gestational age, he is considered small for gestational age. Head circumference and length between the 10th and 90th percentiles indicate asymmetrical IUGR.

[vinney12]

Thanks for the timely response, appreciate it

[chjcharjto14]

Excellent