Author Question: For which patient should the labor and delivery nurse care first? 1. 26-year-old primip with a ... (Read 36 times)

geoffrey · **on:** Jun 27, 2018

For which patient should the labor and delivery nurse care first?

1. 26-year-old primip with a history of depression stating that she can't labor successfully and will need a cesarean
2. 28-year-old multip with a diagnosis of schizophrenia who is oriented to person, place, time, and location
3. 24-year-old primip diagnosed 6 years ago with bipolar disease who is moving constantly and refusing to lie in the bed
4. 30-year-old multip with an anxiety disorder who experienced tachycardia and tachypnea on the last shift

Question 2

The client is having fetal heart rate decelerations. An amnioinfusion has been ordered for the client to alleviate the decelerations.

The nurse understands that the type of decelerations that will be alleviated by amnioinfusion is which of the following? 1. Early decelerations
2. Moderate decelerations
3. Late decelerations
4. Variable decelerations

ju · **Reply #1 on:** Jun 27, 2018

Answer to Question 1

3
Rationale 1: This patient is exhibiting negative thoughts and a lack of hope, which are common with depression but not life-threatening.
Rationale 2: Although she has a history of schizophrenia, there are currently no abnormal findings with this patient.
Rationale 3: This patient is in the manic phase of her disease. It is difficult to auscultate fetal heart tones and monitor the fetus of a pregnant woman in constant motion. If the fetus is not monitored, fetal intolerance to labor might not be detected, with the possibility of fetal death as a result.
Rationale 4: Tachycardia and tachypnea are signs of an anxiety disorder; however, this patient currently is not experiencing any problems.

Answer to Question 2

4
Explanation: 4. When cord compression is suspected, amnioinfusion (AI) may be considered. AI helps to prevent the possibility of variable decelerations by increasing the volume of amniotic fluid.