Author Question: Which client should the Labor and Delivery nurse care for first? 1. 26-year-old primip with a ... (Read 26 times)

Awilson837 · **on:** Jun 28, 2018

Which client should the Labor and Delivery nurse care for first?

1. 26-year-old primip with a history of depression stating that she knows 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 six 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 at 38 weeks' gestation has been diagnosed with oligohydramnios. Which statement indicates that teaching has been effective?

1. My gestational diabetes may have caused this problem to develop.
2. When I go into labor, I should come to the hospital right away.
3. This problem is common, and will likely occur with my next pregnancy.
4. Women with this condition usually go into labor after their due date.

aburgess · **Reply #1 on:** Jun 28, 2018

Answer to Question 1

3
Rationale:
1. This client is exhibiting a lack of hope and negative thoughts, which are common with depression but not life-threatening.
2. Although she has a history of schizophrenia, there are currently no abnormal findings with this client.
3. This client is in the manic phase of her disease. It is difficult to auscultate fetal heart tones and difficult to 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.
4. Tachycardia and tachypnea are signs of an anxiety disorder; however, currently this client is not experiencing any problems.

Answer to Question 2

2
Rationale:
1. Gestational diabetes can lead to polyhydramnios, but does not cause oligohydramnios.
2. The incidence of cord compression and resulting fetal distress is high when there is an inadequate amount of amniotic fluid to cushion the umbilical cord. Thus the client with oligohydramnios should come to the hospital in early labor to detect any fetal intolerance of labor that might develop.
3. Oligohydramnios occurs in 13 of pregnancies. It rarely recurs in subsequent pregnancies.
4. The risk of fetal demise is increased with oligohydramnios. Labor is usually induced when the client reaches term pregnancy to prevent fetal demise.