The nurse manager in a perinatal clinic is reviewing research ...

[corkyiscool3328]

The nurse manager in a perinatal clinic is reviewing research related to care of patients with cervical insufficiency and preterm birth. What practice change might result from this review of the literature?
 
  A.
  Administering fewer doses of Rho(D) immune globulin (RhoGAM)
  B.
  Decreased utilization of cerclage placement in women with preterm labor
  C.
  Measuring serial cervical lengths in all women pregnant with singletons
  D.
  Providing betamethasone (Celestone) as long-term therapy

Question 2

A woman is being dismissed after undergoing placement of a cerclage. The woman is married with a husband who travels frequently and the couple has two other children. Which action by the nurse is most helpful?
 
  A.
  Arrange for the visiting nurse to administer IV antibiotics.
  B.
  Educate the woman on the need for strict bedrest.
  C.
  Enlist the services of a social worker to help her plan care for her other children.
  D.
  Teach the woman about the side effects of metachlopramide (Reglan).

[Mochi]

Answer to Question 1

ANS: B
According to a meta-analysis by Berghella and Mackeen (2011), singleton gestations in women with prior preterm birth might be monitored safely with transvaginal ultrasound cervical length screening, and they suggested that cerclage placement be reserved for the minority of women who actually develop a short cervical length. Administration of RhoGAM is not related. Only women with a history of preterm birth need cervical length measurement according to current practice. Celestone is not used for long-term therapy.

Answer to Question 2

ANS: C
After cerclage placement, bedrest is necessary. It is often difficult for a woman to maintain bedrest, especially if she has other children. A social worker can be helpful in assisting the woman to make contact with support organizations and in developing a working plan to care for the other children and household obligations. IV antibiotics are not routinely needed. Education on bedrest is important, but without acknowledging and acting on the profound disruptions that it can cause for a family, education alone is likely to be unsuccessful in promoting bedrest. Metachlopramide is used for nausea.

[corkyiscool3328]

Thank you

[Mochi]

Happy to help you