A nurse is performing the third Leopold maneuver on a woman who ...

[jparksx]

A nurse is performing the third Leopold maneuver on a woman who is gravida 3, para 3 and is currently 37 weeks' gestation. The nurse's fingers can be pressed together below the presenting part, which is firm to the touch.
 
  What action should the nurse take regarding this assessment data?
  A.
  Facilitate a referral to a perinatologist.
  B.
  Inform the health-care provider immediately.
  C.
  Prepare the woman for a breech delivery.
  D.
  Reassure the woman and document the findings.

Question 2

A pregnant teen is in the clinic for a prenatal visit. The nurse needs to obtain informed consent. What action by the nurse is best?
 
  A.
  Ask the teen to call a parent and get consent over the phone.
  B.
  Have the teen sign the consent and then place it on the chart.
  C.
  Let the teen keep her appointment, but limit it to teaching only.
  D.
  Tell the teen that she must return with her parent/guardian.

[bubulittle310@msn.cn]

Answer to Question 1

ANS: D
The third Leopold maneuver is performed to confirm the presentation noted in the first maneuver and to determine if the presenting part is engaged. If the presenting part moves upward so that the examiner's fingers can be pressed together, the presenting part is not engaged. In a first pregnancy, engagement usually occurs around 37 weeks' gestation; with subsequent pregnancies engagement may not occur until labor has begun. If the presenting part is firm, it is the head. If the presenting part is soft, the fetus is in the breech position. This woman is in her third pregnancy, so the lack of engagement is not abnormal. The presenting part was firm, so the baby is not breech. There is no need to inform the health-care provider immediately or facilitate a referral to a higher level of care. The nurse should reassure the woman and document the findings.

Answer to Question 2

ANS: B
A pregnant teen is considered emancipated, so she can sign for her own care. The nurse should obtain and document informed consent from the teen. The other actions are not necessary.

[jparksx]

Excellent

[bblaney]

TYSM