A 38-year-old patient in her second trimester states a desire to ...

[yoooooman]

A 38-year-old patient in her second trimester states a desire to begin an exercise program to decrease her fatigue. What is the most appropriate nursing response?
 
  1. Fatigue should resolve in the second trimester, but walking daily might help.
  2. Avoid a strenuous exercise regimen at your age. Drink coffee to combat fatigue.
  3. Avoid an exercise regimen due to your pregnancy. Try to nap daily.
  4. Fatigue will increase as pregnancy progresses, but running daily might help.

Question 2

If the physician indicates a shoulder dystocia during the delivery of a macrosomic fetus, how would the nurse assist?
 
  1. Call a second physician to assist.
  2. Prepare for an immediate cesarean delivery.
  3. Assist the woman into McRoberts maneuver.
  4. Utilize fundal pressure to push the fetus out.

[mariahkathleeen]

Answer to Question 1

1
Rationale 1: Mild to moderate exercise during pregnancy is healthy for moms and babies. The increased stamina that correlates with physical fitness can help decrease fatigue in pregnancy, but the second trimester will bring greater fatigue, as fetal metabolism creates demands on the maternal system.
Rationale 2: The age of 38 is not too old to begin an exercise routine, but during pregnancy, a patient should not begin a new type of extremely strenuous or high-impact activity. It is not appropriate to drink a lot of coffee.
Rationale 3: Those patients who have regularly engaged in strenuous or high-impact activities prior to pregnancy can continue that practice unless they develop pregnancy complications that contraindicate exercise.
Rationale 4: Mild to moderate exercise during pregnancy is healthy for moms and babies, but a patient should not begin a new type of extremely strenuous or high-impact activity.

Answer to Question 2

3
Explanation: 3. The McRoberts maneuver is thought to change the maternal pelvic angle and therefore reduce the force needed to extract the shoulders, thereby decreasing the incidence of brachial plexus stretching and clavicular fracture.

[yoooooman]

TYSM

[dantucker]

Excellent