A nurse recognizes that uterine hyperstimulation with oxytocin ...

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A nurse recognizes that uterine hyperstimulation with oxytocin requires emergency interventions. What clinical cues would alert the nurse that the patient is experiencing uterine hyperstimulation? (Choose all that apply.)
 
  1. Uterine contractions lasting <90 seconds and occurring>2 minutes in frequency
  2. Uterine contractions lasting >90 seconds and occurring <2 minutes in frequency
  3. Uterine tone <20 mm hg
  4. Uterine tone >20 mm Hg
  5. Increased uterine activity accompanied by a nonreassuring FHR and pattern.

Question 2

Assessment of a woman's nutritional status includes a diet history, medication regimen, physical exam, and relevant laboratory tests. A maternity nurse making such an assessment should be aware that:
 
  1. oral contraceptive use may interfere with the absorption of iron.
  2. illnesses that created nutritional deficits such as PKU may require nutritional care before conception.
  3. the woman's socioeconomic status and educational level are not relevant to her examination; they belong to the social worker, if to anybody.
  4. the only nutrition-related laboratory testing needed by most pregnant women is for diabetes.

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Answer to Question 1

2, 4, 5.
1. Incorrect. Uterine contractions that occur over 2 minutes apart and last less than 90 seconds are the expected goal of oxytocin induction.
2, 4, 5. Correct. Uterine contractions that are occurring less than 2 minutes apart and are lasting more than 90 seconds, a uterine tone of over 20 mm Hg, and a nonreassuring FHR and pattern are all indications of uterine hyperstimulation with oxytocin administration.
3. Incorrect. A uterine tone of less than 20 mm Hg is normal.

Answer to Question 2

2
1. Incorrect. Oral contraceptive use may interfere with the absorption of folic acid. Iron de-ficiency can appear if an IUD placement resulted in blood loss.
2. Correct. A registered dietitian can help with therapeutic diets.
3. Incorrect. A woman's finances impact her access to good nutrition; her education (or lack of) can influence the nurse's teaching decisions.
4. Incorrect. The nutrition-related lab testing usually needed is a screen for anemia.