A client is 6 centimeters dilated, but she has a strong urge to ...

[ahriuashd]

A client is 6 centimeters dilated, but she has a strong urge to push. The best nursing action at this time is to
 
  a. closely observe the fetal heart rate for variable decelerations
  b. give the client a prescribed sedative
  c. position the client on her side
  d. suggest that the client use a panting pattern of breathing

Question 2

A 24-hour urine for vanillylmandelic acid (VMA) has been ordered on a child suspected of having neuroblastoma. The nurse begins the collection:
 
  1. At 0700.
  2. After the next time the child voids.
  3. At bedtime.
  4. When the order is noted.

[shewald78]

Answer to Question 1

D
The panting pattern of breathing is very helpful to the mother experiencing the desire to push during the first stage of labor. Pushing at this point (6 cm dilated) could cause cervical tears and increased pressure on the fetus. Closely observing the fetal heart rate for variable decelerations will not assist the mother and prevent pushing. Sedation crosses the placenta, sedating the fetus as well as the mother and labor. Positioning the client on her side will assist the fetus with variable decelerations or the mother with supine hypotension.

Answer to Question 2

2
Rationale:
1. It would not be an accurate collection of 24 hours of urine if the collection began at 0700.
2. A 24-hour urine collection is started after the child voids. That specimen is not saved, but all subsequent specimens in that 24-hour period should be collected.
3. It would not be an accurate collection of 24 hours of urine if the collection were at bedtime.
4. It would not be an accurate collection of 24 hours of urine if the collection began when the order was noted.

[ahriuashd]

Thank you

[shewald78]

No problemo