To clarify the fetal condition when baseline variability is ...

[Coya19@aol.com]

To clarify the fetal condition when baseline variability is absent, the nurse should first:
 
  a. monitor fetal oxygen saturation using fetal pulse oximetry.
  b. notify the physician so that a fetal scalp blood sample can be obtained.
  c. apply pressure to the fetal scalp with a glove finger using a circular motion.
  d. increase the rate of nonadditive IV fluid to expand the mother's blood volume.

Question 2

A 6-year-old child has patient-controlled analgesia (PCA) for pain management after orthopedic surgery. The parents are worried that their child will be in pain. What should your explanation to the parents include?
 
  a. The child will continue to sleep and be pain free.
  b. Parents cannot administer additional medication with the button.
  c. The pump can deliver baseline and bolus dosages.
  d. There is a high risk of overdose, so monitoring is done every 15 minutes.

[johnpizzaz]

Answer to Question 1

ANS: C
Fetal scalp stimulation helps identify whether the fetus responds to gentle massage. An acceleration in response to the massage suggests that the fetus is in normal oxygen and acid-base balance. Monitoring fetal oxygen saturation using fetal pulse oximetry is no longer available in the United States. Obtaining a fetal scalp blood sample is invasive and the results are not immediately available. Increasing the rate of nonadditive IV fluid would not clarify the fetal condition.

Answer to Question 2

ANS: C
The PCA prescription can be set for a basal rate for a continuous infusion of pain medication. Additional doses can be administered by the patient, parent, or nurse as necessary. Although the goal of PCA is to have effective pain relief, a pain-free state may not be possible. With a 6-year-old child, the parents and nurse must assess the child to ensure that adequate medication is being given because the child may not understand the concept of pushing a button. Evidence-based practice suggests that effective analgesia can be obtained with the parents and nurse giving boluses as necessary. The prescription for the PCA includes how much medication can be given in a defined period. Monitoring every 1 to 2 hours for patient response is sufficient.

[Coya19@aol.com]

TYSM

[mohan]

Excellent