A woman is in labor. The fetus is in vertex position. When the client's membranes rupture, the nurse sees that the amniotic fluid is meconium-stained. The nurse should immediately:
1. Change the client's position in bed.
2. Notify the physician that birth is imminent.
3. Administer oxygen at 2 liters per minute.
4. Begin continuous fetal heart rate monitoring.
4
Rationale:
1. Changing the client's position is not indicated.
2. Meconium-stained amniotic fluid does not indicate that birth is imminent.
3. Oxygen administration is not indicated.
4. Meconium-stained amniotic fluid is an abnormal fetal finding, and is an indication for continuous fetal monitoring.
You might also like to view...
A client states "I'm pretty fed up with my wife. I'm thinking I should just get a divorce, but I worry
about how that will affect my kids. What do you think I should do?" The psychiatric mental health nurse responds "Tell me what is happening between you and your wife.". Which basic nursing intervention does this interchange characterize? a. Advocacy b. Counseling c. Health teaching d. Milieu management
Which of the following should the qualitative researcher pay attention to as part of observation?
a. Focusing only on what is directly happening to the participant. b. Focusing solely on the unexpected events in the participant's life. c. General overview of the participant's routine. d. Personal reactions to the situation.
An important concept to teach patients who take expectorants, antitussives, decongestants, or bronchodilators is that:
1. these are all over-the-counter medications that must be used with caution. 2. medication effectiveness will be enhanced with adequate patient hydration of more than 2 quarts of water per day. 3. these preparations frequently cause adverse effects, and the patient should not take them without consulting a physician. 4. patients may expect to develop fever, swollen lymph nodes, and tightness in the chest when taking these products.
Which statement identifies a truth regarding the generally accepted plan for the reentry of the chemically impaired employee into the workplace?
A) It is successful in only a small number of cases despite active treatment programs B) It is discouraged by the board of registered nursing C) It should not occur until 3 years after the employee has completed the treatment program D) It often includes an employer requirement that the employee agree to random urine screening on request by the employer