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A nurse is assisting the provider to administer a dinoprostone insert to induce labor for a client. Which of the following actions should the nurse take?

A. Place the client in a semi-Fowler's position for 1 hr after administration.

Placing the client in a semi-Fowler's position for 1 hour after administering the dinoprostone insert is not necessary. There is no evidence or indication that this position enhances the medication's effectiveness or safety.

B. Instruct the client to avoid urinary elimination until after administration.

Instructing the client to avoid urinary elimination until after administration is not appropriate and can lead to discomfort and potential complications. There is no connection between urinary elimination and the administration of dinoprostone. Instructing the client to avoid urinary elimination until after administration is unnecessary. The client's bladder should be emptied prior to administration, but there is no need to restrict urinary elimination afterward . Instructing the client to avoid urinary elimination until after administration is incorrect. Urinary elimination does not interfere with the administration or effectiveness of a dinoprostone insert.

C. Verify that informed consent is obtained prior to administration.

Verifying that informed consent is obtained before administering any medication or procedure is a crucial nursing responsibility. Informed consent ensures that the client is fully aware of the risks, benefits, and alternatives, and gives permission for the procedure to take place. Dinoprostone is a medication that is used to soften and dilate the cervix in pregnant women who need to have labor induced. It is inserted into the vagina as a gel, jelly, or a small tampon-like device. According to the guidelines from the American College of Obstetricians and Gynecologists (ACOG), the correct answer is c. Verify that informed consent is obtained prior to administration4. This is because dinoprostone is associated with some risks and side effects, such as excessive bleeding, infection, uterine rupture, and fetal distress. Therefore, the provider should explain the benefits and risks of the medication to the client and obtain their written consent before proceeding with the induction.

D. Allow the medication to reach room temperature prior to administration.

Allowing the medication to reach room temperature prior to administration is not necessary for a dinoprostone insert. Medications that require temperature adjustment are specified in the manufacturer's instructions or facility protocols, and this is not one of them.

This question is an excerpt from Nurse Dive's nursing test bank - ATI Maternal Newborn 2019 NGN Proctored Exam. Take the full exam now

Full Explanation

The correct answer is choice C: Verify that informed consent is obtained prior to administration. Choice A rationale: Placing the client in a semi-Fowler’s position is not specifically related to the administration of dinoprostone. This position is often used post-administration to promote comfort and labor progression, but it is not a required action prior to the administration of dinoprostone. Choice B rationale: Instructing the client to avoid urinary elimination until after administration is not necessary. There is no evidence to suggest that retaining urine affects the efficacy or safety of dinoprostone administration. Choice C rationale: Verifying that informed consent is obtained prior to administration is crucial. Dinoprostone, like any medication used to induce labor, carries potential risks and side effects. It is essential that the client is informed about these risks and consents to the procedure before the medication is administered. Choice D rationale: Allowing the medication to reach room temperature prior to administration is not a standard requirement for dinoprostone inserts. Medications have specific storage and administration guidelines that should be followed according to the manufacturer’s instructions and facility protocols.

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Full Explanation

The correct answer is choice c. Heart rate 72/min.

Choice A rationale:

A blood pressure of 80/50 mm Hg is within the normal range for a full-term newborn.

Choice B rationale:

A respiratory rate of 55/min is also within the normal range for a newborn, which typically ranges from 30 to 60 breaths per minute.

Choice C rationale:

Choice D rationale:

A temperature of 36.5°C (97.7°F) is within the normal range for a newborn, which is generally between 36.5°C to 37.5°C (97.7°F to 99.5°F).

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QUESTION

A nurse is providing teaching to a postpartum client who has type 1 diabetes mellitus and is breastfeeding her newborn. Which of the following instructions should the nurse give the client?

A. "Maintain scheduled mealtimes for yourself.".

Instructing the client to maintain scheduled mealtimes is essential for a postpartum client with type 1 diabetes mellitus who is breastfeeding. Consistent and balanced meals help stabilize blood glucose levels, especially in diabetic clients who need to manage their insulin.

B. "Check your blood glucose levels every 8 hours.".

Checking blood glucose levels every 8 hours is not appropriate for a postpartum client with type 1 diabetes mellitus. Diabetic clients typically need to monitor their blood glucose more frequently, especially after meals and during breastfeeding.

C. "Take more insulin with each meal than you did prior to pregnancy.".

Instructing the client to take more insulin with each meal than she did prior to pregnancy is not accurate advice. The insulin requirements may change during pregnancy, but it is essential to follow the healthcare provider's guidance on adjusting insulin doses after delivery.

D. "Limit your carbohydrate intake to 30 grams per day.".

Limiting carbohydrate intake to 30 grams per day is not suitable for a breastfeeding postpartum client with type 1 diabetes mellitus. Carbohydrates are a crucial source of energy, and breastfeeding mothers usually require more carbohydrates to support lactation and energy needs. Restricting carbohydrates to such a low level could be harmful.

Full Explanation

Choice A rationale:

Choice B rationale:

Choice C rationale:

Choice D rationale:

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QUESTION

A nurse is providing teaching about increasing dietary fibre to an antepartum client who reports constipation. Which of the following food selections has the highest fibre content per cup?

A. Oatmeal.

Oatmeal is a good source of fibre, but its fibre content per cup is not as high as some other options.

B. Cabbage.

Cabbage is a healthy choice with some fibre content, but it does not have as much fibre per cup as lentils.

C. Lentils.

Lentils have the highest fibre content per cup compared to the other options listed. They are rich in both soluble and insoluble fibre, which helps promote bowel regularity and alleviate constipation.

D. Asparagus.

Asparagus is a nutritious vegetable but does not have as much fibre per cup as lentils.

Full Explanation

Choice A rationale:

Oatmeal is a good source of fibre, but its fibre content per cup is not as high as some other options.

Choice B rationale:

Cabbage is a healthy choice with some fibre content, but it does not have as much fibre per cup as lentils.

Choice C rationale:

Choice D rationale:

Asparagus is a nutritious vegetable but does not have as much fibre per cup as lentils.

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