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The nurse assesses a pregnant patient and finds that the
patient has reduced strength of uterine contractions (UCs).
Upon further assessment, the nurse suspects that the
patient may have slow progress in labor. Which statement
made by the patient indicates the reason for slow progress
in labor?
A. "I have a family history of diabetes and hypertension."
B. "I stopped taking folic acid supplements a week ago."
C. "I have been on a diet with high amounts of protein for
15 days."
,D. "I am worried a lot this time; I had a lot of problems in
my last labor." - ANSWER-D
(The nurse suspects that the patient may have slow
progress in labor after knowing that the patient is worried
and stressed, because she had complications in the
previous labor. Stress may reduce the progress in the
labor by decreasing the levels of catecholamines. This, in
turn, reduces the UCs. Family history of diabetes does not
affect the labor progression or UCs. Folic acid
supplements are necessary for fetal growth and are given
early in pregnancy to prevent neural tube defects. They do
not affect the birth process. Taking a diet with a high
amount of protein may not affect the onset of labor.
Moreover, it helps in the fetal growth and development.)
,After reviewing the laboratory reports of a pregnant patient
at term, the primary health care provider (PHP) advised
the nurse to administer intravenous (I.V.) fluids to the
patient. What is the reason for giving such advice?
A. Dehydration
B. Hypertension
C. Maternal hyperglycemic
D. Preterm labor - ANSWER-A
(I.V. fluids are administered to increase the amount of
fluids and restore the electrolyte balance. As the patient is
dehydrated, the PHP advises the nurse to administer I.V.
, fluids. Administration of I.V. fluids as a medical treatment
for the prevention of preterm labor is not indicated unless
medical management involves use of therapeutic
protocols such as magnesium sulfate. As the patient is at
term, preterm labor would not be a factor. Administering
fluids may increase the venous pressure, thereby
enhancing the blood pressure. Therefore I.V. fluids must
not be administered if the patient has hypertension. Other
prospective medical management should be initiated if
maternal hypertension is noted. I.V. fluids should not be
administered to hyperglycemic patients, but rather other
prospective medical management should be initiated if
maternal hyperglycemia is noted and deemed to be
significant.)