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    Ati rn maternal newborn 2023 proctored exam

    A nurse is admitting a female client, age 34, who is at 38 weeks of gestation to the labor and delivery unit for induction of labor. For each potential intervention, click to specify if the intervention is expected or unexpected for the client.

    Explanation & Rationale

    Discontinue oxytocin infusion (Expected): The client has contractions every 1–2 minutes lasting 90–120 seconds, indicating uterine tachysystole. Stopping oxytocin is a primary intervention to reduce contraction frequency and duration, preventing further fetal hypoxia. Assist with amnioinfusion (Expected): Amnioinfusion can help dilute thick meconium-stained amniotic fluid or relieve cord compression, which can cause late decelerations and minimal variability in FHR. It is often used to improve fetal oxygenation during uterine hyperstimulation. Give 500 mL of lactated Ringer’s IV bolus (Expected): Increasing maternal hydration improves uteroplacental perfusion, which can be compromised during frequent contractions. This intervention helps restore blood volume and oxygen delivery to the fetus. Place the client in a side-lying position (Expected): Lateral positioning improves uterine blood flow by relieving pressure on the vena cava and optimizing cardiac output and fetal oxygenation. Give betamethasone 12 mg IM now (Unexpected): Betamethasone is administered antenatally to accelerate fetal lung maturity in preterm labor (before 34 weeks). This client is at 38 weeks gestation, so corticosteroids are not indicated.

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