Question

1. A client at 34 weeks gestation is scheduled to travel for business using a commercial airline. Which instruction is most important for the nurse to provide this client?

1. explore the availability of medical care at the destination site
2. request an aisle seat in a row that is not designated as an exit row
3. perform ankle flexion and extension several times throughout the trip
4. wear non-constricting clothing to prevent edema of the feet and hand

2. The nurse is receiving a report for a laboring client who arrived in the ER with ruptured membranes that the client did not recognize. What is the priority nursing action to implement when the client is admitted to the labor and delivery suite?

1. Prepare to start at IV
2. take the clients temp
3. begin a pad count
4. monitor amniotic fluid for meconium

Answer 1

PRECAUTIONS TO BE TAKEN DURING AIR TRAVEL AT 34 WEEKS

1. There is no absolute contraindications for air travel during pregnancy.

Pregnancy is a stage of hypercoagulation. The clotting factors in the body will increase and the platelet count also will increase, especially towards the end of the pregnancy. Along with this the gravid uterus will compress the blood vessels of the lower extremities and this may leads to sluggishness of venous return. This slow venous return leads to the pooling of blood in the lower extremities . This pooling of blood and increased platelet count and clotting factors may cause the clot formation in the lower extremities and if the clot is getting dislodged from lower extremity it may block the major blood vessels and may produce even pulmonary embolism and death of the mother.

So it is most important to give exercise for the lower extremity like flexion and extension of the knee in order to improve the circulation and to prevent venous stasis.

The lady should wear loose garments for the better circulation and it is  better for her to be in the aisle seat where exit is easy so if she wants to walk or if she want to go the toilet this will be easy and she should make sure the medical facilities available at the destination.

But we know that the main complication that can come due to prolonged sitting is clot formation so she is advised to perform ankle flexion and extension several times during the travel.

2. PRIORITY OF NURSING ACTION IN CASE OF RUPTURED MEMBRANE

The amnion and chorion are the covering membranes of the baby during pregnancy . These membranes will rupture during the process of labour. After the rupture of the membrane the first thing should be observed is the colour of the amniotic fluid. The colour of the amniotic fluid gives a picture about the condition of the baby. The normal amniotic fluid is pale straw coloured. If the colour of the amniotic fluid is greenish it shows that the baby has passed the meconium. If the baby has passed the meconium it is a symbol of the foetal distress and immediate care should be taken to save the life of the baby. The priority is for the life of the mother and baby so here the priority action is monitoring the amniotic fluid for meconium.

It is the responsibility of the nurse to monitor the mothers vital signs and start IV line and nurse should begin the pad count also but these three things are having less priority when comparing the signs of foetal distress and life of the baby .