Maternal Monitoring During Labor

Maternal Monitoring During Labor Related

Review Maternal Monitoring During Labor related questions and content

A 40-year-old primiparous woman who is 38 weeks pregnant has been on the labor unit for an hour when she starts to complain of feeling dizzy, light-headed, and nauseous. Her blood pressure is 90/60. What should be the first response of the nurse?

  • A. Give the patient a bolus of intravenous fluid.
  • B. Turn the patient to her left side.
  • C. Call the obstetrician or nurse midwife.
  • D. Give the patient an antiemetic medication for the nausea.
Correct Answer: B

Rationale: The correct answer is B: Turn the patient to her left side.

Rationale:
1. The patient's symptoms of dizziness, light-headedness, and low blood pressure (90/60) suggest hypotension, which could be due to supine hypotensive syndrome in pregnancy.
2. Turning the patient to her left side can help alleviate pressure on the vena cava, improving blood flow back to the heart and subsequently increasing blood pressure.
3. This immediate action can help prevent further complications such as decreased placental perfusion and fetal distress.

Summary:
- Choice A (Give the patient a bolus of intravenous fluid): While IV fluids may be needed, the priority is to address the underlying cause of hypotension first.
- Choice C (Call the obstetrician or nurse midwife): While it is important to involve the healthcare provider, immediate action to address the hypotension is crucial.
- Choice D (Give the patient an antiemetic medication for

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A patient who has been in labor for several hours is now fully dilated and ready to push. What is the first action the nurse should take?

  • A. Encourage the patient to push with each contraction
  • B. Prepare the delivery room for delivery
  • C. Assess the fetal heart rate
  • D. Administer pain relief
Correct Answer: C

Rationale: The correct answer is C: Assess the fetal heart rate. This is important to ensure the baby's well-being during the pushing phase. By monitoring the fetal heart rate, the nurse can detect any signs of distress or complications, allowing for prompt intervention if needed. Encouraging the patient to push (A) is appropriate once the fetal well-being is confirmed. While preparing the delivery room (B) is important, it is not the immediate priority. Administering pain relief (D) can be considered after assessing the fetal heart rate and ensuring the baby's safety.

A nurse is assisting a postpartum person with breastfeeding. What is the best intervention to help relieve nipple pain?

  • A. apply lanolin cream
  • B. administer analgesics
  • C. apply a warm compress
  • D. apply cold compresses
Correct Answer: A

Rationale: The correct answer is A: apply lanolin cream. Lanolin cream helps to soothe and moisturize the nipples, reducing pain and promoting healing. It is safe for the baby and does not need to be removed before breastfeeding. Applying analgesics (B) is not recommended as they can be harmful to the baby. Warm compresses (C) may not provide the same level of relief for nipple pain as lanolin cream. Cold compresses (D) are not suitable for relieving nipple pain as they can further exacerbate discomfort. Therefore, applying lanolin cream is the best intervention for relieving nipple pain during breastfeeding.

Which is fetal tachycardia likely caused by?

  • A. Compression of the umbilical cord
  • B. Maternal infection
  • C. Compression of the fetal head
  • D. Maternal hypertension
Correct Answer: B

Rationale: The correct answer is B: Maternal infection. Maternal infection can lead to fetal tachycardia due to the transfer of inflammatory mediators from the mother to the fetus, causing an increase in the fetal heart rate. This physiological response is a common indicator of fetal distress in utero.

A: Compression of the umbilical cord can lead to fetal distress, but it typically manifests as bradycardia rather than tachycardia.
C: Compression of the fetal head can cause fetal distress, but it is more likely to result in decelerations in heart rate rather than tachycardia.
D: Maternal hypertension can lead to complications during pregnancy, but it is not typically associated with fetal tachycardia.

The nurse is caring for a patient who is in labor with her first child. The patient's mother is present for support and notes that things have changed in the delivery room since she last gave birth in the early 1980s. Which current trend or intervention may the patient's mother find most different?

  • A. Fetal monitoring throughout labor
  • B. Postpartum stay of 10 days
  • C. Expectant partner and family in operating room for cesarean birth
  • D. Hospital support for breastfeeding
Correct Answer: D

Rationale: Step 1: The correct answer is D because hospital support for breastfeeding is a current trend that has significantly changed since the early 1980s. Back then, breastfeeding support in hospitals was minimal or nonexistent.
Step 2: Hospitals now provide extensive support for breastfeeding, including lactation consultants, education, and resources to help new mothers succeed in breastfeeding.
Step 3: This change in practice is a significant departure from the past and reflects the growing awareness of the importance of breastfeeding for both the mother and the baby's health.
Step 4: In contrast, choices A, B, and C are not as significant changes or trends compared to the evolution of hospital support for breastfeeding. Fetal monitoring, postpartum stay duration, and family presence during cesarean births have been around for a while and have seen some modifications, but they are not as dramatic as the shift in breastfeeding support.

A patient is in active labor and is experiencing back labor. Which position would be most helpful to relieve the back pain?

  • A. Supine position
  • B. Hands and knees position
  • C. Lithotomy position
  • D. Squatting position
Correct Answer: B

Rationale: The correct answer is B: Hands and knees position. This position helps relieve back pain during labor by promoting optimal fetal positioning, reducing pressure on the back, and allowing gravity to assist in the descent of the baby. It also opens up the pelvic outlet, making it easier for the baby to navigate through the birth canal.

Incorrect choices:
A: Supine position can worsen back pain as it puts pressure on the lower back and restricts blood flow to the uterus.
C: Lithotomy position can exacerbate back pain as it involves lying on the back with legs in stirrups, which can increase pressure on the back.
D: Squatting position may not be ideal for relieving back pain in this scenario as it can put additional strain on the back muscles and may not provide optimal support for the laboring individual.

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