Atrium Health Womens Care Maternal Fetal Monitoring

Atrium Health Womens Care Maternal Fetal Monitoring Related

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A nurse is caring for a laboring person who is in the first stage of labor. What is the most important intervention to support the person during this stage?

  • A. provide non-pharmacological pain relief
  • B. administer pain relief
  • C. administer analgesics
  • D. administer IV fluids
Correct Answer: A

Rationale: The correct answer is A: provide non-pharmacological pain relief. During the first stage of labor, it is crucial to prioritize non-pharmacological pain relief techniques such as breathing exercises, massage, and positioning to help manage the discomfort and promote comfort. This approach aligns with the goal of supporting the person's natural labor process and minimizing interventions that could potentially affect the progress of labor. Administering pain relief (B) or analgesics (C) may not be necessary or advisable at this stage unless specifically requested by the laboring person or deemed appropriate by the healthcare provider. Administering IV fluids (D) is important for hydration but is not the most critical intervention during the first stage of labor.

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Which clinical conditions are associated with increased levels of alpha-fetoprotein (AFP)? (Select all that apply.)

  • A. Down syndrome
  • B. Molar pregnancy
  • C. Twin gestation
  • D. Incorrect gestational age assessment of a normal fetus—estimation is earlier in the pregnancy
Correct Answer: C

Rationale: Elevated AFP levels are seen in multiple gestations, miscalculated gestational age, and threatened abortion.

Which statement accurately describes the importance of birthing person position changes during the second stage of labor?

  • A. Position changes have an impact on fetal descent.
  • B. Position changes can lead to support person stress.
  • C. Fetal descent is solely determined by uterine contractions.
  • D. Maintaining a supine position is the safest option.
Correct Answer: A

Rationale: The correct answer is A because position changes during the second stage of labor can indeed impact fetal descent. Different positions such as upright, squatting, or on hands and knees can help utilize gravity to aid in the descent of the baby through the birth canal. This can potentially speed up labor and reduce the risk of complications.

Explanation of why the other choices are incorrect:
B: Position changes are not intended to lead to support person stress, but rather to optimize the birthing process.
C: Fetal descent is influenced by a combination of factors, including uterine contractions and maternal positioning.
D: Maintaining a supine position is not always the safest option as it can compress blood vessels, potentially reducing blood flow to the baby.

A 24-year-old patient is in labor and requests pain relief. What is the most appropriate intervention for a patient who is in the active phase of labor?

  • A. Administer an epidural block
  • B. Provide non-pharmacological pain relief methods
  • C. Administer narcotic analgesics
  • D. Encourage the patient to push with each contraction
Correct Answer: A

Rationale: The correct answer is A: Administer an epidural block. In the active phase of labor, the pain is typically intense and continuous. Administering an epidural block can provide effective pain relief by blocking nerve signals, allowing the patient to rest and conserve energy for the pushing phase. It does not affect the ability to push and can improve maternal satisfaction. Non-pharmacological methods (B) may not provide sufficient relief at this stage. Narcotic analgesics (C) can cross the placenta and affect the baby's respiratory system. Encouraging the patient to push (D) is appropriate during the second stage of labor, not the active phase.

A nurse is providing discharge instructions to a postpartum person who had a cesarean birth. What is the most important instruction to include?

  • A. avoid heavy lifting
  • B. encourage deep breathing exercises
  • C. encourage early ambulation
  • D. avoid sexual activity
Correct Answer: B

Rationale: The correct answer is B: encourage deep breathing exercises. Deep breathing helps prevent complications like pneumonia after surgery, aids in lung expansion, and promotes overall respiratory health. Choice A is important but not the most crucial post-cesarean. Choice C promotes mobility but doesn't address immediate respiratory needs. Choice D is important but not the most vital in the early postpartum period.

The nurse is assisting a couple to develop decisions for their birth plan. Which of the following decisions should be considered nonnegotiable by the parents?

  • A. Whether or not the father will be present during labor.
  • B. Whether or not the woman will have an episiotomy.
  • C. Whether or not the woman will be able to have an epidural.
  • D. Whether or not the father will be able to take pictures of the delivery.
Correct Answer: A

Rationale: The decision regarding the father's presence during labor is deeply personal and should respect the parents' wishes. Medical interventions like episiotomy or epidural can involve clinical judgment, but the presence of a partner is entirely up to the parents.

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