Intrapartum-Related Complications

Intrapartum-Related Complications Related

Review Intrapartum-Related Complications related questions and content

A patient at 41 weeks' gestation is undergoing an induction of labor with an IV administration of oxytocin (Pitocin). The fetal heart rate starts to demonstrate a recurrent pattern of late decelerations with moderate variability. What is the nurse's priority action?

  • A. Stop the infusion of Pitocin.
  • B. Reposition the patient from her right to her left side
  • C. Perform a vaginal exam to assess for a prolapsed cord
  • D. Perform a vaginal exam to assess for a prolapsed cor
Correct Answer: A

Rationale: The priority action for the nurse in this situation is to stop the infusion of Pitocin. Late decelerations are a concerning fetal heart rate pattern that indicates uteroplacental insufficiency. Oxytocin (Pitocin) can cause hyperstimulation of the uterus, leading to poor oxygenation of the fetus and resulting in late decelerations. Stopping the Pitocin infusion can help to improve placental perfusion and oxygenation to the fetus, potentially reversing the late decelerations. It is crucial to address the fetal distress promptly to prevent further compromise and ensure the safety of both the mother and the baby. Other interventions, such as repositioning the patient or preparing for a cesarean birth, may also be necessary but should occur after stopping the Pitocin infusion.

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The nurse in labor and delivery notices an increase in the number of women requesting cesarean births. Which are the parameters and criteria used when making the decision to perform a cesarean delivery on maternal request (CDMR)? Select all that apply.

  • A. Patient is able to self-pay for the procedure.
  • B. Patient is willing to defer from legal litigation.
  • C. Mother is planning to only have one child.
  • D. Patient is aware of possible neonatal complications.
Correct Answer: D

Rationale: Choice B is correct because CDMR (cesarean delivery on maternal request) is often performed after 39 weeks gestation when the mother is fully aware of the risks and potential complications involved with the procedure.

A nurse is performing an initial assessment of a multigravida patient who is 10 weeks gestation. Which assessment finding would necessitate further testing?

  • A. Rubella titer ratio of 1:10
  • B. Blood type A+
  • C. White blood cell count of 5,000
  • D. Previous history of gestational diabetes
Correct Answer: A

Rationale: Chadwick’s sign, which is the bluish coloration of the cervix, is an early positive sign of pregnancy. It indicates increased blood flow and is often noted during a pelvic examination.

The nurse is caring for a postpartum person after a hemorrhage. How does the nurse monitor for decreased perfusion?

  • A. Monitor lochia.
  • B. Measure blood loss.
  • C. Check temperature.
  • D. Monitor 24-hour urine output.
Correct Answer: B

Rationale: After postpartum hemorrhage, monitoring the 24-hour urine output can help assess for signs of decreased perfusion.

To clarify the fetal condition when baseline variability is absent, the nurse should first

  • A. monitor fetal oxygen saturation using fetal pulse oximetry.
  • B. notify the physician so that a fetal scalp blood sample can be obtaine
  • C. apply pressure to the fetal scalp with a glove finger using a circular motion.
  • D. increase the rate of nonadditive IV fluid to expand the mother's blood volume
Correct Answer: C

Rationale: When baseline variability is absent in fetal monitoring, it may indicate fetal hypoxia or acidemia. The appropriate action to further evaluate the fetal condition would be to notify the physician so that a fetal scalp blood sample can be obtained. This blood sample can provide important information about the oxygenation status of the fetus, helping to guide the management and interventions needed to support the baby's well-being. Monitoring fetal oxygen saturation using fetal pulse oximetry (choice A) or performing other interventions such as applying pressure to the fetal scalp (choice D) or increasing IV fluids for the mother (choice E) would not provide as direct or specific information about the fetal condition as obtaining a blood sample would.

A 26-year-old multigravida patient is 14 weeks pregnant and is scheduled for a maternal serum alpha-fetoprotein test. She asks the nurse, 'What does this test indicate?' The nurse explains that this test can detect which of the following?

  • A. Leg defects
  • B. Gastrointestinal defects
  • C. Neural tube defects
  • D. Renal defects
Correct Answer: C

Rationale: Quickening is the term used when a woman feels the first fetal movements. It typically happens around the second trimester and is a sign of fetal development and activity.

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