An emergency cesarean is being implemented. The patient describes tingling in her ears and a metallic taste with the administration of regional anesthesia. The nurse is aware that which incidence has occurred?
- A. Manifestation of maternal respiratory depression related to anesthesia
- B. Inadvertent injection of the anesthetic agent into the maternal bloodstream
- C. Maternal hypotension is occurring related to administration of anesthesia
- D. Expected manifestations related to anesthetic medications are present
Correct Answer: B
Rationale: The correct answer is B: Inadvertent injection of the anesthetic agent into the maternal bloodstream. This is indicated by the patient experiencing tingling in her ears and a metallic taste, which are signs of systemic toxicity from the anesthetic agent. The anesthetic has entered the bloodstream instead of staying localized to the intended area. Other choices are incorrect as A is more related to opioid overdose, C is more related to hypotension, and D implies that these symptoms are normal when they are not.
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Which statement by the patient indicates to the nurse that the patient understands danger signs during the second trimester?
- A. I should contact the doctor if I experience heartburn.
- B. I should contact the doctor if I experience constipation.
- C. I should contact the doctor if I experience hurting when I urinate.
- D. I should contact the doctor if I experience leg cramps.
Correct Answer: C
Rationale: The correct answer is C because pain while urinating can be a sign of a urinary tract infection, which is common during pregnancy and can lead to complications if not treated promptly. Heartburn, constipation, and leg cramps are common discomforts during pregnancy but are not typically considered emergency danger signs. Therefore, option C is the most critical symptom that requires immediate medical attention to prevent potential harm to the mother and baby.
The nurse-manager on a labor and delivery unit is monitoring the reasons for cesarean births at the facility. Which reasons contribute to the high rates of cesarean births? Select all that apply.
- A. Fetuses in breech position unable to deliver vaginally
- B. Increased number of elective or maternal request cesareans
- C. Incidences of women of older maternal age getting pregnant
- D. Decreasing rate of malpractice litigation with cesarean birth
Correct Answer: B
Rationale: The correct answer is B: Increased number of elective or maternal request cesareans. This is correct because the rise in elective cesarean births, often due to patient preference or convenience, can contribute to the overall high rates of cesarean births.
A: Fetuses in breech position unable to deliver vaginally - This is a valid reason for cesarean births, but it does not address the question about high rates of cesarean births.
C: Incidences of women of older maternal age getting pregnant - While advanced maternal age can be a factor in cesarean births, it is not directly related to the high rates of cesarean births at the facility.
D: Decreasing rate of malpractice litigation with cesarean birth - This is an irrelevant factor in determining the reasons for high rates of cesarean births at the facility.
What is a possible complication of oligohydramnios?
- A. fetal macrosomia
- B. preterm labor
- C. placenta previa
- D. fetal growth restriction
Correct Answer: D
Rationale: The correct answer is D: fetal growth restriction. Oligohydramnios refers to low levels of amniotic fluid, which can restrict fetal growth due to decreased cushioning and space for movement. This can lead to complications such as poor fetal nutrition, musculoskeletal abnormalities, and pulmonary hypoplasia. Fetal macrosomia (A) is the opposite of fetal growth restriction, preterm labor (B) is not directly associated with oligohydramnios, and placenta previa (C) is a separate condition involving the placenta's position in the uterus.
In a spontaneous abortion, if bleeding from the retained products of conception cannot be stopped, what is the next course of action?
- A. surgery for a dilation and curettage
- B. surgery for a hysterectomy
- C. administration of magnesium sulfate
- D. administration of calcium gluconate
Correct Answer: C
Rationale: The correct answer is C: administration of magnesium sulfate. This is because magnesium sulfate is used to control bleeding in cases of retained products of conception in a spontaneous abortion. It works by causing uterine contractions, which help expel the remaining tissue and stop the bleeding. Surgery for dilation and curettage (choice A) is typically performed if bleeding persists after medical management. Surgery for a hysterectomy (choice B) is not necessary for managing bleeding in this situation. Administration of calcium gluconate (choice D) is not indicated for controlling bleeding in cases of retained products of conception.
The nurse is concerned that a patient’s uterine activity is too intense and that her obesity is
preventing accurate assessment of the actual intrauterine pressure. Based on this information,
which action should the nurse take?
- A. Reposition the tocotransducer.
- B. Reposition the Doppler transducer.
- C. Obtain an order from the health care provider for a spiral electrod
- D. Obtain an order from the health care provider for an intrauterine pressure catheter.
Correct Answer: D
Rationale: The correct answer is D: Obtain an order from the health care provider for an intrauterine pressure catheter. This is the most appropriate action because an intrauterine pressure catheter provides the most accurate assessment of intrauterine pressure, especially in cases where obesity may interfere with external monitoring methods. Repositioning the tocotransducer (choice A) or Doppler transducer (choice B) may not significantly improve accuracy in this situation. Obtaining an order for a spiral electrod (choice C) is not necessary as it does not directly address the issue of accurate intrauterine pressure assessment.