Nokea
Decelerations that mirror the contractions are present with each contraction on the monitor strip of a multipara who received epidural anesthesia 20 minutes ago. The nurse should
- A. maintain the normal assessment routine
- B. administer O at 8 to 10 L/minute by face mask.
- C. increase the IV flow rate from 125 to 150 mL/hour.
- D. assess the maternal blood pressure for a systolic pressure below 100 mm Hg.
Correct Answer: A
Rationale: The correct answer is A: maintain the normal assessment routine. Decelerations mirroring contractions in a multipara with epidural anesthesia likely indicate normal physiologic response to labor. There is no indication of fetal distress. Administering O2 (B) is unnecessary as there is no indication of maternal hypoxemia. Increasing IV flow rate (C) is not necessary if there are no signs of hypovolemia. Assessing maternal blood pressure (D) for hypotension is not relevant without other signs of maternal compromise. Maintaining the normal assessment routine ensures ongoing monitoring and evaluation of both mother and baby without unnecessary interventions.
You may also like to solve these questions
What is the condition in which the umbilical cord vessels branch prior to insertion into the placenta?
- A. placenta previa
- B. placenta cervix
- C. velamentous insertion
- D. vasa previa
Correct Answer: C
Rationale: The correct answer is C: velamentous insertion. In this condition, the umbilical cord vessels branch before reaching the placenta, making them vulnerable to compression and rupture. Placenta previa (A) refers to the placenta covering the cervix, not cord insertion. Placenta cervix (B) is not a recognized term. Vasa previa (D) is when fetal vessels traverse the fetal membranes overlying the cervix, not related to branching of umbilical cord vessels before insertion into the placenta.
When evaluating the patient's progress, the nurse knows that four of the five fetal factors that interact to regulate the heart Nrate Rare I(SeGlect Bal.l CthatM apply.) U S N T O
- A. baroreceptors.
- B. adrenal glands.
- C. chemoreceptors.
- D. uterine activity.
Correct Answer: A
Rationale: The correct answer is A: baroreceptors. Baroreceptors are sensory receptors that detect changes in blood pressure and play a role in regulating heart rate. They are one of the fetal factors that interact to regulate heart rate. Adrenal glands (B) primarily regulate stress response, chemoreceptors (C) detect changes in oxygen and carbon dioxide levels, and uterine activity (D) refers to contractions during labor, which are not directly related to regulating fetal heart rate. Thus, A is correct as it directly influences heart rate regulation.
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.
What is one potential fetal complication of using the vacuum extractor?
- A. cephalohematoma
- B. face presentation
- C. fetal growth restriction
- D. scalp fracture
Correct Answer: A
Rationale: The correct answer is A: cephalohematoma. When using a vacuum extractor during childbirth, the device applies suction to the baby's head to assist with delivery. This suction can cause a collection of blood between the baby's skull and periosteum, resulting in a cephalohematoma. This complication is due to the pressure exerted on the baby's head during the extraction process. Cephalohematoma is a common side effect of vacuum extraction and typically resolves on its own. Face presentation and fetal growth restriction are not directly related to the use of a vacuum extractor. Scalp fracture is a rare but serious complication that can occur if excessive force is applied during vacuum extraction, leading to bone injury, which is different from the collection of blood in a cephalohematoma.
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.