Nokea
Decreased capillary refill, delay in milk production, and diminished peripheral pulses are signs of what complication?
- A. alteration in perfusion
- B. alteration in liver function
- C. alteration in kidney function
- D. alteration in uterine function
Correct Answer: C
Rationale: The correct answer is C, alteration in kidney function. Decreased capillary refill indicates poor perfusion due to impaired kidney function leading to reduced blood flow. Delay in milk production is not directly related to kidney or liver function. Diminished peripheral pulses can be a sign of decreased blood flow due to kidney dysfunction affecting circulation. Alteration in liver or uterine function would not typically present with these specific signs. Therefore, the signs listed are most indicative of a complication related to kidney function.
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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.
A patient who is expecting her first baby tells the nurse, “I am afraid of the whole birth experience and plan to ask the doctor for a cesarean delivery.” Which response by the nurse is most appropriate?
- A. I will get you some material about how labor pain is managed.
- B. Most women avoid cesarean births unless it is an emergency.
- C. I suggest you talk with the physician and get another opinion.
- D. Cesarean will cause you issues with additional pregnancies.
Correct Answer: B
Rationale: The correct answer is B: Most women avoid cesarean births unless it is an emergency.
Rationale:
1. Cesarean delivery is a major surgery with potential risks and longer recovery time compared to vaginal birth.
2. Most women opt for vaginal birth unless there are medical reasons necessitating a cesarean section.
3. It is important for the nurse to educate the patient on the benefits of vaginal birth and address her fears about the birth experience.
4. Encouraging the patient to consider vaginal birth unless there is a medical emergency aligns with best practices in obstetric care.
Summary:
- Choice A is incorrect because focusing solely on pain management may not address the patient's underlying fear of the birth experience.
- Choice C is incorrect as seeking another opinion may not be necessary if the patient's concerns can be addressed through education and counseling.
- Choice D is incorrect as not all cesarean deliveries lead to complications in subsequent pregnancies.
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.
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.
The fetal heart rate baseline increases 20 bpm after vibroacoustic stimulation. The best interpretation of this is that the fetus is showing
- A. a worsening hypoxi
- B. progressive acidosis.
- C. an expected respons
- D. parasympathetic stimulation.
Correct Answer: C
Rationale: The correct answer is C. After vibroacoustic stimulation, an increase in fetal heart rate baseline indicates an expected response, showing the fetus is healthy and responding appropriately to the stimulus. This increase is a sign of fetal well-being and does not suggest worsening hypoxia (choice A) or progressive acidosis (choice B). Additionally, parasympathetic stimulation (choice D) would typically lead to a decrease in heart rate, not an increase as observed in this scenario. Therefore, choice C is the best interpretation based on the positive response of the fetal heart rate to the stimulation, indicating a healthy and expected reaction.