Nokea
How might the nurse instruct the patient to stimulate her nipples in an attempt to increase the quality of uterine contractions?
- A. Place a warm, moist washcloth over the breast.
- B. Brush the nipples with a dry washcloth.
- C. Gently pull on the nipples.
- D. Apply suction to the nipples with a breast pump.
- E. Press the palms of her hands down on her breasts.
Correct Answer: B,C,D
Rationale: Brushing nipples with a dry washcloth, gently pulling nipples, and applying suction with a breast pump are effective methods to increase uterine contractions.
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What is the best nursing action?
- A. Give the pain remedy.
- B. Notify the charge nurse immediately.
- C. Turn the patient to her back and flex her knees.
- D. Suggest that the coach give her a back rub.
Correct Answer: B
Rationale: Sudden pain between the scapulae during a strenuous labor is an indicator of uterine rupture. This should be reported immediately.
What sign(s) of infection should the nurse assess for after an amniotomy?
- A. Oral temperature of 37?°C (99.8?°F)
- B. Increase of fetal heart rate (FHR) from 160 to 174 beats/minute
- C. Flecks of vernix in the amniotic fluid
- D. Low back pain
Correct Answer: B
Rationale: Increase in the FHR above 160 beats/minute frequently precedes a woman's temperature elevation, indicating possible infection.
What does the nurse explain is used to soften the cervix with a 'cervical ripening' agent?
- A. Prostaglandin gel insertion
- B. Intravenous oxytocin
- C. Warm saline douches
- D. Nipple stimulation
Correct Answer: A
Rationale: Prostaglandin gel is inserted in the cervix and the woman remains in bed for 1 to 2 hours, being monitored for uterine contractions.
What action by the physician will the nurse anticipate?
- A. Perform an amniotomy.
- B. Initiate tocolytic drugs.
- C. Order a sedative for the patient.
- D. Plan to do an emergency cesarean section.
Correct Answer: A
Rationale: Medical treatment for hypotonic labor dysfunction includes an amniotomy as the first remedy if the membranes are intact.
What nursing actions will the nurse anticipate implementing?
- A. Insert IV.
- B. Record a baseline fetal heart rate.
- C. Explain procedure to patient.
- D. Instruct patient to ambulate immediately afterward.
- E. Ensure a tocolytic is available.
Correct Answer: A,B,C
Rationale: The cervical ripening procedure should be explained, a fetal heart rate baseline recorded, and an IV line placed in case tocolytics are needed for uterine tachysystole.