Nokea
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.
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What is the most common cause of placenta accreta?
- A. malnutrition
- B. smoking
- C. previous cesarean birth
- D. obesity
Correct Answer: B
Rationale: Previous cesarean births are a leading cause of placenta accreta, where the placenta attaches too deeply into the uterine wall.
What is a sign of fetal distress?
- A. prolonged moderate variability
- B. accelerations
- C. repetitive late decelerations
- D. variable decelerations
Correct Answer: C
Rationale: Fetal distress can be indicated by repetitive late decelerations, which show a lack of oxygen during labor.
A pregnant woman is being seen at her first prenatal visit. The RN should correct which action of a student nurse who is preparing the client for a pelvic examination?
- A. Asking the client if she needs something to drink
- B. Assembling the necessary equipment for the pelvic examination
- C. Positioning the client in the lithotomy position
- D. Explaining the procedure prior to the pelvic examination
Correct Answer: A
Rationale: Multipara is a term used for a woman who has given birth more than once, which is consistent with the birth history provided. Primigravida refers to a woman who is pregnant for the first time, and primipara refers to a woman who has had one pregnancy outcome.
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.
The nurse is educating a primigravida patient during her first prenatal clinic appointment about follow-up prenatal care. How often will follow-up prenatal clinic visits be scheduled if the patient has a low-risk pregnancy and develops no complications? Select all that apply.
- A. Every 2 weeks for the first 28 weeks
- B. Every 4 weeks until 30 weeks
- C. Every 4 weeks until 28 weeks
- D. Every 2 weeks after 28 completed weeks until 36 weeks gestation
Correct Answer: C
Rationale: Ballottement is a physical examination technique used to detect the presence of a floating fetus or other abnormalities. A gentle tap on the cervix causes a rebound or sensation, confirming fetal presence.