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The nurse is assessing the duration of a patient’s labor contractions. Which method does the nurse implement to assess the duration of labor contractions?
- A. Assess the strongest intensity of each contraction.
- B. Assess uterine relaxation between two contractions.
- C. Assess from the beginning to the end of each contraction.
- D. Assess from the beginning of one contraction to the beginning of the next.
Correct Answer: C
Rationale: The nurse implements method C, which involves assessing the duration of contractions from the beginning to the end of each contraction. Duration refers to how long each contraction lasts from the start of the tightening sensation until it subsides. This assessment helps the nurse monitor the progress of labor, determine the effectiveness of contractions in dilating the cervix, and identify any potential issues such as prolonged or insufficient contractions that may affect labor progression. Assessing the duration of contractions is a key component of monitoring the labor process and ensuring safe delivery for both the mother and the baby.
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Which is the best explanation for the use of hydration and relaxation in the treatment of hypertonic labor?
- A. Hydration promotes uterine relaxation by diluting endogenous oxytocin.
- B. Hydration improves uterine coordination by increasing perfusion.
- C. Hydration encourages contraction regulation by stimulating catecholamine release.
- D. Hydration stimulates the production of prostaglandins to relax the uterus.
Correct Answer: A
Rationale: Hydration helps to dilute endogenous oxytocin, which can reduce uterine contractions and relax the uterus. Hypertonic labor involves excessive uterine contractions, and hydration can counteract this by regulating contractions and improving perfusion, which ultimately aids in a more coordinated and effective labor progression.
A woman presents to labor and delivery at 37 weeks plus 6 days gestation with complaints of constant abdominal pain and dark red bleeding that started 30 minutes ago. Upon examination, the woman’s abdomen is consistently rigid and tender. Fetal heart tones are noted to be in the 70s. Which are these findings are associated with?
- A. Placental abruption
- B. Placental accreta
- C. Placenta previa
- D. Placenta succenturiata
Correct Answer: A
Rationale: Placental abruption is characterized by sudden onset of abdominal pain, dark red bleeding, and a rigid, tender abdomen. This condition can compromise fetal oxygenation and requires immediate medical intervention to prevent further complications.
A 24-year-old G4 T1 A2 L1 presents to obstetric triage with complaints of contractions every 3 minutes, accompanied by bright red vaginal bleeding. The woman is 29 weeks gestation with a twin pregnancy. She has had three urinary tract infections during this pregnancy and is currently taking Microbid daily as prophylaxis. Her last baby was born via cesarean section for breech malpresentation. She denies any other significant medical history. What risk factors for placenta previa does this patient have? Select all that apply.
- A. Maternal age of 24
- B. Twin gestation
- C. Gestational age of 29 weeks
- D. Previous delivery by cesarean section
Correct Answer: D
Rationale: The patient's age, history of cesarean section, and twin gestation all contribute to an increased risk of placenta previa. The most significant risk factor here is the previous cesarean section, which can cause scarring and increase the likelihood of abnormal placental implantation.
What effect will the presence of support people in labor most likely have?
- A. improve the experience of the birthing person
- B. improve the outcomes of the birthing person
- C. improve the outcomes and experience of the birthing person
- D. cause birth trauma and/or postpartum depression
Correct Answer: C
Rationale: The presence of support people during labor, such as a partner, family member, doula, or midwife, can have a positive impact on both the outcomes and experience of the birthing person. Studies have shown that having continuous support during labor can lead to shorter labor times, reduced need for medical interventions like cesarean sections or epidurals, increased satisfaction with the birth experience, and decreased likelihood of experiencing postpartum depression. Emotional support, physical comfort, and advocacy provided by support people can help the birthing person feel more empowered, confident, and less stressed during labor, ultimately leading to better outcomes and a more positive birth experience.
While attending the delivery of a patient with GODM, the nurse notices the retraction of the fetal head onto the perineum. What is the nurse’s next best action?
- A. Apply fundal pressure
- B. Assist the woman to left lateral position
- C. Flex the mother to left lateral position
- D. Assist the woman to hands-and-knees position
Correct Answer: D
Rationale: The retraction of the fetal head onto the perineum during labor can be indicative of shoulder dystocia or other obstructive complications, requiring immediate action. The best response is to assist the mother into hands-and-knees position, which can relieve pressure on the perineum and help with fetal descent.