Nokea
The nurse is aware that there are multiple classifications for cesarean deliveries. Which situations does the nurse classify as an unscheduled cesarean birth? Select all that apply.
- A. Patient had a previous cesarean delivery.
- B. There is evidence of a prolapsed cord with membrane rupture.
- C. The cervix fails to fully dilate after prolonged labor.
- D. Patient has a preexisting cardiac health condition.
Correct Answer: C
Rationale: The correct answer is C because an unscheduled cesarean birth occurs when the cervix fails to fully dilate after prolonged labor, leading to the need for an emergency cesarean section. This situation poses risks to both the mother and the baby, necessitating immediate intervention.
Choice A is incorrect because a previous cesarean delivery does not necessarily mean the current cesarean birth is unscheduled. Choice B is incorrect as evidence of a prolapsed cord with membrane rupture would typically lead to an emergency cesarean delivery but is not the only scenario for unscheduled cesarean birth. Choice D is also incorrect as a preexisting cardiac health condition does not automatically indicate the need for an unscheduled cesarean birth.
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What is a potential complication for the neonate due to precipitous labor?
- A. respiratory distress
- B. low birth weight
- C. prelabor rupture of membranes
- D. placenta previa
Correct Answer: A
Rationale: The correct answer is A: respiratory distress. During precipitous labor, the rapid delivery can cause the neonate to experience respiratory distress due to inadequate time for fluid clearance from the lungs, leading to transient tachypnea or respiratory distress syndrome. This complication can result in difficulty breathing and require immediate medical intervention.
Summary:
B: Low birth weight is not directly associated with precipitous labor.
C: Prelabor rupture of membranes is unrelated to the speed of labor.
D: Placenta previa is a condition involving the placenta's position, not typically related to the duration of labor.
What is a potential sign of intrauterine fetal demise?
- A. increased fetal heart rate
- B. vaginal bleeding
- C. decreased or absent fetal movement
- D. macrosomia
Correct Answer: C
Rationale: The correct answer is C: decreased or absent fetal movement. This is a potential sign of intrauterine fetal demise because it indicates a lack of fetal activity, which could suggest fetal distress or death. Reduced or absent fetal movement may be an early warning sign that the fetus is not receiving enough oxygen or nutrients. It is important to monitor fetal movement regularly to ensure the well-being of the fetus.
Other choices are incorrect because:
A: increased fetal heart rate is more commonly associated with fetal distress, not demise.
B: vaginal bleeding can be a sign of various conditions such as placental abruption or placenta previa, but it is not specific to fetal demise.
D: macrosomia refers to a large baby, which is not indicative of fetal demise.
Shoulder dystocia is difficult to predict. What are thought to be predictors for shoulder dystocia?
- A. estimated birth weight of 4,000 g
- B. gestational diabetes
- C. previous shoulder dystocia
- D. hypertension
Correct Answer: B
Rationale: The correct answer is B: gestational diabetes. Gestational diabetes can lead to larger fetal size, increasing the risk of shoulder dystocia. It is a known risk factor that healthcare providers consider when assessing the likelihood of shoulder dystocia. Estimated birth weight alone (A) may not accurately predict shoulder dystocia. While previous shoulder dystocia (C) is a risk factor, it is not a predictor as it is based on past occurrences. Hypertension (D) is not directly associated with an increased risk of shoulder dystocia.
What newborn complication does type 1 diabetes mellitus cause?
- A. hyperglycemia
- B. fetal macrosomia
- C. group B strep
- D. cyanosis
Correct Answer: C
Rationale: The correct answer is C: group B strep. Women with type 1 diabetes are at higher risk of developing infections, including group B strep, which can be passed to the newborn during childbirth. This can lead to serious complications such as pneumonia, sepsis, and meningitis in the newborn. Hyperglycemia (choice A) is a common complication of maternal diabetes but is not specific to type 1 diabetes. Fetal macrosomia (choice B) is a condition where the baby is larger than average, which can be a complication of diabetes but not specific to type 1. Cyanosis (choice D) refers to a bluish discoloration of the skin due to lack of oxygen and is not directly related to type 1 diabetes complications in newborns.
The nurse is making a plan of care for a patient who is in the first 24-hour period past a cesarean delivery. Which interventions will the nurse include in regards to medications? Select all that apply.
- A. Continue a daily stool softener.
- B. Manage pain with morphine.
- C. Ensure the availability of naloxone.
- D. Provide prophylaxis antibiotics.
Correct Answer: C
Rationale: The correct answer is C: Ensure the availability of naloxone. Naloxone is an opioid antagonist used to reverse the effects of opioid overdose, which could occur if the patient is receiving morphine for pain management post-cesarean delivery. It is essential to have naloxone readily available to counteract any potential opioid-related respiratory depression.
A: Continuing a daily stool softener is not directly related to medications typically given post-cesarean delivery and is not a priority in the immediate post-operative period.
B: Managing pain with morphine is a common practice post-cesarean delivery, but the focus here is on the intervention related to medication safety, which is ensuring naloxone availability.
D: Providing prophylactic antibiotics is important post-cesarean delivery to prevent infection but is not directly related to medication safety in this scenario.