Nokea
The nurse is concerned that a patient’s uterine activity is too intense and that her obesity is
preventing accurate assessment of the actual intrauterine pressure. Based on this information,
which action should the nurse take?
- A. Reposition the tocotransducer.
- B. Reposition the Doppler transducer.
- C. Obtain an order from the health care provider for a spiral electrod
- D. Obtain an order from the health care provider for an intrauterine pressure catheter.
Correct Answer: D
Rationale: The correct answer is D: Obtain an order from the health care provider for an intrauterine pressure catheter. This is the most appropriate action because an intrauterine pressure catheter provides the most accurate assessment of intrauterine pressure, especially in cases where obesity may interfere with external monitoring methods. Repositioning the tocotransducer (choice A) or Doppler transducer (choice B) may not significantly improve accuracy in this situation. Obtaining an order for a spiral electrod (choice C) is not necessary as it does not directly address the issue of accurate intrauterine pressure assessment.
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Which of the following therapeutic applications provides the most accurate information related to uterine contraction strength?
- A. External fetal monitoring (EFM)
- B. Internal fetal monitoring
- C. Intrauterine pressure catheter (IUP
- D. Maternal comments based on perception
Correct Answer: C
Rationale: The correct answer is C: Intrauterine pressure catheter (IUP). This device directly measures the pressure within the uterus, providing precise data on uterine contraction strength. It is considered the gold standard for assessing uterine activity.
A: External fetal monitoring (EFM) measures fetal heart rate and uterine contractions but doesn't provide direct information on contraction strength.
B: Internal fetal monitoring measures fetal heart rate and uterine contractions internally but focuses on fetal well-being, not contraction strength.
D: Maternal comments based on perception are subjective and not reliable for accurately assessing uterine contraction strength.
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.
Multiple gestation can lead to what labor complication?
- A. tachysystole
- B. postterm birth
- C. postterm birth
- D. early declarations
Correct Answer: C
Rationale: The correct answer is C: postterm birth. Multiple gestation, such as twins or triplets, often leads to a higher risk of postterm birth due to the increased likelihood of preterm labor and delivery. This is because the uterus may become overdistended and unable to maintain the pregnancy to full term, resulting in postterm birth.
Incorrect choices:
A: Tachysystole is excessive uterine contractions, which is not directly related to multiple gestation.
B: Postterm birth is already covered as the correct answer.
D: Early decelerations are a common finding in labor but not specifically associated with multiple gestation complications.
The nurse is instructing a nursing student on the application of fetal monitoring devices. Which method of assessing the fetal heart rate requires the use of a gel?
- A. Doppler
- B. Fetoscope
- C. Scalp electrode
- D. Tocodynamometer
Correct Answer: A
Rationale: The correct answer is A: Doppler. Doppler requires the use of a gel to enhance the transmission of sound waves for accurate assessment of the fetal heart rate. Gel helps to eliminate air between the Doppler probe and the skin, improving signal quality. Fetoscope (B) is a direct listening device; Scalp electrode (C) and Tocodynamometer (D) do not require gel for fetal heart rate assessment.
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.