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The physician has ordered an amnioinfusion for the laboring patient. Which data supports the use of this therapeutic procedure?
- A. Presenting part not engaged
- B. +4 meconium-stained amniotic fluid on artificial rupture of membranes (AROM)
- C. Breech position of fetus
- D. Twin gestation
Correct Answer: B
Rationale: The correct answer is B because +4 meconium-stained amniotic fluid on AROM indicates meconium passage by the fetus, which can lead to meconium aspiration syndrome. Amnioinfusion can help dilute the meconium, reducing the risk of respiratory complications for the newborn.
A: Presenting part not engaged is not a direct indication for amnioinfusion.
C: Breech position of the fetus does not specifically warrant amnioinfusion.
D: Twin gestation alone is not a direct indication for amnioinfusion.
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Which of the following is theN pUriRorSitIy NinGteTrvBen.tiConO fMor the patient in a left side-lying position whose monitor strip shows a deceleration that extends beyond the end of the contraction?
- A. Administer O at 8 to 10 L/minut
- B. Decrease the IV rate to 100 mL/hour.
- C. Reposition the ultrasound transducer.
- D. Perform a vaginal exam to assess for cord prolaps
Correct Answer: A
Rationale: The correct answer is A: Administer O at 8 to 10 L/minut. In a left side-lying position, this deceleration indicates possible umbilical cord compression, reducing oxygen supply to the fetus. Administering oxygen at 8 to 10 L/min can help improve fetal oxygenation. Decreasing the IV rate (B) wouldn't directly address the fetal distress. Repositioning the ultrasound transducer (C) is irrelevant to the situation. Performing a vaginal exam (D) could worsen the cord compression if the cord is prolapsed.
What is a possible complication of uterine tachysystole?
- A. Category I fetal heart rate tracing
- B. placenta previa
- C. fetal hypoxia
- D. prolapsed cord
Correct Answer: C
Rationale: Uterine tachysystole is excessive uterine contractions, reducing placental perfusion and causing fetal hypoxia. This can lead to potential complications such as fetal distress and hypoxia. Category I fetal heart rate tracing is typically associated with normal fetal heart rate. Placenta previa is unrelated to uterine tachysystole. Prolapsed cord is a potential complication of uterine hyperstimulation, not tachysystole.
The nurse documents a prenatal patient’s GTPAL as G5T2P1A1L4. Which obstetric history is consistent with this assessment?
- A. The woman is currently pregnant, has five living children.
- B. The woman is currently pregnant and had two preterm pregnancies.
- C. The woman is not currently pregnant and has had one abortion.
- D. The woman is currently pregnant and had one set of twins.
Correct Answer: A
Rationale: Rationale:
1. G5 = Gravida 5 (woman has been pregnant 5 times)
2. T2 = Term births 2 (woman has had 2 full-term pregnancies)
3. P1 = Preterm births 1 (woman has had 1 preterm pregnancy)
4. A1 = Abortions 1 (woman has had 1 abortion)
5. L4 = Living children 4 (woman has 4 living children)
Summary:
- Choice A is correct as it aligns with the GTPAL components.
- Choice B is incorrect because it does not match the number of term and preterm births.
- Choice C is incorrect as it does not reflect the number of living children.
- Choice D is incorrect as it does not indicate any preterm pregnancies.
A multigravida patient comes into the clinic for one of her second-trimester prenatal visits. The nurse reviews her laboratories that were drawn prior to the visit. Which laboratories results should concern the nurse most?
- A. Platelet count of 200,000 per μL (microliter) of blood
- B. Hemoglobin 9.5 g/dL
- C. White blood cell count of 11,000/μL
- D. Rubella titer ratio of 1:10
Correct Answer: B
Rationale: The correct answer is B: Hemoglobin 9.5 g/dL. This result indicates the patient is anemic, which is concerning during pregnancy as it can lead to complications like preterm birth or low birth weight. Anemia can also affect the mother's health. Platelet count of 200,000/μL is within the normal range, not a cause for concern. White blood cell count of 11,000/μL may indicate infection but is not as critical as anemia in pregnancy. Rubella titer ratio of 1:10 suggests immunity to rubella, which is not an immediate concern during the prenatal visit.
What medication is administered to treat uterine atony?
- A. ampicillin
- B. nitroglycerine
- C. magnesium sulfate
- D. methylergonovine
Correct Answer: D
Rationale: The correct answer is D: methylergonovine. Methylergonovine is a uterotonic medication used to treat uterine atony by causing the uterus to contract and prevent postpartum hemorrhage. Ampicillin (A) is an antibiotic, nitroglycerine (B) is a vasodilator, and magnesium sulfate (C) is a medication used for conditions like preeclampsia and eclampsia, but not specifically for uterine atony. Therefore, D is the correct choice for treating uterine atony.