Nokea
What complication makes uterine inversion an emergency?
- A. shock
- B. pain
- C. retained placenta
- D. hypertension
Correct Answer: A
Rationale: The correct answer is A: shock. Uterine inversion is an emergency due to the risk of shock. When the uterus turns inside out, it can lead to severe bleeding and disruption of blood flow, causing hypovolemic shock. This can be life-threatening if not promptly addressed. Pain (choice B) and retained placenta (choice C) are potential complications of uterine inversion but do not pose the immediate threat of shock. Hypertension (choice D) is not directly related to the urgency of uterine inversion.
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A nurse has recently transferred to a labor and delivery unit. During a scheduled cesarean, the nurse notices a prescription for the administration of 1,000 mL of prewarmed IV fluid. For which reason does the health care provider prescribe the fluid in this manner? Select all that apply.
- A. Results in an increased maternal core temperature
- B. Results in improved neonatal umbilical arterial pH
- C. Results in improved Apgar scores
- D. Results in decreased risk for maternal shock
Correct Answer: A
Rationale: Step 1: IV fluid is prewarmed to prevent hypothermia in the mother during cesarean delivery, which can occur due to exposure to cold operating room environment.
Step 2: Hypothermia in the mother can lead to adverse outcomes such as increased blood loss, delayed wound healing, and increased risk of infection.
Step 3: Maintaining maternal normothermia through prewarmed IV fluids is crucial for optimal maternal outcomes during cesarean delivery.
Summary:
- B: Improved neonatal umbilical arterial pH is not directly related to prewarmed IV fluid administration.
- C: Apgar scores are primarily influenced by factors like neonatal resuscitation and immediate care, not IV fluid temperature.
- D: Prewarmed IV fluid administration is more about preventing hypothermia in the mother rather than decreasing the risk for maternal shock.
A primigravida patient asks the nurse to explain the term quickening. Which statement by the nurse is correct?
- A. It is intermittent uterine contractions caused by the increase in hormones, especially estrogen.
- B. It is the absence of menses and is one of the earliest symptoms a woman reports when she is pregnant.
- C. It is when the mother can first feel the movements of the fetus.
- D. It is an increase in vaginal discharge caused by the increase in estrogen.
Correct Answer: C
Rationale: The correct answer is C because quickening refers to the first time a mother feels fetal movements, usually around 18-20 weeks gestation. This marks the beginning of fetal movements that the mother can perceive.
A is incorrect because intermittent uterine contractions are not referred to as quickening.
B is incorrect as it describes amenorrhea, not quickening.
D is incorrect as an increase in vaginal discharge is not the definition of quickening.
What can amniotomy cause?
- A. six-hour decrease of labor
- B. chorioamnionitis
- C. elevated blood pressure
- D. second stage labor dystocia
Correct Answer: B
Rationale: Amniotomy can cause chorioamnionitis, as the procedure involves breaking the amniotic sac which increases the risk of introducing bacteria into the uterus. This can lead to infection of the fetal membranes, causing chorioamnionitis. Choices A, C, and D are incorrect as amniotomy does not directly cause a six-hour decrease of labor, elevated blood pressure, or second stage labor dystocia.
The nurse is monitoring a patient who has been in prolonged labor. Which assessment finding will result in the nurse notifying the health care provider about the development of an emergent situation requiring a cesarean delivery?
- A. Maternal blood pressure indicative of hypotension
- B. Maternal exhaustion from prolonged uterine activity
- C. Recognition of a Category II fetal heart rate pattern
- D. Increased maternal temperature related to infection
Correct Answer: C
Rationale: The correct answer is C: Recognition of a Category II fetal heart rate pattern. This indicates fetal distress and potential compromise to the baby's well-being, necessitating immediate intervention like a cesarean delivery to prevent adverse outcomes. A: Maternal hypotension may require intervention but is not an emergent indication for a cesarean section. B: Maternal exhaustion can be managed with support and rest, not an immediate indication for cesarean delivery. D: Maternal fever may indicate infection but does not necessarily require cesarean delivery unless it poses a significant risk to the baby.
Which medications could potentially cause hyperstimulation of the uterus during labor? (Select all that apply.)
- A. Oxytocin (Pitocin)
- B. Misoprostol (Cytote
- C. Dinoprostone (Cervidil)
- D. Methylergonovine maleate (Methergin
Correct Answer: A
Rationale: The correct answer is A: Oxytocin (Pitocin). Oxytocin is a uterotonic agent commonly used to induce or augment labor. It can cause hyperstimulation of the uterus, leading to uterine hypertonicity and potentially compromising fetal oxygenation. Misoprostol, Dinoprostone, and Methylergonovine maleate are not known to cause hyperstimulation of the uterus during labor.