Intrapartum Complication

Intrapartum Complication Related

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What complications can cocaine and methamphetamine use in pregnancy cause?

  • A. seizures
  • B. hypotonic contractions
  • C. prolonged second stage labor
  • D. prolonged first stage labor
Correct Answer: C

Rationale: The correct answer is C: Prolonged second stage labor. Cocaine and methamphetamine use in pregnancy can lead to vasoconstriction, decreased blood flow to the uterus, and reduced oxygen supply to the fetus, resulting in uterine hyperactivity and fetal distress during labor. This can cause the second stage of labor to be prolonged as the uterus may struggle to effectively contract and progress labor.

Explanation for other choices:
A: Seizures - While cocaine and methamphetamine use can lead to seizures in pregnant individuals, this is not directly related to labor complications.
B: Hypotonic contractions - Cocaine and methamphetamine use are more likely to cause hypertonic contractions (excessive uterine contractions) rather than hypotonic contractions.
D: Prolonged first stage labor - Cocaine and methamphetamine use are more likely to impact the second stage of labor rather than the first stage.

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The placenta is diagnosed as retained when it is not delivered in what timeframe after the birth of the infant?

  • A. 10 minutes
  • B. 30 minutes
  • C. 1 hour
  • D. 2 hours
Correct Answer: B

Rationale: The correct answer is B (30 minutes) because the placenta should be delivered within 30 minutes after the birth of the infant to prevent excessive bleeding and potential complications. If the placenta is retained beyond 30 minutes, it may lead to postpartum hemorrhage. Choices A, C, and D are incorrect as they do not align with the standard timeframe for the delivery of the placenta. A (10 minutes) is too soon for a normal delivery, C (1 hour) is too long and increases the risk of complications, and D (2 hours) is significantly delayed and poses serious health risks.

What is one potential fetal complication of using obstetric forceps?

  • A. flexion of the head
  • B. abdominal complications
  • C. skull fracture
  • D. femur fracture
Correct Answer: C

Rationale: The correct answer is C: skull fracture. When obstetric forceps are used during delivery, there is a risk of excessive pressure on the fetal skull, leading to a potential complication such as a skull fracture. This occurs due to the force exerted by the instrument during the delivery process, which can cause trauma to the baby's delicate skull bones. Flexion of the head (choice A) is a normal part of the birthing process and not a complication of forceps use. Abdominal complications (choice B) and femur fracture (choice D) are not typically associated with obstetric forceps use.

A nurse is examining a G1P0 who is 10 weeks gestation. The nurse notes a bluish coloration of her cervix. The nurse should document this finding as which positive sign?

  • A. Quickening
  • B. Goodell’s sign
  • C. Chadwick’s sign
  • D. Hegar’s sign
Correct Answer: C

Rationale: The correct answer is C: Chadwick's sign. Chadwick's sign refers to the bluish coloration of the cervix due to increased vascularity in early pregnancy. This is a positive sign of pregnancy, indicating the presence of hormonal changes and increased blood flow to the cervix. Quickening is the first fetal movements felt by the mother, typically around 18-20 weeks gestation. Goodell's sign refers to the softening of the cervix, not discoloration. Hegar's sign is the softening of the lower uterine segment, also not related to discoloration. Chadwick's sign specifically describes the bluish discoloration of the cervix due to increased blood flow, making it the correct answer in this scenario.

Which maternal condition should be considered a contraindication for the application of internal monitoring devices?

  • A. Unruptured membranes
  • B. intravenous (IV) fluid.
  • C. Fetus has known heart defect
  • D. must act quickly to improve placental blood flow and fetal oxygen supply
Correct Answer: A

Rationale: The correct answer is A: Unruptured membranes. Internal monitoring devices are inserted through the cervix and into the uterus, which can introduce bacteria and increase the risk of infection if the membranes are not ruptured. This can lead to serious complications for both the mother and the baby.

Choice B (intravenous fluid) is incorrect because IV fluids are commonly used during labor to maintain hydration and provide necessary nutrients.

Choice C (Fetus has known heart defect) is incorrect because internal monitoring devices are used to assess fetal heart rate and detect any abnormalities, making this condition a reason for monitoring rather than a contraindication.

Choice D (must act quickly to improve placental blood flow and fetal oxygen supply) is incorrect because internal monitoring devices are usually used for continuous monitoring and do not require immediate intervention to be placed.

What type of dystocia should the nurse prepare for if she palpates prominent ischial spines during the vaginal exam?

  • A. pelvic dystocia
  • B. fetal dystocia
  • C. contraction dystocia
  • D. uterine dystocia
Correct Answer: A

Rationale: The correct answer is A: pelvic dystocia. Prominent ischial spines indicate a contracted pelvis, which can obstruct the baby's passage during labor, leading to pelvic dystocia. Pelvic dystocia involves the bony pelvis causing difficulty in the descent of the fetus. Choices B, C, and D are incorrect because fetal dystocia refers to issues related to the fetus, contraction dystocia involves ineffective contractions, and uterine dystocia pertains to abnormalities of the uterus itself, none of which are indicated by prominent ischial spines.

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