Nokea
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.
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What intervention may be used to manage failure to descend during labor?
- A. administering pain medication
- B. allowing the patient to rest
- C. continuing to push for an extended period of time
- D. using forceps or a vacuum to assist delivery
Correct Answer: D
Rationale: The correct answer is D because using forceps or a vacuum to assist delivery can help manage failure to descend during labor by aiding in the descent of the baby through the birth canal. Forceps or vacuum extraction can provide the necessary assistance to safely deliver the baby when maternal pushing alone is insufficient.
Explanation for why the other choices are incorrect:
A: Administering pain medication does not address the underlying issue of failure to descend during labor.
B: Allowing the patient to rest may not resolve the issue of failure to descend and could potentially delay necessary interventions.
C: Continuing to push for an extended period of time without progress can lead to maternal exhaustion and fetal distress without addressing the root cause of failure to descend.
The nurse will monitor for aspiration, thought processes, and improved mobility after which complication?
- A. neurologic dysfunction
- B. Measure blood loss.
- C. gestational diabetes
- D. postpartum hemorrhage
Correct Answer: D
Rationale: The correct answer is D: postpartum hemorrhage. The nurse monitors for aspiration due to potential bleeding or clotting issues postpartum. Monitoring thought processes is important as postpartum hemorrhage can lead to hypovolemic shock affecting cognition. Improved mobility is assessed as excessive bleeding can cause weakness. Neurologic dysfunction (choice A) is not directly related to postpartum hemorrhage. Measuring blood loss (choice B) is important but not the primary focus after postpartum hemorrhage. Gestational diabetes (choice C) is a separate condition unrelated to postpartum hemorrhage.
Which method of intrapartum fetal monitoring is the most appropriate when a woman has a history of hypertension during pregnancy?
- A. Continuous auscultation with a fetoscope
- B. Continuous electronic fetal monitoring
- C. Intermittent assessment with a Doppler transducer
- D. Intermittent electronic fetal monitoring for 15 minutes each hour
Correct Answer: B
Rationale: The correct answer is B: Continuous electronic fetal monitoring. This method is most appropriate for a woman with a history of hypertension during pregnancy because it allows continuous monitoring of fetal heart rate patterns and uterine contractions, providing real-time data to detect any signs of fetal distress promptly. Continuous monitoring is crucial in high-risk pregnancies to ensure timely intervention if any issues arise.
A: Continuous auscultation with a fetoscope is not ideal for a woman with a history of hypertension as it does not provide continuous monitoring and may miss subtle changes in fetal well-being.
C: Intermittent assessment with a Doppler transducer does not offer continuous monitoring, which is essential in high-risk pregnancies like hypertension.
D: Intermittent electronic fetal monitoring for 15 minutes each hour is not as effective as continuous monitoring in detecting changes in fetal well-being promptly, which is crucial in cases of hypertension during pregnancy.
What is a potential complication when the fetus is footling breech?
- A. prolapsed cord
- B. oligohydramnios
- C. low biophysical profile score
- D. meconium-stained fluid
Correct Answer: A
Rationale: The correct answer is A: prolapsed cord. In a footling breech presentation, the feet or legs of the fetus are positioned to deliver first, increasing the risk of the umbilical cord slipping down before the fetus during labor, leading to a prolapsed cord. This is a serious emergency as it can compromise fetal blood flow and oxygen supply.
Choice B: Oligohydramnios is a decreased level of amniotic fluid and is not directly related to a footling breech presentation.
Choice C: Low biophysical profile score indicates fetal well-being based on specific parameters and is not a direct complication of a footling breech presentation.
Choice D: Meconium-stained fluid can occur due to fetal distress but is not specific to a footling breech presentation.
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.