Nokea
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.
You may also like to solve these questions
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 is providing care in PACU for a patient who just delivered a neonate via cesarean section. The patient reports tightness in her chest. Assessment findings include tachypnea, hypotension, and decreasing oxygen saturation levels. Which complication does the nurse report to the health care provider?
- A. Pulmonary embolism
- B. Postpartum hemorrhage
- C. Surgical-site infection
- D. Developing endometritis
Correct Answer: A
Rationale: The correct answer is A: Pulmonary embolism. The patient's symptoms of chest tightness, tachypnea, hypotension, and decreasing oxygen saturation levels are indicative of a potential pulmonary embolism, which is a serious complication post-cesarean section. A pulmonary embolism occurs when a blood clot travels to the lungs, causing respiratory distress and cardiovascular compromise. The nurse should report this immediately to the healthcare provider for prompt intervention to prevent further complications.
Incorrect choices:
B: Postpartum hemorrhage - Symptoms of postpartum hemorrhage include excessive bleeding, not chest tightness and respiratory distress.
C: Surgical-site infection - Symptoms of surgical-site infection include redness, swelling, and drainage at the incision site, not chest tightness and respiratory distress.
D: Developing endometritis - Symptoms of endometritis include fever, pelvic pain, and abnormal vaginal discharge, not chest tightness and respiratory distress.
What nursing intervention is performed during labor for a person with preeclampsia?
- A. Assess deep tendon reflexes for hyperreflexia.
- B. Provide frequent IV fluid boluses.
- C. Educate the laboring person that preeclampsia is only a concern for pregnancy, not labor.
- D. Discourage pain medication in order to assess for headache.
Correct Answer: A
Rationale: The correct answer is A: Assess deep tendon reflexes for hyperreflexia. This is crucial in preeclampsia to monitor for signs of worsening condition like eclampsia. Hyperreflexia is a common symptom in severe preeclampsia indicating CNS irritability. Providing IV fluid boluses (B) can worsen fluid overload. Educating that preeclampsia is only a concern for pregnancy (C) is incorrect as it can progress during labor. Discouraging pain medication (D) is inappropriate as it can mask symptoms like headaches, a common sign of worsening preeclampsia.
The nurse evaluates a pattern on the fetal monitor that appears similar to early decelerations. The deceleration begins near the acme of the contraction and continues well beyond the end of the contraction. Which nursing action indicates the proper evaluation of this situation?
- A. This pattern reflects variable decelerations. No interventions are necessary at this time
- B. Document this Category I fetal heart rate pattern and decrease the rate of the
- C. Continue to monitor these early decelerations, which occur as the fetal head is
compressed during a contraction - D. This deceleration pattern is associated with uteroplacental insufficiency. The nurse
Correct Answer: D
Rationale: Step-by-step rationale for why answer D is correct:
1. The deceleration pattern described, beginning near the acme of the contraction and extending beyond, is associated with uteroplacental insufficiency.
2. Uteroplacental insufficiency indicates a potential problem with oxygen and nutrient delivery to the fetus.
3. This situation requires immediate intervention to improve oxygenation to the fetus.
4. Monitoring alone is not sufficient; action is needed to address the underlying issue.
5. Therefore, the correct nursing action in this situation is to recognize the potential uteroplacental insufficiency and take appropriate measures to address it.
Summary of why other choices are incorrect:
A: This pattern reflects variable decelerations - Incorrect because the described pattern is not characteristic of variable decelerations.
B: Document this Category I fetal heart rate pattern and decrease the rate of the - Incorrect because immediate action is needed in the presence of potential uteroplacental insufficiency.
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.