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What is a potential risk associated with prolonged second stage labor?
- A. decreased risk of instrumental delivery
- B. decreased risk of cesarean birth
- C. increased risk of fetal distress
- D. increased risk of rapid delivery
Correct Answer: C
Rationale: The correct answer is C: increased risk of fetal distress. Prolonged second stage labor can lead to decreased oxygen supply to the fetus, causing fetal distress. This can result in adverse outcomes for the baby. Other options are incorrect because prolonged second stage labor is actually associated with an increased risk of instrumental delivery (A), an increased risk of cesarean birth (B), and not rapid delivery (D) as it is a prolonged process.
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The nurse is making a plan of care for a patient who is in the first 24-hour period past a cesarean delivery. Which interventions will the nurse include in regards to medications? Select all that apply.
- A. Continue a daily stool softener.
- B. Manage pain with morphine.
- C. Ensure the availability of naloxone.
- D. Provide prophylaxis antibiotics.
Correct Answer: C
Rationale: The correct answer is C: Ensure the availability of naloxone. Naloxone is an opioid antagonist used to reverse the effects of opioid overdose, which could occur if the patient is receiving morphine for pain management post-cesarean delivery. It is essential to have naloxone readily available to counteract any potential opioid-related respiratory depression.
A: Continuing a daily stool softener is not directly related to medications typically given post-cesarean delivery and is not a priority in the immediate post-operative period.
B: Managing pain with morphine is a common practice post-cesarean delivery, but the focus here is on the intervention related to medication safety, which is ensuring naloxone availability.
D: Providing prophylactic antibiotics is important post-cesarean delivery to prevent infection but is not directly related to medication safety in this scenario.
The nurse is preparing supplies for an amnioinfusion on a patient with intact membranes. Which supplies should the nurse gather? (Select all that apply.)
- A. Extra underpads
- B. Solution of 3% normal saline
- C. Amniotic hook to perform an amniotomy
- D. Solid intrauterine pressure catheter with a pressure transducer on its tip
Correct Answer: A
Rationale: The correct answer is A: Extra underpads. For an amnioinfusion on a patient with intact membranes, extra underpads are necessary to absorb any excess fluid leakage during the procedure. The other choices are incorrect because:
B: Solution of 3% normal saline is not necessary for an amnioinfusion with intact membranes as there is no need for amniotic fluid replacement.
C: Amniotic hook to perform an amniotomy is not required when the patient's membranes are intact; this procedure involves rupturing the membranes.
D: Solid intrauterine pressure catheter with a pressure transducer on its tip is used for monitoring intrauterine pressure during labor, not for an amnioinfusion procedure.
What is a potential sign of intrauterine fetal demise?
- A. increased fetal heart rate
- B. vaginal bleeding
- C. decreased or absent fetal movement
- D. macrosomia
Correct Answer: C
Rationale: The correct answer is C: decreased or absent fetal movement. This is a potential sign of intrauterine fetal demise because it indicates a lack of fetal activity, which could suggest fetal distress or death. Reduced or absent fetal movement may be an early warning sign that the fetus is not receiving enough oxygen or nutrients. It is important to monitor fetal movement regularly to ensure the well-being of the fetus.
Other choices are incorrect because:
A: increased fetal heart rate is more commonly associated with fetal distress, not demise.
B: vaginal bleeding can be a sign of various conditions such as placental abruption or placenta previa, but it is not specific to fetal demise.
D: macrosomia refers to a large baby, which is not indicative of fetal demise.
Which nursing action is correct when initiating electronic fetal monitoring?
- A. Lubricate the tocotransducer with an ultrasound gel.
- B. Securely apply the tocotransducer with a strap or belt.
- C. Inform the patient that she should remain in the semi-Fowler position.
- D. Determine the position of the fetus before attaching the electrode to the maternal abdomen.
Correct Answer: D
Rationale: The correct answer is D because determining the position of the fetus before attaching the electrode is crucial for accurate monitoring. This step ensures proper placement, reducing the risk of misinterpretation of data. Lubricating the tocotransducer with gel (A) is unnecessary and may interfere with the signal. Securing the tocotransducer with a strap (B) is important but should come after determining fetal position. Informing the patient to remain in semi-Fowler position (C) is not directly related to the correct initiation of electronic fetal monitoring.
A gravida 1 para 0 who is 10 weeks pregnant has her first prenatal visit. After performing a history and physical, which test ordered by the physician should the nurse verify with the examiner?
- A. Serological test for syphilis
- B. Rubella vaccine
- C. Clean-catch urinalysis
- D. Abdominal ultrasound
Correct Answer: D
Rationale: The correct answer is D: Abdominal ultrasound. At 10 weeks gestation, an abdominal ultrasound is typically ordered to confirm the viability of the pregnancy, assess fetal development, and determine gestational age. This test allows the healthcare provider to visualize the fetus, placenta, and amniotic fluid. It is essential in monitoring the progress of the pregnancy and identifying any potential complications.
Rationale for other choices:
A: Serological test for syphilis - While this test is important in prenatal care to screen for syphilis, it is usually done as part of routine prenatal blood work and not typically verified immediately after the first visit.
B: Rubella vaccine - Administering the rubella vaccine during pregnancy is contraindicated as it poses a risk to the developing fetus.
C: Clean-catch urinalysis - While urinalysis is a common test in prenatal care to screen for urinary tract infections and other conditions, it is not typically the first test verified following