Nokea
What is one potential fetal complication of using the vacuum extractor?
- A. cephalohematoma
- B. face presentation
- C. fetal growth restriction
- D. scalp fracture
Correct Answer: A
Rationale: The correct answer is A: cephalohematoma. When using a vacuum extractor during childbirth, the device applies suction to the baby's head to assist with delivery. This suction can cause a collection of blood between the baby's skull and periosteum, resulting in a cephalohematoma. This complication is due to the pressure exerted on the baby's head during the extraction process. Cephalohematoma is a common side effect of vacuum extraction and typically resolves on its own. Face presentation and fetal growth restriction are not directly related to the use of a vacuum extractor. Scalp fracture is a rare but serious complication that can occur if excessive force is applied during vacuum extraction, leading to bone injury, which is different from the collection of blood in a cephalohematoma.
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What pregnant person is at high risk for labor dystocia?
- A. 38-week gestation
- B. 41-year-old
- C. prenatal anemia
- D. no prenatal care
Correct Answer: B
Rationale: The correct answer is B: 41-year-old. Advanced maternal age increases the risk of labor dystocia due to reduced uterine muscle tone and coordination. Older individuals are more likely to experience prolonged labor or difficulty with fetal descent. Choice A (38-week gestation) is not a risk factor for labor dystocia. Prenatal anemia (Choice C) may lead to complications during pregnancy but is not directly linked to labor dystocia. Lack of prenatal care (Choice D) can increase the risk of complications but is not a specific risk factor for labor dystocia.
Following a cesarean birth, intrathecal morphine is administered to the patient for postoperative pain management. Of which fact about intrathecal morphine therapy is the nurse aware? Select all that apply.
- A. An anesthesiologist or CRNA administers it intrathecally.
- B. The nurse needs to closely monitor for common side effects.
- C. The drug produces generalized CNS depression.
- D. The recommended dose is 10 to 15 mg.
Correct Answer: B
Rationale: The correct answer is B: The nurse needs to closely monitor for common side effects.
1. Intrathecal morphine can lead to side effects such as respiratory depression, nausea, vomiting, and pruritus.
2. Monitoring for these side effects is crucial for early detection and intervention.
3. Anesthesiologists or CRNAs typically administer intrathecal morphine, not nurses.
4. Intrathecal morphine primarily acts locally at the spinal cord level, not producing generalized CNS depression.
5. The recommended dose of intrathecal morphine is typically much lower than 10-15 mg to avoid overdose and side effects.
Which of the following therapeutic applications provides the most accurate information related to uterine contraction strength?
- A. External fetal monitoring (EFM)
- B. Internal fetal monitoring
- C. Intrauterine pressure catheter (IUP
- D. Maternal comments based on perception
Correct Answer: C
Rationale: The correct answer is C: Intrauterine pressure catheter (IUP). This device directly measures the pressure within the uterus, providing precise data on uterine contraction strength. It is considered the gold standard for assessing uterine activity.
A: External fetal monitoring (EFM) measures fetal heart rate and uterine contractions but doesn't provide direct information on contraction strength.
B: Internal fetal monitoring measures fetal heart rate and uterine contractions internally but focuses on fetal well-being, not contraction strength.
D: Maternal comments based on perception are subjective and not reliable for accurately assessing uterine contraction strength.
When evaluating the patient's progress, the nurse knows that four of the five fetal factors that interact to regulate the heart Nrate Rare I(SeGlect Bal.l CthatM apply.) U S N T O
- A. baroreceptors.
- B. adrenal glands.
- C. chemoreceptors.
- D. uterine activity.
Correct Answer: A
Rationale: The correct answer is A: baroreceptors. Baroreceptors are sensory receptors that detect changes in blood pressure and play a role in regulating heart rate. They are one of the fetal factors that interact to regulate heart rate. Adrenal glands (B) primarily regulate stress response, chemoreceptors (C) detect changes in oxygen and carbon dioxide levels, and uterine activity (D) refers to contractions during labor, which are not directly related to regulating fetal heart rate. Thus, A is correct as it directly influences heart rate regulation.
What medication is used for cervical ripening?
- A. amniotomy
- B. Hemabate
- C. misoprostol
- D. progesterone
Correct Answer: C
Rationale: The correct answer is C: misoprostol. Misoprostol is used for cervical ripening in obstetrics due to its ability to soften and dilate the cervix, making it favorable for induction of labor. It is a prostaglandin E1 analogue that helps prepare the cervix for childbirth. Amniotomy (A) is the artificial rupture of membranes and does not directly aid in cervical ripening. Hemabate (B) is a medication used to treat postpartum hemorrhage, not for cervical ripening. Progesterone (D) is a hormone that helps maintain pregnancy and is not used for cervical ripening.