Nokea
What is the best nursing action?
- A. Give the pain remedy.
- B. Notify the charge nurse immediately.
- C. Turn the patient to her back and flex her knees.
- D. Suggest that the coach give her a back rub.
Correct Answer: B
Rationale: Sudden pain between the scapulae during a strenuous labor is an indicator of uterine rupture. This should be reported immediately.
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What will the nurse expect when caring for this patient?
- A. Elevated uterine resting tone
- B. Painful and poorly coordinated contractions
- C. Implementation of fluid restriction
- D. Use of frequent position changes
Correct Answer: D
Rationale: A woman with hypotonic labor dysfunction will be encouraged to change position frequently to enhance contractions.
What action by the physician will the nurse anticipate?
- A. Perform an amniotomy.
- B. Initiate tocolytic drugs.
- C. Order a sedative for the patient.
- D. Plan to do an emergency cesarean section.
Correct Answer: A
Rationale: Medical treatment for hypotonic labor dysfunction includes an amniotomy as the first remedy if the membranes are intact.
How might the nurse instruct the patient to stimulate her nipples in an attempt to increase the quality of uterine contractions?
- A. Place a warm, moist washcloth over the breast.
- B. Brush the nipples with a dry washcloth.
- C. Gently pull on the nipples.
- D. Apply suction to the nipples with a breast pump.
- E. Press the palms of her hands down on her breasts.
Correct Answer: B,C,D
Rationale: Brushing nipples with a dry washcloth, gently pulling nipples, and applying suction with a breast pump are effective methods to increase uterine contractions.
What conditions would contraindicate labor induction?
- A. Maternal gynecoid pelvis
- B. Placenta previa
- C. Horizontal cesarean incision
- D. Prolapsed cord
- E. Gestational diabetes
Correct Answer: B,D
Rationale: Labor induction is contraindicated with placenta previa or a prolapsed umbilical cord.
What is the purpose of glucocorticoid administration?
- A. Prevent infection.
- B. Increase fetal lung maturity.
- C. Increase blood flow from placenta.
- D. Relax the cervix.
Correct Answer: B
Rationale: Glucocorticoids assist with improving the lung maturity of a fetus that is preterm.