Nokea
What is the condition where the umbilical cord vessels cross the cervix?
- A. placenta previa
- B. placenta cervix
- C. velamentous insertion
- D. vasa previa
Correct Answer: D
Rationale: The correct answer is D: vasa previa. This condition occurs when the umbilical cord vessels cross the cervix, making them vulnerable to compression during labor. This can lead to fetal blood vessel rupture and potentially life-threatening bleeding. Placenta previa (A) is when the placenta partially or fully covers the cervix, unrelated to the cord position. Placenta cervix (B) is not a recognized medical term. Velamentous insertion (C) is when the blood vessels of the umbilical cord insert into the fetal membranes before reaching the placenta, also not directly related to cord position over the cervix.
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A nurse is examining a G1P0 who is 10 weeks gestation. The nurse notes a bluish coloration of her cervix. The nurse should document this finding as which positive sign?
- A. Quickening
- B. Goodell’s sign
- C. Chadwick’s sign
- D. Hegar’s sign
Correct Answer: C
Rationale: The correct answer is C: Chadwick's sign. Chadwick's sign refers to the bluish coloration of the cervix due to increased vascularity in early pregnancy. This is a positive sign of pregnancy, indicating the presence of hormonal changes and increased blood flow to the cervix. Quickening is the first fetal movements felt by the mother, typically around 18-20 weeks gestation. Goodell's sign refers to the softening of the cervix, not discoloration. Hegar's sign is the softening of the lower uterine segment, also not related to discoloration. Chadwick's sign specifically describes the bluish discoloration of the cervix due to increased blood flow, making it the correct answer in this scenario.
What complication makes uterine inversion an emergency?
- A. shock
- B. pain
- C. retained placenta
- D. hypertension
Correct Answer: A
Rationale: The correct answer is A: shock. Uterine inversion is an emergency due to the risk of shock. When the uterus turns inside out, it can lead to severe bleeding and disruption of blood flow, causing hypovolemic shock. This can be life-threatening if not promptly addressed. Pain (choice B) and retained placenta (choice C) are potential complications of uterine inversion but do not pose the immediate threat of shock. Hypertension (choice D) is not directly related to the urgency of uterine inversion.
Why is continuous electronic fetal monitoring generally used when oxytocin is administered?
- A. Fetal chemoreceptors are stimulated
- B. The mother may become hypotensive
- C. Maternal fluid volume deficit may occur.
- D. Uteroplacental exchange may be compromised
Correct Answer: D
Rationale: The correct answer is D because oxytocin can cause increased uterine contractions, potentially impacting uteroplacental exchange and reducing oxygen delivery to the fetus. This can lead to fetal distress, making continuous electronic fetal monitoring crucial to detect any signs of distress promptly.
A: Fetal chemoreceptors being stimulated is not directly related to the need for continuous monitoring with oxytocin administration.
B: Maternal hypotension is a potential side effect of oxytocin but does not directly necessitate continuous fetal monitoring.
C: Maternal fluid volume deficit is a concern with oxytocin, but it does not directly link to the need for continuous fetal monitoring.
A nurse has recently transferred to a labor and delivery unit. During a scheduled cesarean, the nurse notices a prescription for the administration of 1,000 mL of prewarmed IV fluid. For which reason does the health care provider prescribe the fluid in this manner? Select all that apply.
- A. Results in an increased maternal core temperature
- B. Results in improved neonatal umbilical arterial pH
- C. Results in improved Apgar scores
- D. Results in decreased risk for maternal shock
Correct Answer: A
Rationale: Step 1: IV fluid is prewarmed to prevent hypothermia in the mother during cesarean delivery, which can occur due to exposure to cold operating room environment.
Step 2: Hypothermia in the mother can lead to adverse outcomes such as increased blood loss, delayed wound healing, and increased risk of infection.
Step 3: Maintaining maternal normothermia through prewarmed IV fluids is crucial for optimal maternal outcomes during cesarean delivery.
Summary:
- B: Improved neonatal umbilical arterial pH is not directly related to prewarmed IV fluid administration.
- C: Apgar scores are primarily influenced by factors like neonatal resuscitation and immediate care, not IV fluid temperature.
- D: Prewarmed IV fluid administration is more about preventing hypothermia in the mother rather than decreasing the risk for maternal shock.
Which of the following is the priority intervention for a supine patient whose monitor strip shows decelerations that begin after the peak of the contraction and return to the baseline after the contraction ends?
- A. Increase IV infusion.
- B. Elevate lower extremities.
- C. Reposition to left side-lying position.
- D. Administer oxygen per face mask at 4 to 6 L/minut
Correct Answer: C
Rationale: The correct answer is C: Reposition to left side-lying position. This is the priority intervention because decelerations that start after the peak of the contraction and return to baseline after it ends suggest umbilical cord compression. Repositioning the patient to the left side-lying position can alleviate pressure on the cord, potentially improving fetal perfusion.
Increasing IV infusion (A) may not directly address the cord compression. Elevating lower extremities (B) may not alleviate the pressure on the cord. Administering oxygen (D) may be beneficial, but repositioning the patient is the primary intervention to address the underlying issue.