Nokea
What should the nurse consider when the birthing person has a decrease in blood pressure after the placenta is delivered?
- A. The birthing person is in pain.
- B. Place the newborn skin-to-skin.
- C. The bladder is distended
- D. Check for possible hemorrhage.
Correct Answer: E
Rationale: Based on the scenario, the decrease in blood pressure post-placenta delivery indicates potential hemorrhage, a common complication. The nurse should assess for signs of bleeding, such as excessive vaginal bleeding or tachycardia. Prompt intervention is crucial to prevent further complications. Other choices are less relevant - pain alone does not directly cause a decrease in blood pressure, skin-to-skin contact is important but not the priority in this situation, and a distended bladder can be addressed later. Assessing for possible hemorrhage is the most critical action to take in this scenario.
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A patient who is 8 cm dilated develops circumoral numbness and dizziness. What is the nurse’s priority intervention?
- A. Call the health care provider immediately.
- B. Increase intravenous fluid, as these are signs of hypovolemia.
- C. Have the patient slow down her breathing.
- D. Have her start pushing, as these are signs of the beginning of the second stage.
Correct Answer: C
Rationale: The correct answer is C: Have the patient slow down her breathing. Circumoral numbness and dizziness are signs of hyperventilation, which can occur due to rapid breathing during labor. Slowing down the patient's breathing helps prevent respiratory alkalosis and promotes proper oxygenation for both the mother and the baby. Calling the health care provider immediately (A) may cause a delay in addressing the immediate issue. Increasing IV fluids (B) may not address the root cause of the symptoms. Having her start pushing (D) prematurely can be harmful if she is not fully dilated.
The primary difference between the labor of a nullipara and that of a multipara is
- A. total duration of labor.
- B. level of pain experience
- C. amount of cervical dilation.
- D. sequence of labor mechanisms.
Correct Answer: A
Rationale: The correct answer is A: total duration of labor. This is because nulliparas (women who have never given birth before) generally have longer labors compared to multiparas (women who have given birth before). This is due to factors such as the first-time stretching of the birth canal and the body's learning process. The level of pain experience (B) can vary among individuals and is not a primary difference between nulliparas and multiparas. The amount of cervical dilation (C) can be influenced by various factors and is not a defining difference between the two groups. The sequence of labor mechanisms (D) is a universal process in labor and does not differ based on whether a woman is a nullipara or multipara.
When does the active phase of labor begin according to ACOG?
- A. 6 cm
- B. 3 cm
- C. 5 cm
- D. 10 cm
Correct Answer: A
Rationale: The active phase of labor begins at 6 cm dilation according to ACOG guidelines. At this point, the cervix is significantly dilated, signaling the transition to active labor. This stage is crucial as it signifies the acceleration of labor progress and typically involves stronger contractions leading to efficient cervical dilation. Choices B, C, and D are incorrect as they do not align with the established criteria for the active phase of labor. Choice B (3 cm) is too early for active labor, choice C (5 cm) is close but not quite at the threshold for active labor, and choice D (10 cm) is actually the full dilation stage, not the beginning of active labor. Hence, choice A (6 cm) is the correct answer.
A gravida 3, para 2 is attempting a vaginal birth without the use of pain medicine or anesthesia. Following spontaneous rupture of membranes, the patient’s cervical exam was 5 cm dilated, 60% effaced, -2 station. Which therapeutic intervention is appropriate for this patient?
- A. Ambulation with assistance
- B. Squatting with support from partner
- C. Sitting on birthing ball
- D. Resting on hands and knees
Correct Answer: C
Rationale: The correct answer is C: Sitting on birthing ball. This position helps to open up the pelvis, allowing gravity to assist in descent of the baby. It also promotes optimal positioning for the baby, reducing the risk of malpresentation. The other choices (A, B, D) do not provide the same benefits in terms of promoting optimal fetal positioning and utilizing gravity to aid in labor progress. Ambulation with assistance may not provide as much support for the pelvis, squatting with support from the partner may not be as stable or comfortable for the mother, and resting on hands and knees may not encourage as much engagement of the baby's head in the pelvis.
What should the nurse consider when the birthing person has a decrease in blood pressure after the placenta is delivered?
- A. The birthing person is in pain.
- B. Place the newborn skin-to-skin.
- C. The bladder is distended
- D. Check for possible hemorrhage.
Correct Answer: E
Rationale: It seems like option E is missing from the choices provided. Could you please provide the correct options so that I can give you a detailed explanation for the correct answer?