Intrapartum Complication

Intrapartum Complication Related

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When the mother's membranes rupture during active labor, the fetal heart rate should be observed for the occurrence of which periodic pattern?

  • A. Early decelerations
  • B. Variable decelerations
  • C. Nonperiodic accelerations
  • D. Increase in baseline variability
Correct Answer: B

Rationale: The correct answer is B: Variable decelerations. When the mother's membranes rupture during active labor, variable decelerations should be observed in the fetal heart rate. This is because the rupture of membranes can lead to umbilical cord compression, causing variable decelerations in the fetal heart rate pattern. Variable decelerations are characterized by abrupt and visually apparent decreases in heart rate variability.

A: Early decelerations are usually associated with head compression during contractions and are benign.
C: Nonperiodic accelerations are not a typical pattern seen in response to ruptured membranes during labor.
D: An increase in baseline variability is a positive sign and does not specifically indicate the occurrence of variable decelerations related to umbilical cord compression.

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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.

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.

What type of dystocia should the nurse prepare for if she palpates prominent ischial spines during the vaginal exam?

  • A. pelvic dystocia
  • B. fetal dystocia
  • C. contraction dystocia
  • D. uterine dystocia
Correct Answer: A

Rationale: The correct answer is A: pelvic dystocia. Prominent ischial spines indicate a contracted pelvis, which can obstruct the baby's passage during labor, leading to pelvic dystocia. Pelvic dystocia involves the bony pelvis causing difficulty in the descent of the fetus. Choices B, C, and D are incorrect because fetal dystocia refers to issues related to the fetus, contraction dystocia involves ineffective contractions, and uterine dystocia pertains to abnormalities of the uterus itself, none of which are indicated by prominent ischial spines.

A new client is seen at the prenatal clinic and says she thinks she is pregnant. The first day of her last menstrual period was April 1, 2014. What is her EDB?

  • A. December 30, 2014
  • B. January 1, 2015
  • C. January 8, 2015
  • D. December 8, 2014
Correct Answer: A

Rationale: The correct answer is A: December 30, 2014. To calculate the Estimated Date of Birth (EDB), you add 9 months and 7 days to the first day of the last menstrual period. In this case, April 1, 2014 + 9 months is January 1, 2015, and then adding 7 days gives December 30, 2014 as the EDB. This calculation takes into account the typical 40-week gestational period of a pregnancy. Choices B, C, and D are incorrect because they do not consider the full 40-week gestational period from the last menstrual period.

Which maternal condition should be considered a contraindication for the application of internal monitoring devices?

  • A. Unruptured membranes
  • B. intravenous (IV) fluid.
  • C. Fetus has known heart defect
  • D. must act quickly to improve placental blood flow and fetal oxygen supply
Correct Answer: A

Rationale: The correct answer is A: Unruptured membranes. Internal monitoring devices are inserted through the cervix and into the uterus, which can introduce bacteria and increase the risk of infection if the membranes are not ruptured. This can lead to serious complications for both the mother and the baby.

Choice B (intravenous fluid) is incorrect because IV fluids are commonly used during labor to maintain hydration and provide necessary nutrients.

Choice C (Fetus has known heart defect) is incorrect because internal monitoring devices are used to assess fetal heart rate and detect any abnormalities, making this condition a reason for monitoring rather than a contraindication.

Choice D (must act quickly to improve placental blood flow and fetal oxygen supply) is incorrect because internal monitoring devices are usually used for continuous monitoring and do not require immediate intervention to be placed.

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