Nokea
Which criteria should be verified prior to vacuum or forceps use? Select all that apply.
- A. The woman’s bladder is empty.
- B. The fetus must be at least 34 weeks gestation.
- C. There is a Category I tracing.
- D. The cervix must be completely dilated.
Correct Answer: B
Rationale: The correct answer is B: The fetus must be at least 34 weeks gestation. This is important because before using vacuum or forceps, the fetus should be mature enough to withstand the extraction process. Premature infants may not have fully developed skull bones to withstand the pressure, increasing the risk of injury.
Explanation for other choices:
A: The woman’s bladder is empty - While it's ideal for the bladder to be empty to prevent injury during the procedure, it's not a criteria that must be verified prior to vacuum or forceps use.
C: There is a Category I tracing - Fetal heart rate monitoring is important during labor, but the tracing being Category I does not specifically correlate with the need for vacuum or forceps.
D: The cervix must be completely dilated - While full cervical dilation is necessary for vaginal delivery, it is not a specific criteria to verify before vacuum or forceps use.
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During the COVID-19 pandemic, what was revealed about the importance of labor support?
- A. Labor support can only be provided by the significant other.
- B. Laboring patients did not need support from outside sources.
- C. Outcomes for birth were not changed by pandemic requirements.
- D. Patients during the pandemic's support ban experienced more depression.
Correct Answer: D
Rationale: The correct answer is D because patients who experienced a support ban during the pandemic were more likely to experience depression due to the lack of emotional and physical support during labor. This is supported by research showing the negative impact of isolation on mental health. Choices A and B are incorrect as labor support can come from various sources, not just the significant other, and patients benefit from support during labor. Choice C is incorrect as pandemic requirements did impact birth outcomes, such as increased stress and anxiety levels.
A 28-year-old gravida 1, para 0 patient who is at term calls the labor and birth unit stating that she thinks she is in labor. She states that she does have some vaginal discharge and feels wet;
- A. She relates a contraction pattern that is irregular, ranging from 5 to 7 minutes and lasting 30 seconds. Which questions should the nurse pose to the patient during this telephone triage? (Select all that apply.)
- B. Does she think that her membranes have ruptured?
- C. Is there any evidence of bloody show?
- D. Instruct the patient to keep monitoring her contraction pattern and call you back if they become more regular.
Correct Answer: A
Rationale: The correct answer is A because the patient's irregular contraction pattern and varying duration indicate early labor. By asking the patient about the contraction pattern, the nurse can assess the progression of labor and provide appropriate guidance. Choice B is incorrect because if the patient's membranes have ruptured, she would most likely feel a gush of fluid rather than just feeling wet. Choice C is incorrect as bloody show is not typically a reliable indicator of early labor. Choice D is incorrect as it does not address the need to assess the contraction pattern for progression of labor.
The nurse midwife caring for a multiparous client who is 5 cm dilated requests intermittent auscultation (IA) of the fetal heart rate. The woman’s history reveals no risk factors. How often should IA be performed in this patient?
- A. Every 15 minutes
- B. Every 5 minutes
- C. Every 20 minutes
- D. Every 30 minutes
Correct Answer: A
Rationale: The correct answer is A: Every 15 minutes. This frequency is recommended for a low-risk multiparous client in active labor without risk factors. Intermittent auscultation every 15 minutes allows for adequate monitoring of fetal well-being while also promoting maternal autonomy and mobility. Choices B, C, and D are incorrect because they are either too frequent or too infrequent for a low-risk client in active labor. Every 5 minutes (B) may be excessive and disrupt the labor process, every 20 minutes (C) may not provide sufficient monitoring, and every 30 minutes (D) may not detect changes in fetal status promptly.
The nurse is assessing a patient in the active phase of labor. What should the nurse expect during this phase?
- A. The patient is sociable and excite
- B. The patient is requesting pain medication.
- C. The patient begins to experience the urge to push.
- D. The patient experiences loss of control and irritability.
Correct Answer: C
Rationale: The correct answer is C because during the active phase of labor, the cervix dilates from 4 to 7 centimeters, and the patient typically experiences the urge to push as the baby descends further down the birth canal. This indicates progress in labor and readiness for the second stage. Choices A, B, and D are incorrect as they do not specifically align with the characteristics of the active phase of labor. Choice A is not necessarily indicative of the active phase, choice B may happen at any stage of labor, and choice D is more characteristic of transition phase rather than the active phase.
To determine if the patient is in true labor, the nurse would assess for changes in
- A. cervical dilation.
- B. amount of bloody show.
- C. fetal position and station.
- D. pattern of uterine contractions.
Correct Answer: D
Rationale: The correct answer is D: pattern of uterine contractions. This is because the pattern of contractions is a key indicator of true labor. True labor contractions are regular, increasing in frequency, duration, and intensity. Assessing the pattern helps differentiate true labor from false labor.
A: Cervical dilation is important but may not necessarily indicate true labor as it can occur in false labor as well.
B: The amount of bloody show is a sign of cervical changes, but it alone does not confirm true labor.
C: Fetal position and station are important for labor progress but do not definitively confirm true labor.
In summary, assessing the pattern of uterine contractions is crucial in determining true labor as it provides direct insight into the progression and intensity of contractions, distinguishing it from false labor.