Nokea
Which explains why infants who are delivered via cesarean section before the start of labor have more difficulty transitioning to extrauterine life?
- A. The use of warm IV fluids precipitates hyperthermia.
- B. Regional anesthesia causes respiratory depression.
- C. The maternal left tilt position reduces placental blood flow.
- D. Residual amniotic fluid in the lungs makes spontaneous respirations difficult.
Correct Answer: D
Rationale: The correct answer is D because infants delivered via cesarean section before labor may not have had the opportunity to expel amniotic fluid from their lungs through the vaginal passage, leading to respiratory distress. This residual fluid can hinder the initiation of spontaneous respirations, causing difficulty in transitioning to extrauterine life. Choices A, B, and C are incorrect because hyperthermia from warm IV fluids, respiratory depression from regional anesthesia, and reduced placental blood flow from maternal position are not primary factors affecting the infant's ability to transition to extrauterine life in this scenario.
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The nurse is planning care for a patient during the fourth stage of labor. Which interventions should the nurse plan to implement? (Select all that apply.)
- A. Offer the patient a warm blanket.
- B. Place an ice pack on the perineum.
- C. Massage the uterus if it is boggy.
- D. Delay breastfeeding until the patient is reste
Correct Answer: A
Rationale: The correct answer is A: Offer the patient a warm blanket. In the fourth stage of labor, the mother experiences postpartum hemorrhage risk due to uterine atony. Keeping the patient warm helps prevent hypothermia, which can lead to increased bleeding. Ice packs (B) are not indicated as they can cause vasoconstriction and inhibit proper blood flow. Massaging the uterus (C) is appropriate in the third stage of labor to prevent hemorrhage but not in the fourth stage. Delaying breastfeeding (D) is incorrect as early breastfeeding promotes uterine contractions, reducing the risk of postpartum hemorrhage.
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: Step-by-step rationale:
1. The pattern of uterine contractions is crucial in determining true labor as true contractions are regular, increasing in frequency, duration, and intensity.
2. Assessing cervical dilation alone may not confirm true labor as some women may have cervical changes without being in active labor.
3. Bloody show may occur in both true and false labor, making it an unreliable indicator.
4. Fetal position and station are important for labor progression but do not definitively confirm true labor.
Therefore, by assessing the pattern of uterine contractions, the nurse can accurately determine if the patient is in true labor.
Why is precipitous labor most often seen in multiparous women?
- A. The cervix weakens after each delivery.
- B. The cervix can dilate and efface simultaneously.
- C. The multigravida uterus is better able to coordinate muscle movements.
- D. It is more difficult for multiparous women to know when labor begins.
Correct Answer: C
Rationale: Step 1: In multiparous women, the uterus has gone through labor before, making muscle coordination more efficient.
Step 2: Efficient muscle coordination helps in effective contractions, leading to faster labor progress.
Step 3: Multiparous women have experienced labor before, allowing the uterus to contract more effectively.
Step 4: This efficiency in muscle coordination is why precipitous labor is more often seen in multiparous women.
Summary:
A: The weakening of the cervix after each delivery is not a direct cause of precipitous labor.
B: The ability of the cervix to dilate and efface simultaneously does not explain why precipitous labor is more common in multiparous women.
D: The difficulty in knowing when labor begins is not a reason for the occurrence of precipitous labor in multiparous women.
Which of the following are signs of impending labor? Select all that apply.
- A. Weight gain
- B. Surge of energy
- C. Increase in urinary frequency
- D. Dyspnea
Correct Answer: B
Rationale: The correct answer is B: Surge of energy. This is a sign of impending labor as some women experience a sudden burst of energy before going into labor, known as the "nesting instinct." Weight gain (A) is not a sign of impending labor, but rather a common occurrence throughout pregnancy. Increase in urinary frequency (C) is a common symptom in the third trimester but not a direct sign of labor starting. Dyspnea (D), or shortness of breath, can be a normal pregnancy symptom but is not specifically indicative of impending labor.
Arrange the seven cardinal movements of labor, in order.
- A. Descent
- B. Expulsion
- C. Extension
- D. External rotation
Correct Answer: A
Rationale: The correct order of the seven cardinal movements of labor is: Descent, Flexion, Internal Rotation, Extension, Restitution, External Rotation, and Expulsion. Descent is the first cardinal movement, as the baby moves down the birth canal. Flexion follows to allow the baby's head to pass through the pelvis. Internal Rotation, Extension, and Restitution then occur to facilitate the baby's shoulders and body turning in alignment with the mother's pelvis. External Rotation follows to help the shoulders rotate to the correct position for delivery. Finally, Expulsion is when the baby is born. This sequence ensures a smooth and safe delivery. The other choices are incorrect as they are not part of the specific sequence of cardinal movements during labor.