Intrapartum Complications

Intrapartum Complications Related

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Which method of intrapartum fetal monitoring is the most appropriate when a woman has a history of hypertension during pregnancy?

  • A. Continuous auscultation with a fetoscope
  • B. Continuous electronic fetal monitoring
  • C. Intermittent assessment with a Doppler transducer
  • D. Intermittent electronic fetal monitoring for 15 minutes each hour
Correct Answer: B

Rationale: The correct answer is B: Continuous electronic fetal monitoring. This method is most appropriate for a woman with a history of hypertension during pregnancy because it allows continuous monitoring of fetal heart rate patterns and uterine contractions, providing real-time data to detect any signs of fetal distress promptly. Continuous monitoring is crucial in high-risk pregnancies to ensure timely intervention if any issues arise.

A: Continuous auscultation with a fetoscope is not ideal for a woman with a history of hypertension as it does not provide continuous monitoring and may miss subtle changes in fetal well-being.

C: Intermittent assessment with a Doppler transducer does not offer continuous monitoring, which is essential in high-risk pregnancies like hypertension.

D: Intermittent electronic fetal monitoring for 15 minutes each hour is not as effective as continuous monitoring in detecting changes in fetal well-being promptly, which is crucial in cases of hypertension during pregnancy.

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The nurse will monitor for aspiration, thought processes, and improved mobility after which complication?

  • A. neurologic dysfunction
  • B. Measure blood loss.
  • C. gestational diabetes
  • D. postpartum hemorrhage
Correct Answer: D

Rationale: The correct answer is D: postpartum hemorrhage. The nurse monitors for aspiration due to potential bleeding or clotting issues postpartum. Monitoring thought processes is important as postpartum hemorrhage can lead to hypovolemic shock affecting cognition. Improved mobility is assessed as excessive bleeding can cause weakness. Neurologic dysfunction (choice A) is not directly related to postpartum hemorrhage. Measuring blood loss (choice B) is important but not the primary focus after postpartum hemorrhage. Gestational diabetes (choice C) is a separate condition unrelated to postpartum hemorrhage.

How soon should delivery of the fetus occur when a Category III FHR tracing is diagnosed?

  • A. 15 minutes
  • B. 30 minutes
  • C. 45 minutes
  • D. 60 minutes
Correct Answer: B

Rationale: The correct answer is B: 30 minutes. When a Category III FHR tracing is diagnosed, it indicates severe fetal distress. Prompt delivery is crucial to prevent adverse outcomes. 30 minutes allows for timely intervention without risking further harm to the fetus. Option A (15 minutes) may be too rushed, potentially causing unnecessary stress during the delivery process. Options C (45 minutes) and D (60 minutes) delay delivery, increasing the risk of complications due to prolonged fetal distress. Timing is critical in ensuring the best possible outcome for both the mother and the baby.

What medication is administered to treat uterine atony?

  • A. ampicillin
  • B. nitroglycerine
  • C. magnesium sulfate
  • D. methylergonovine
Correct Answer: D

Rationale: The correct answer is D: methylergonovine. Methylergonovine is a uterotonic medication used to treat uterine atony by causing the uterus to contract and prevent postpartum hemorrhage. Ampicillin (A) is an antibiotic, nitroglycerine (B) is a vasodilator, and magnesium sulfate (C) is a medication used for conditions like preeclampsia and eclampsia, but not specifically for uterine atony. Therefore, D is the correct choice for treating uterine atony.

When the deceleration pattern of the fetal heart rate mirrors the uterine contraction, which nursing action is indicated?

  • A. Reposition the patient.
  • B. Apply a fetal scalp electrode.
  • C. Record this normal pattern.
  • D. Administer oxygen by nasal cannula.
Correct Answer: C

Rationale: Rationale for correct answer (C): Recording the normal pattern is indicated because the deceleration pattern mirroring uterine contractions is a reassuring sign of fetal well-being. It indicates a physiologic response to labor. Repositioning the patient (A) is unnecessary as the pattern is normal. Applying a fetal scalp electrode (B) is invasive and unnecessary in this scenario. Administering oxygen (D) is not indicated as the fetal heart rate pattern is normal.

The nurse is assisting with the preparation of a patient admitted for a planned cesarean birth. The patient has signed the consent form and discussed the elected regional anesthesia with the nurse anesthetist. Which is the most important action for the nurse related to anesthesia?

  • A. Verify the patient has been NPO for 6 to 8 hours.
  • B. Start an IV line and administer an IV fluid as ordered.
  • C. Administer preoperative medications per orders.
  • D. Obtain a baseline fetal heart rate monitor strip.
Correct Answer: A

Rationale: Step-by-step rationale for why answer A is correct:
1. NPO status is crucial to prevent aspiration during anesthesia administration.
2. Anesthesia guidelines typically require patients to be NPO for 6-8 hours.
3. Failure to verify NPO status can lead to serious complications.
4. Ensuring NPO status is a fundamental safety measure in anesthesia administration.

Summary of why other choices are incorrect:
B. Starting an IV and administering fluids are important but not as critical as verifying NPO status for anesthesia safety.
C. Administering preoperative medications is important, but ensuring NPO status takes precedence to prevent aspiration.
D. Obtaining a fetal heart rate monitor strip is important for monitoring the baby's well-being but does not directly impact anesthesia safety.

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