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 because some women experience a burst of energy as the body prepares for childbirth. Weight gain (A) is not a typical sign of impending labor, as weight gain usually occurs earlier in pregnancy. Increase in urinary frequency (C) is a common symptom throughout pregnancy and may not specifically indicate impending labor. Dyspnea (D), which is difficulty breathing, is not typically a sign of impending labor unless it is due to specific complications.
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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.
The nurse is directing an unlicensed assistive personnel (UAP) to obtain maternal vital signs between contractions. Which statement is the appropriate rationale for assessing maternal vital signs between contractions raNtheRr thaIn aGt anBot.heCr inMterval? U S N T O
- A. Vital signs taken during contractions are inaccurat
- B. During a contraction, assessing fetal heart rate is the priority.
- C. Maternal blood flow to the heart is reduced during contractions.
- D. Maternal circulating blood volume increases temporarily during contractions.
Correct Answer: D
Rationale: The correct answer is D. During contractions, maternal circulating blood volume increases temporarily due to the compression of blood vessels. Therefore, assessing vital signs between contractions provides a more accurate baseline measurement. Choice A is incorrect because vital signs taken during contractions may be affected by the pain and stress of labor. Choice B is incorrect as fetal heart rate assessment is a separate priority. Choice C is incorrect as maternal blood flow to the heart actually increases during contractions to ensure adequate oxygen supply.
Which woman is the best candidate for a trial of labor after cesarean (TOLAC)?
- A. A 34-year-old gravida 2, para 1 with one previous classical cesarean section for prematurity
- B. A 21-year-old gravida 2, para 1 with one previous low-transverse cesarean section for CPD
- C. A 31-year-old gravida 4, para 2 with one previous low-transverse cesarean section for late decelerations
- D. A 27-year-old gravida 3, para 2 with one previous T-shaped incision for macrosomia
Correct Answer: B
Rationale: Rationale for Choice B (Correct Answer):
- A 21-year-old gravida 2, para 1 with one previous low-transverse cesarean section for CPD is the best candidate for TOLAC.
- Low-transverse incisions have the lowest risk of uterine rupture during labor.
- CPD is not a contraindication for TOLAC.
- Young age and low parity are favorable factors for successful TOLAC.
- Therefore, this candidate has the highest likelihood of a successful VBAC.
Summary for Other Choices:
- Choice A: Classical cesarean section carries a high risk of uterine rupture; prematurity increases this risk.
- Choice C: Low-transverse incision is favorable, but the indication for the previous cesarean (late decelerations) may indicate an ongoing fetal concern.
- Choice D: T-shaped incision increases the risk of uterine rupture; macrosomia is a risk factor for failed TOL
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: The correct answer is C because the multigravida uterus has undergone labor before, making muscle coordination more efficient. This allows for faster and more coordinated contractions, leading to precipitous labor. Choice A is incorrect because the cervix does not weaken after each delivery. Choice B is incorrect as simultaneous dilation and effacement are not specific to multiparous women. Choice D is incorrect because the ability to recognize labor onset is not a determining factor in the occurrence of precipitous labor.
What anticipatory guidance should the nurse provide for new parents regarding sociologic changes?
- A. Explain that roles will not change at home
- B. Explain that stresses will be over now that the newborn is born.
- C. Tell the parents not to stress over household changes.
- D. Prepare them for possible strains on relationships.
Correct Answer: D
Rationale: The correct answer is D because it addresses the potential strains on relationships that can occur after the birth of a child. New parents often experience changes in their relationship dynamics due to increased responsibilities, sleep deprivation, and shifts in priorities. By preparing them for these possible strains, the nurse can help them navigate these challenges effectively.
A is incorrect because roles often do change at home with the arrival of a newborn. B is incorrect as stresses can actually increase after the baby is born. C is incorrect as it dismisses the importance of addressing household changes and potential stressors.