Intrapartum Complications Nursing

Intrapartum Complications Nursing Related

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Which patient is a candidate for internal monitoring with an intrauterine pressure catheter?

  • A. Obese patient whose contractions are 3 to 6 minutes apart, lasting 20 to 50 seconds
  • B. Gravida 1, para 0, whose contractions are 2 to 3 minutes apart, lasting 60 seconds
  • C. Multigravida whose contractions are 2 minutes apart, lasting 60 to 70 seconds
  • D. Gravida 2, para 1, in latent phase whose contractions are irregular and mild
Correct Answer: B

Rationale: The correct answer is B because the patient is a primigravida (first pregnancy) with frequent contractions (2 to 3 minutes apart, lasting 60 seconds), which indicates active labor and the need for internal monitoring with an intrauterine pressure catheter. This level of contraction frequency and duration suggests progression towards the active phase of labor, where accurate monitoring is crucial for the well-being of both the mother and the baby.

Choice A is incorrect because the contractions are not as frequent or long-lasting as in active labor. Choice C is incorrect because although the contractions are frequent, the duration is longer than typical active labor. Choice D is incorrect because the contractions are irregular and mild, indicating the latent phase of labor where internal monitoring is not necessary.

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How much blood loss must occur to define the loss as a postpartum hemorrhage?

  • A. 250 mL
  • B. 500 mL
  • C. 750 mL
  • D. 1,000 mL
Correct Answer: B

Rationale: The correct answer is B (500 mL) for defining postpartum hemorrhage. This amount is used as the threshold because it represents a significant loss that may lead to maternal complications. Excessive bleeding after childbirth can quickly become life-threatening, so it is crucial to define postpartum hemorrhage accurately. Choices A (250 mL), C (750 mL), and D (1,000 mL) are incorrect as they do not align with the standard definition of postpartum hemorrhage, which is typically considered when blood loss exceeds 500 mL.

What is a potential risk associated with prolonged second stage labor?

  • A. decreased risk of instrumental delivery
  • B. decreased risk of cesarean birth
  • C. increased risk of fetal distress
  • D. increased risk of rapid delivery
Correct Answer: C

Rationale: The correct answer is C: increased risk of fetal distress. Prolonged second stage labor can lead to decreased oxygen supply to the fetus, causing fetal distress. This can result in adverse outcomes for the baby. Other options are incorrect because prolonged second stage labor is actually associated with an increased risk of instrumental delivery (A), an increased risk of cesarean birth (B), and not rapid delivery (D) as it is a prolonged process.

Which clinical finding can be determined only by electronic fetal monitoring?

  • A. Variability
  • B. Tachycardia
  • C. Bradycardia
  • D. Fetal response to contractions
Correct Answer: D

Rationale: The correct answer is D because electronic fetal monitoring is the only method that can directly measure and display the fetal heart rate in response to contractions. Variability, tachycardia, and bradycardia can also be observed through electronic fetal monitoring, but fetal response to contractions specifically requires continuous monitoring of the fetal heart rate during contractions. Therefore, D is the only clinical finding that can be determined exclusively through electronic fetal monitoring. Variability (A), tachycardia (B), and bradycardia (C) can be identified through other means of monitoring and assessment as well.

What newborn complication does type 1 diabetes mellitus cause?

  • A. hyperglycemia
  • B. fetal macrosomia
  • C. group B strep
  • D. cyanosis
Correct Answer: C

Rationale: The correct answer is C: group B strep. Women with type 1 diabetes are at higher risk of developing infections, including group B strep, which can be passed to the newborn during childbirth. This can lead to serious complications such as pneumonia, sepsis, and meningitis in the newborn. Hyperglycemia (choice A) is a common complication of maternal diabetes but is not specific to type 1 diabetes. Fetal macrosomia (choice B) is a condition where the baby is larger than average, which can be a complication of diabetes but not specific to type 1. Cyanosis (choice D) refers to a bluish discoloration of the skin due to lack of oxygen and is not directly related to type 1 diabetes complications in newborns.

What Bishop score describes the most favorable cervix?

  • A. 2
  • B. 4
  • C. 6
  • D. 8
Correct Answer: D

Rationale: The Bishop score assesses cervical readiness for labor. A score of 8 indicates a cervix that is most favorable for labor, with characteristics such as cervical dilation, effacement, station of the presenting part, cervical consistency, and cervical position all being favorable for childbirth. A score of 8 signifies a well-prepared cervix for labor, making it the correct answer. Choices A, B, and C (2, 4, and 6) represent scores indicating varying degrees of cervical readiness, but they are not as optimal as a score of 8. A Bishop score of 8 is associated with a higher likelihood of successful induction and progression of labor compared to lower scores.

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