Dystocia: Labor Complications

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Questions and Answers

What is the primary purpose of fontanelles in a newborn's skull?

To serve as attachment points for muscles that control head movement.

To regulate temperature within the cranial cavity.

To allow the skull to expand and accommodate brain growth. (correct)

To provide structural rigidity to the skull immediately after birth.

In obstetrics, what does 'footling' presentation typically indicate about the fetus's position?

The fetus is in a breech position, with the buttocks presenting first.

The fetus's lower legs and thighs are extended, with one or both feet presenting first. (correct)

The fetus is in a cephalic presentation but with the head poorly flexed.

The fetus is in a transverse lie within the uterus.

Which of the following factors is least likely to contribute to a breech presentation?

Presence of hydramnios (excessive amniotic fluid).

Fetal position correcting itself to cephalic presentation by 38 weeks. (correct)

Gestational age of the fetus being less than 38 weeks.

A pendulous abdomen in the mother.

A patient is diagnosed with hydramnios at 32 weeks gestation. Which fetal presentation is this condition most likely to cause?

Footling breech presentation. (A) Signup and view all the answers

A primigravida at 39 weeks presents with a fetus in breech presentation. She asks about the likelihood of the baby turning spontaneously before labor. What is the most accurate response?

The likelihood of spontaneous version at this stage is low, but external cephalic version might be an option. (B) Signup and view all the answers

A laboring patient's cervical dilation has shown no change in more than 2 hours. Which of the following nursing actions is MOST appropriate according to the provided information?

Administer adequate fluids to prevent dehydration. (B) Signup and view all the answers

A patient is diagnosed with secondary arrest of dilatation. Which of the following best describes this condition?

No progress in cervical dilation for more than 2 hours. (A) Signup and view all the answers

In the context of abnormal fetal head positions, which intervention is MOST likely required if other measures are unsuccessful?

Cesarean section (CS) birth. (D) Signup and view all the answers

A primiparous woman in labor has been receiving adequate intravenous fluids. Her cervix was dilated to 6 cm two hours ago, but a recent examination reveals no further progress. What is the priority nursing intervention?

Continuing close monitoring and documentation of labor progress. (A) Signup and view all the answers

A laboring patient is being treated for dehydration with IV fluids. Despite this, her labor is not progressing, and her cervix has remained unchanged for more than 2 hours. What should the nurse suspect?

An abnormal fetal head position or secondary arrest of dilatation. (B) Signup and view all the answers

Which of the following combinations of factors presents the highest risk for complications during labor?

Advanced maternal age, grand multiparity, and poor nutrition. (B) Signup and view all the answers

A laboring patient exhibits a hard band forming across the junction of the upper and lower uterine segments. This is MOST indicative of what condition?

Pathologic retraction ring (Bandl's ring). (C) Signup and view all the answers

In a patient with a history of previous preterm labor and multiple abortions, which self-care measure is MOST crucial to emphasize during prenatal education?

Drinking plenty of fluids regularly. (D) Signup and view all the answers

Which patient characteristic is LEAST likely to be associated with increased risk during labor and delivery, based on the provided information?

History of enema. (A) Signup and view all the answers

Which statement BEST differentiates between a simple constriction ring and a pathologic retraction ring during labor?

A simple constriction ring occurs at any time during labor, while a pathologic retraction ring is mainly Bandl’s ring. (C) Signup and view all the answers

A patient experiencing prolonged first stage of labor exhibits anxiety and fear. Which additional symptom is most closely associated with their level of consciousness?

Lethargy (C) Signup and view all the answers

A nulliparous woman has been in the latent phase of labor for 22 hours. Based on the provided information, what is the most likely underlying cause for this prolonged latent phase?

Cervix not ripe at the beginning of labor (B) Signup and view all the answers

During labor, a patient's uterine contractions are mild and infrequent, showing inadequate relaxation between them. If cephalopelvic disproportion (CPD) is ruled out, which intervention is most appropriate?

Prescribe oxytocin to augment labor (B) Signup and view all the answers

A multiparous woman's labor has progressed to the dilatation phase. After one hour, she has dilated only 0.5 cm. Considering dysfunctional labor during dilatation, what is the most likely underlying issue?

Hypotonic uterine dysfunction (B) Signup and view all the answers

A patient is diagnosed with Placenta Succenturiata. Which potential complication should the healthcare provider be most vigilant in monitoring?

Risk of retained placental fragments (D) Signup and view all the answers

Flashcards

Fontanelles

Soft spots on an infant's skull where bones have not yet fused.

Breech Presentation

When a fetus presents with buttocks or feet first instead of the head during birth.

Footling Breech

Breech presentation where one or both feet are positioned to come out first.

Causes of Breech Presentation

Factors that may lead to a fetus being in a breech position, such as multiple pregnancies or uterine abnormalities.