Special Situations in L & D
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Special Situations in L & D

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Questions and Answers

What are the three main complications of amniotomy?

  • Prolapse of the umbilical cord, infection, and abruptio placentae (correct)
  • Infection, uterine rupture, and postpartum hemorrhage
  • Prolapse of the umbilical cord, preterm labor, and placental abruption
  • Fetal distress, maternal fever, and amniotic fluid embolism

    • What is the nursing intervention if non-reassuring fetal heart rate patterns or hypertonic uterine contractions occur during oxytocin administration?

  • Reposition the woman, decrease or discontinue the oxytocin, administer oxygen, and prepare terbutaline (correct)
  • Administer IV fluids to prevent maternal water intoxication
  • Notify the healthcare provider and prepare for an emergency cesarean delivery
  • Increase the dose of oxytocin to enhance uterine contractions

    • What is the purpose of administering oxytocin (Pitocin) during labor?

  • To reduce maternal fever and fetal distress
  • To induce labor and augment uterine contractions (correct)
  • To treat preterm labor
  • To prevent postpartum hemorrhage

    • What is the purpose of amnioinfusion during labor?

    <p>To treat oligohydramnios and prevent umbilical cord compression</p> Signup and view all the answers

    Which of the following is a potential complication of oxytocin (Pitocin) administration during labor?

    <p>Hypertonic uterine activity (Tachysystole)</p> Signup and view all the answers

    What is the purpose of closely monitoring the woman's intake and output during oxytocin (Pitocin) administration?

    <p>To identify potential water intoxication</p> Signup and view all the answers

    What is the primary purpose of inducing labor?

    <p>To initiate labor before it begins naturally</p> Signup and view all the answers

    What is the purpose of the Bishop score?

    <p>To assess the likelihood of successful labor induction</p> Signup and view all the answers

    What is the minimum recommended Bishop score before attempting labor induction?

    <p>6</p> Signup and view all the answers

    Which method is used to confirm fetal maturity before inducing labor?

    <p>Both ultrasound and amniotic fluid analysis</p> Signup and view all the answers

    What is the minimum gestational age recommended for labor induction?

    <p>39 weeks</p> Signup and view all the answers

    Which monitoring is essential during labor induction?

    <p>Uterine activity and fetal heart rate</p> Signup and view all the answers

    Which of the following is NOT a contraindication for labor induction?

    <p>Favorable fetal station</p> Signup and view all the answers

    What is the purpose of nipple stimulation during labor?

    <p>To improve the quality of contractions that have slowed or weakened</p> Signup and view all the answers

    What is the main risk associated with artificial rupture of membranes (AROM)?

    <p>Increased risk of umbilical cord prolapse</p> Signup and view all the answers

    Which of the following is a mechanical method of cervical ripening?

    <p>Laminiaria and Lamicel</p> Signup and view all the answers

    What is the recommended nursing care for a patient after insertion of a prostaglandin vaginal insert?

    <p>Bed rest for 1-2 hours and monitoring for uterine contractions</p> Signup and view all the answers

    Which of the following maternal medical conditions is NOT listed as a reason for labor induction?

    <p>Hypertension</p> Signup and view all the answers

    What is the primary goal of infusion during labor?

    <p>To relieve variable decelerations of the fetal heart rate</p> Signup and view all the answers

    Which statement about external version is correct?

    <p>It is done to change the fetal presentation from breech or oblique to cephalic</p> Signup and view all the answers

    What is the purpose of giving Rhogam to an Rh-negative mother after an external version?

    <p>To prevent sensitization to the fetal Rh-positive blood</p> Signup and view all the answers

    Which of the following is NOT a nursing care responsibility during an external version?

    <p>Administering tocolytic medication to the mother</p> Signup and view all the answers

    What is the purpose of an internal version?

    <p>To change the fetal presentation of the second twin during a vaginal birth</p> Signup and view all the answers

    Which of the following is a nursing responsibility when monitoring a patient after an external version?

    <p>Ensuring the mother's vital signs and fetal heart rate return to normal</p> Signup and view all the answers

    What is the purpose of performing a non-stress test or biophysical profile before an external version?

    <p>Both A and B</p> Signup and view all the answers

    What is the primary purpose of applying cold packs to the perineum after birth?

    <p>To reduce pain, bruising, and edema</p> Signup and view all the answers

    What is the primary indication for using forceps or vacuum extraction during labor?

    <p>To provide traction and rotation to the fetal head when the mother's pushing efforts are insufficient</p> Signup and view all the answers

    Which of the following is a contraindication for the use of forceps or vacuum extraction during labor?

    <p>The fetus is high in the pelvis or too large for a vaginal delivery</p> Signup and view all the answers

    What is the primary nursing care responsibility when a vacuum extractor is used during birth?

    <p>All of the above</p> Signup and view all the answers

    What is the purpose of applying warmth in the form of heat packs or sitz baths after the initial 12-24 hours of cold application to the perineum?

    <p>To increase blood circulation and enhance comfort and healing</p> Signup and view all the answers

    Which of the following is a potential complication associated with the use of forceps or vacuum extraction during birth?

    <p>Trauma to maternal or fetal tissues</p> Signup and view all the answers

    What is the primary advantage of a low transverse cesarean incision?

    <p>It increases the likelihood of a successful vaginal birth after cesarean (VBAC) in future pregnancies.</p> Signup and view all the answers

    Which statement about postpartum nursing care after a cesarean birth is correct?

    <p>The mother and her partner should be encouraged to talk about the cesarean birth experience.</p> Signup and view all the answers

    Which of the following assessments should be performed every 15 minutes for the first hour and every 30 minutes for the second hour after a cesarean birth?

    <p>Fundal assessment and clot formation</p> Signup and view all the answers

    What is the recommended nursing intervention if non-reassuring fetal heart rate patterns or hypertonic uterine contractions occur during oxytocin (Pitocin) administration?

    <p>Discontinue the oxytocin infusion.</p> Signup and view all the answers

    Which of the following is a potential complication of oxytocin (Pitocin) administration during labor?

    <p>Uterine hypertonicity</p> Signup and view all the answers

    What is the purpose of closely monitoring the woman's intake and output during oxytocin (Pitocin) administration?

    <p>To assess for signs of dehydration or fluid overload.</p> Signup and view all the answers

    Which of the following is a nursing responsibility when monitoring a patient after an external version?

    <p>Monitoring for signs of placental abruption.</p> Signup and view all the answers

    What is the main difference between episiotomy and lacerations?

    <p>Episiotomy is a controlled surgical enlargement, while lacerations are uncontrolled tears.</p> Signup and view all the answers

    Which degree of laceration involves the anal sphincter?

    <p>Third degree</p> Signup and view all the answers

    What is the difference in healing outcomes between midline and mediolateral episiotomy?

    <p>Midline episiotomy causes less scarring than mediolateral episiotomy.</p> Signup and view all the answers

    What is the primary reason for performing an episiotomy?

    <p>To control the amount and location of vaginal opening enlargement.</p> Signup and view all the answers

    Which direction does mediolateral episiotomy extend towards?

    <p>Towards the right or left side</p> Signup and view all the answers

    What is the current goal for reducing cesarean sections in the United States, as outlined in Healthy People 2030?

    <p>15%</p> Signup and view all the answers

    Which of the following is NOT listed as an indication for a cesarean birth?

    <p>Placenta previa or abruptio placentae</p> Signup and view all the answers

    Which of the following is a contraindication for a cesarean birth?

    <p>All of the above</p> Signup and view all the answers

    Which of the following is a potential risk of cesarean birth for the newborn?

    <p>All of the above</p> Signup and view all the answers

    What is the purpose of administering a Foley catheter during a cesarean birth?

    <p>To keep the bladder empty and prevent trauma to the bladder</p> Signup and view all the answers

    What is the expected rate of cervical dilation during the active phase of labor for a woman who has had a child before?

    <p>1.5 cm/hr</p> Signup and view all the answers

    Which factor is used as a guide to assess and manage the progress of cervical dilation and fetal descent during labor?

    <p>Friedman curve</p> Signup and view all the answers

    What is a potential problem that can result from prolonged labor, especially if the membranes have been ruptured for an extended period?

    <p>Maternal or newborn infection</p> Signup and view all the answers

    In the case of precipitate birth, what maternal injury should be observed and reported, which can improve with cold applications?

    <p>Excessive pain or bruising of vulva</p> Signup and view all the answers

    What is the primary reason for inducing labor if premature rupture of membranes occurs at 36 weeks of gestation or later?

    <p>To minimize infection risk</p> Signup and view all the answers

    What should be done if maternal temperature rises above 38°C (100.4°F) along with tenderness over the uterus in the context of premature rupture of membranes?

    <p>Observe, document, and report the findings</p> Signup and view all the answers

    What is a common cause of abnormal labor due to the occiput posterior position of the fetus?

    <p>Uterine overdistention</p> Signup and view all the answers

    Why may women with a small pelvis have difficulty delivering infants in an occiput posterior position?

    <p>Difficulty rotating and descending of the fetus</p> Signup and view all the answers

    What is a potential problem associated with multifetal pregnancies during labor?

    <p>Abnormal presentation of fetuses</p> Signup and view all the answers

    What is the most favorable type of pelvis for vaginal births?

    <p>Gynecoid pelvis</p> Signup and view all the answers

    Which factor can increase stress and contribute to dystocia during labor?

    <p>Increasing anxiety levels</p> Signup and view all the answers

    What is the primary goal of nursing care regarding a woman's psyche during childbirth?

    <p>&quot;Promoting relaxation&quot; and conserving resources</p> Signup and view all the answers

    What is the primary nursing care responsibility when managing a patient with uterine overdistention during labor?

    <p>Provide emotional support and encourage the woman to continue her efforts</p> Signup and view all the answers

    What is the primary nursing intervention for a patient experiencing ineffective maternal pushing during labor?

    <p>Provide coaching on effective pushing techniques</p> Signup and view all the answers

    What is the primary nursing care responsibility when managing a patient with a macrosomic (large) fetus during labor?

    <p>Monitor the mother and newborn for injuries after delivery</p> Signup and view all the answers

    What is the primary nursing intervention for a patient experiencing shoulder dystocia during labor?

    <p>Apply firm downward pressure above the symphysis pubis</p> Signup and view all the answers

    What is the primary nursing care responsibility when managing a patient with a breech presentation during labor?

    <p>Monitor the umbilical cord for compression and deliver the head quickly</p> Signup and view all the answers

    What is the primary nursing intervention for a patient experiencing ineffective uterine contractions during labor?

    <p>Provide emotional support and encouragement to the woman</p> Signup and view all the answers

    What is the primary characteristic of hypertonic labor?

    <p>Frequent, painful, and poorly coordinated contractions</p> Signup and view all the answers

    What is the recommended nursing care for a woman experiencing hypertonic labor?

    <p>Offer warm showers or baths to promote relaxation</p> Signup and view all the answers

    When does hypotonic labor typically occur?

    <p>During the active phase, after 4 cm of cervical dilation</p> Signup and view all the answers

    Which factor increases the likelihood of hypotonic labor?

    <p>Overly distended uterus or multiple previous births</p> Signup and view all the answers

    What is the primary nursing care responsibility for a woman experiencing hypotonic labor?

    <p>Monitor fetal heart rate and uterine contractions closely</p> Signup and view all the answers

    Which statement about abnormalities in labor is correct?

    <p>They may necessitate the use of forceps or cesarean delivery</p> Signup and view all the answers

    What is the primary goal of tocolytic therapy?

    <p>To stop uterine contractions and prolong pregnancy until fetal lung maturity</p> Signup and view all the answers

    Which medication is the drug of choice for tocolytic therapy?

    <p>Magnesium sulfate</p> Signup and view all the answers

    What is a potential adverse effect of magnesium sulfate therapy on the fetus?

    <p>Low blood calcium and bone problems</p> Signup and view all the answers

    What is the purpose of the Preterm Labor Assessment Tool (PLAT)?

    <p>To determine the risk of preterm labor and the need for interventions</p> Signup and view all the answers

    Which of the following is a sign of impending preterm labor?

    <p>Constant low back pain</p> Signup and view all the answers

    What is the purpose of monitoring fetal kick counts during preterm labor management?

    <p>To assess fetal well-being and detect potential fetal distress</p> Signup and view all the answers

    What is a potential complication of using calcium channel blockers like nifedipine (Procardia) to stop labor contractions?

    <p>Neonatal hypoglycemia</p> Signup and view all the answers

    What is a common side effect of administering B-Adrenergic drugs like terbutaline to stop uterine contractions?

    <p>Maternal nasal stuffiness</p> Signup and view all the answers

    What is a significant cardiac side effect associated with B-Adrenergic drugs like terbutaline?

    <p>Increased blood pressure</p> Signup and view all the answers

    What is a potential risk of prolonged pregnancy related to the fetus?

    <p>Low blood glucose levels after birth</p> Signup and view all the answers

    When should B-Adrenergic drugs like terbutaline be discontinued to prevent side effects in the newborn?

    <p>2 hours prior to delivery</p> Signup and view all the answers

    Which medication is contraindicated if magnesium sulfate is being used or uterine infection is suspected?

    <p>Nifedipine (Procardia)</p> Signup and view all the answers

    What is a potential consequence of prostaglandin synthesis inhibitors like indomethacin stimulating the ductus arteriosus to close prematurely?

    <p>Neonatal respiratory distress</p> Signup and view all the answers

    Which medication is most commonly used to reduce amniotic fluid when polyhydramnios is an issue?

    <p>Indomethacin</p> Signup and view all the answers

    What is the most appropriate method for speeding fetal lung maturity when the gestation is between 24 and 34 weeks?

    <p>Administering steroid drugs</p> Signup and view all the answers

    What nursing care should be provided after delivery for a patient who received glucocorticoids like betamethasone for fetal lung maturity?

    <p>Monitor maternal blood glucose levels</p> Signup and view all the answers

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