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

Learn about complications that can develop during pregnancy.

Created by
@PreeminentRational

Questions and Answers

What are the three main complications of amniotomy?

Prolapse of the umbilical cord, infection, and abruptio placentae

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

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

To induce labor and augment uterine contractions

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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