Unit 6 & 7 Review Questions
What factor is a contraindication for induction of labor? a. Post term dates b. Previous cesarean section with a classic incision c. Maternal hypertension d. Fetal death
b. Previous cesarean section with a classic incision A classic incision for a cesarean section is a contraindication for induction of labor. Post term dates, maternal hypertension, and fetal death are indications for induction of labor.
Examples of situations when the birth attendant may do an episiotomy include the following. (Select all that apply.) a. Fetal shoulder dystocia b. Forceps- or vacuum extractor-assisted births c. Breech presentation d. Fetus in an occiput posterior position
a, b, c Fetal shoulder dystocia, forceps- or vacuum extractor-assisted births, or a fetus in an occiput posterior position are all indications for an episiotomy. Most breech presentations are delivered by cesarean.
The unit's pediatric nurse educator is explaining the physiologic differences in infants and young children related to absorption of medications. Which information should the educator present? (Select all that apply.) a. Because of the greater fluid volume per weight in infants and young children, patients in this age range need a higher dose per kilogram of a water-soluble medication to achieve the desired distribution effects. b. Blood flow to muscle tissue can be erratic in young children, and this can increase or decrease the absorption of IM medications. c. Since pancreatic enzyme activity also is variable in infants for the first 3 months of life as the GI system matures, medications that require specific enzymes for dissolution and absorption might not be converted to a suitable form for intestinal action. d. Infants up to 8 months of age tend to have increased gastric motility that is generally predictable. e. The blood-brain barrier does not fully mature until a child is about 18 months old. f. The immaturity of infants' skin creates a decreased absorption of topical medications.
a, b, c It is true that because of the greater fluid volume per weight in infants and young children, patients in this age range need a higher dose per kilogram of a water-soluble medication to achieve the desired distribution effects. It is true that blood flow to muscle tissue can be erratic in young children, and this can increase or decrease the absorption of IM medications. It is true that pancreatic enzyme activity also is variable in infants for the first 3 months of life as the GI system matures, so medications that require specific enzymes for dissolution and absorption might not be converted to a suitable form for intestinal action. The immaturity of infants' skin creates an increased absorption of topical medications. Infants up to 8 months of age tend to have gastric motility that is generally unpredictable. The blood-brain barrier does not fully mature until a child is 2 years old.
The nurse educator is orienting new pediatric nurses to pediatric oxygen therapy. What information should be shared with the new nurses? (Select all that apply.) a. If a child perspires a lot, the nasal cannula can be taped to the side of the face. b. A partial or full non-rebreather mask is a face mask with attached reservoir that allows portion of exhaled gas to remain in the bag and mix with oxygen. c. A Venturi mask is indicated for infants and children who need modest amounts of supplemental oxygen (35% to 60%). d. A full non-rebreather system can deliver close to 90% oxygen at a flow rate of 10 to 15 L/min if a tight seal can be maintained. e. Oxygen flow rates for a nasal cannula should not exceed 4 L/min for a child. f. Toys that are battery-powered can be used by a patient using oxygen.
a, b, c Taping a nasal cannula in place can be helpful if a child perspires a lot. A Venturi mask is indicated for infants and children who need modest amounts of supplemental oxygen (35%-60%). A partial or full non-rebreather mask is a face mask with attached reservoir that allows a portion of exhaled gas to remain in the bag and mix with oxygen. A full non-rebreather system can deliver close to 100% oxygen at a flow rate of 10 to 15 L/min if a tight seal can be maintained. Toys that are battery-powered should not be used by a patient using oxygen. Oxygen flow rates for a nasal cannula should not exceed 6 L/min for a child.
Which of these conditions may cause the fetal heart rate to be lower during labor? (Select all that apply.) a. Prolonged hypoxia, hypercapnia, and acidosis b. Stimulation of the parasympathetic nervous system c. Stimulation of the sympathetic nervous system d. Stimulation of the baroreceptors, which in turn stimulates the vagus nerve
a, b, d Stimulation of the baroreceptors and the parasympathetic nervous system will lower the heart rate. Initial decreased oxygen content and increased carbon dioxide content will trigger an increase in the heart rate. However, if this condition continues, the heart rate will lower. Stimulation of the sympathetic nervous system increases the heart rate.
The nurse is teaching a parents' class about when to call the pediatrician's office if vomiting and diarrhea in their toddlers. Instruction by the nurse is correct if the nurse includes which information? (Select all that apply.) a. If the toddler has a fever (>39° C [102° F]) b. If their child's fontanel appears sunken c. When the diarrhea has been present for 24 hours d. If their child doesn't urinate for longer than 4 hours e. If crying produces no tears f. If severe abdominal cramps occur
a, c, e, f If crying produces no tears, the pediatrician should be notified. When the diarrhea has been present for 24 hours, the pediatrician should be notified. If the toddler has a fever >39° C (102° F), the pediatrician should be notified. If severe abdominal cramps occur, the pediatrician should be notified. If their toddler doesn't urinate for longer than 6 hours, the pediatrician should be notified. The fontanels disappear by 18 months of age.
It is time to give a 3-year-old boy his oral liquid medication. Which approach by the nurse is most likely to receive a positive response? a. "It's time for your medication now. Would you like water or apple juice afterward?" b. "You must take your medicine, because the doctor says it will make you better." c. "See how nicely your roommate took his medicine? Now it's your turn." d. "Wouldn't you like to take your medicine now?"
a. "It's time for your medication now. Would you like water or apple juice afterward?" Water or apple juice are two acceptable options that provide the patient with a structured choice. Forcing the medicine by abdicating responsibility to the physician can elicit negative behavior from the child. Encouraging competition is not appropriate for this age group. Asking the patient if he wants to take his medicine allows the child the option to say "no."
An adolescent with cancer, in hospice care, has had a transdermal fentanyl (Duragesic) patch that has provided pain relief for several hours but now complains of severe pain. What is the most appropriate nursing action? a. Administer the ordered rapid-release opioid IV. b. Place a new Duragesic patch on the adolescent. c. Try a non-pharmacologic approach to comfort care. d. Administer a low dose of meperidine (Demerol) IM.
a. Administer the ordered rapid-release opioid IV. The nurse should administer the rapid-release IV opioid for the breakthrough pain. Non-pharmacologic strategies will not be effective for alleviating severe pain. Intramuscular injections should be avoided in cancer patients. A Duragesic patch will take up to 24 hours to reach peak effect.
The nurse is starting an IV on a school-age child with cancer. The child says, "I have had a million IVs. They hurt." The nurse's response should be based on what information about children and pain? a. Children often demonstrate increased behavioral signs of discomfort with repeated painful procedures. b. Children become accustomed to painful procedures and often demonstrate no increase in behavioral signs of discomfort. c. Children often lie about experiencing pain. d. Children tolerate pain better than adults.
a. Children often demonstrate increased behavioral signs of discomfort with repeated painful procedures. Children with chronic illnesses are more likely to identify invasive procedures as being stressful compared with children who have acute illnesses. There are no data to support the assertion that children tolerate pain better than adults. Pain is whatever the experiencing person says it is. The child experiences increasing difficulty rather than learns to tolerate a painful procedure.
A toddler who was severely dehydrated when first admitted 3 days ago has been receiving treatment for rehydration. Which assessment by the nurse has priority before giving the next dose of medication? a. Determine if the toddler's weight is accurate. b. Assess the toddler's skin turgor. c. Check the toddler's intake and output record. d. Check the toddler's vital signs.
a. Determine if the toddler's weight is accurate. Be sure the child's weight is accurately recorded and is current, especially since his or her weight upon admission would most likely be less than at the current time. Medication calculations are weight-based, and the weight must be checked frequently. The skin turgor will provide an estimate of the toddler's hydration but has nothing to do with medication administration safety. The intake and output record is important but has nothing to do with safe medication administration. Vital signs change late and would not be a priority nursing action pertaining to medication dosage.
A nurse needs to take the blood pressure of a preschool-age child for the first time. What is the most appropriate action by the nurse to gain cooperation from the child? a. Permit the child to handle the equipment and see the dial move before putting the cuff in place. b. Tell the child that this procedure will help him or her get well faster. c. Explain to the child how the blood flows through the arm and why the blood pressure is important. d. Take the blood pressure when a parent is there to comfort the child.
a. Permit the child to handle the equipment and see the dial move before putting the cuff in place. Permitting the child to handle the equipment and see the dial move is the best approach for a preschooler. It allows the child to play out the experience ahead of time. The parent's presence will be helpful, but it will not alleviate fear of the unknown. Telling the child that this procedure will help him or her get well faster is not a true statement, and the child will not be able to understand the relationship between blood pressure and feeling better. Explanations on blood flow and the importance of blood pressure are too complex for this age group.
A nurse is caring postoperatively for an 8-year-old child in severe pain with multiple fractures and other trauma caused by a motor vehicle injury. Which is the most important consideration in managing the child's pain? a. Plan a preventive schedule of pain medication around the clock. b. Increase the dosage of analgesic until the child is adequately sedated. c. Give the child a clock and explain when he or she can have pain medications. d. Give only an opioid analgesic at this time.
a. Plan a preventive schedule of pain medication around the clock. An around-the-clock administration strategy should be used for a child recovering from trauma and surgery. This schedule will help prevent low plasma levels of the drug that could lead to breakthrough pain. The dose is increased until pain is controlled, not necessarily until sedation. Pain medication dosages are ordered by the physician. The nurse communicates the effectiveness of the medications to the physician so that dosages may be modified appropriately. Explaining the medication schedule is not appropriate; the child should be frequently assessed for pain, and medication doses should be adjusted accordingly. An opioid analgesic is appropriate for the immediate concern of the child's pain but will not facilitate a management plan.
A child is receiving morphine sulfate intravenously (IV) and has a new order to start receiving morphine sulfate orally. Based on the nurse's knowledge of morphine sulfate's actions and therapeutic effects, what is the relationship of the oral dose to the intravenous dose? a. The oral dose will be greater than the IV dose. b. The oral dose will be one-fourth of the IV dose. c. The oral dose will be half of the IV dose. d. The oral dose will be the same as the IV dose.
a. The oral dose will be greater than the IV dose. When the route of morphine administration is changed from intravenous to oral, it is essential that the dose be increased to achieve an equal effect. Oral morphine is not as effective at the same dose as IV morphine. Oral morphine is not as effective at the same dose as IV morphine. Oral morphine is not as effective at the same dose as IV morphine.
The nurse is caring for children after a variety of surgeries. What should the nurse consider when using the FACES Pain Rating Scale with children? a. This scale can be used with most children as young as 3 years old. b. The FACES scale uses a scale to document physiologic responses. c. This scale is not appropriate for use with adolescents. d. Children color the face with the color they choose to best describe their pain.
a. This scale can be used with most children as young as 3 years old. The FACES scale has been validated for children as young as 3 years of age. The child points at the face that best describes the pain being felt. The FACES scale does not have a scale for physiologic data. The scale is useful for all ages above 3 years, including adults.
Why should continuous electronic fetal monitoring be used when oxytocin is administered? a. Utero-placental exchange may be compromised. b. The woman may become hypotensive. c. Maternal fluid volume deficit may occur. d. Fetal chemoreceptors are stimulated.
a. Utero-placental exchange may be compromised. The uterus may contract more firmly, and the resting tone may be increased with oxytocin use. This reduces entrance of freshly oxygenated maternal blood into the intervillous spaces, depleting fetal oxygen reserves. Oxytocin use does not cause hypotension, decrease maternal fluid volume, or stimulate the fetal chemoreceptors.
What can be determined only by electronic fetal monitoring? a. Variability b. Tachycardia c. Bradycardia d. Fetal response to contractions
a. Variability Variability cannot be determined by auscultation, because auscultation provides only an average fetal heart rate as it fluctuates. Tachycardia and bradycardia can be determined by electronic fetal monitoring and auscultation. Fetal response to contractions is best determined by electronic fetal monitoring, but some responses can be determined through auscultation.
A nurse is caring for a child immediately after a tonsillectomy. Which action should the nurse include in the child's postoperative care plan? a. Watch for continuous swallowing. b. Apply warm compresses to the neck. c. Position the child on his or her back for sleeping. d. Encourage gargling to reduce discomfort.
a. Watch for continuous swallowing. Continuous swallowing is the most obvious early sign of bleeding from the operative site. Cold is preferred. Ice collars and cold liquids are encouraged for comfort and to decrease swelling. Warm compresses would cause vasodilation and bleeding. Gargling should be avoided because of the potential trauma to the suture line. The child should be positioned on his or her side or abdomen to facilitate drainage.
A woman in active labor and has been admitted to the birthing unit. She calls the nurse and says her "water just broke." The first nursing action should be a. assess the fetal heart rate for 1 minute. b. change the pad under the woman to keep her dry and comfortable. c. notify the nurse-midwife. d. assess the maternal vital signs.
a. assess the fetal heart rate for 1 minute. When the membranes rupture, there is a risk for the umbilical cord to be displaced. Assessment of the fetal heart rate at this time will identify compression of the cord if it occurs. Keeping the woman dry, assessing the maternal vital signs, and notifying the nurse-midwife are all important but not the top priority at this time. The concern is assessment for a prolapsed cord.
During an assessment, the nurse notes that the fetus is in complete flexion, with the head flexed toward the chest and the arms and legs flexed over the thorax. The fetal back is curved in a convex shape. This is termed fetal a. attitude. b. presentation. c. lie. d. passage.
a. attitude. The fetal attitude describes the relationship of fetal body parts to each other. The normal fetal attitude is flexion. Fetal lie is the orientation of the long axis of the fetus to the long axis of the woman. Longitudinal lie is the most common. Fetal presentation is determined by which fetal part enters the pelvis first. Cephalic is the most common fetal presentation. The passage deals with the fetus traveling through the maternal pelvis and soft tissues.
The nurse noted that the woman's Bishop score was 9. This indicates that the woman a. has a high likelihood of successful induction. b. does not have a high likelihood of developing gestational diabetes. c. does not have a high likelihood of successful induction. d. has a high likelihood of developing gestational diabetes.
a. has a high likelihood of successful induction. The Bishop scoring system uses five factors to estimate cervical readiness for labor. A score of 8 or greater has a high level of successful induction. The Bishop scoring system does not refer to gestational diabetes.
An important nursing intervention after a woman in labor has had an epidural block is to a. monitor the woman's bladder. b. turn her from side to side every 2 hours. c. decrease intravenous fluids to prevent fluid overload. d. monitor bowel sounds.
a. monitor the woman's bladder. With the large quantity of IV solutions the woman has received, her bladder fills quickly. The epidural block decreases the sensation of a full bladder so the woman may not be aware of her need to void. Epidural blocks do not alter bowel sounds. IV fluids need to be increased to prevent maternal hypotension. The woman still has limited movement. She may need assistance to move her legs as she turns.
The physician obtains a sample of fetal scalp blood to evaluate the pH. The results of the pH were 7.35. The nurse knows the next action will be a. nothing—this is a normal pH. b. preparing for delivery—the pH shows acidosis. c. repeating the pH in 20 minutes, because it is borderline. d. preparing for delivery—the pH shows alkalosis.
a. nothing—this is a normal pH. Normal scalp pH of a fetus is 7.25 to 7.35.
A 4-year-old has had diarrhea for several days, and her perineum is inflamed and almost excoriated. What nursing actions are indicated? (Select all that apply.) a. Gently wash the perineum with cold water and mild soap after each stool. b. Place the child without underwear for brief periods to allow air to the area. c. Turn the child at least every 2 hours. d. Apply an ointment to the inflamed area to provide a moisture barrier.
b, c, d Applying an ointment to the inflamed area to provide a moisture barrier is important. Placing the child without underwear for brief periods to allow air to the area often helps heal the area. Turning the child at least every 2 hours keeps pressure off the skin and facilitates circulation to the affected area. Gently wash the perineum with warm water and mild soap after each stool.
The nurse is reviewing the list of medications that his patients are receiving. Which medications are members of the group considered opioid medications? (Select all that apply.) a. Ibuprofen b. Methadone c. Codeine d. Morphine e. Fentanyl
b, c, d, e Codeine, Fentanyl, Morphine, and Methadone are opioids. Ibuprofen is a nonsteroidal anti-inflammatory drug.
The nurse educator is orienting a new group of nurses regarding verification of medications, including the dosage and container, with another nurse prior to administration. Which medications should the nurse include in the discussion? (Select all that apply.) a. 5% Dextrose in water b. Warfarin (Coumadin) c. 0.45% sodium chloride d. Digoxin (Lanoxin) e. Insulin f. 0.9% sodium chloride
b, d, e
The nurse has measured the urinary output for the 12-hour shift and has 340 mL for a 12-kg toddler. What is the normal range of urinary output for this child for a 12-hour shift so the nurse can evaluate the output obtained? a. 238 to 366 mL b. 288 to 432 mL c. 246 to 398 mL d. 274 to 416 mL
b. 288 to 432 mL The normal urinary output for infants and toddlers is greater than 2 to 3 mL/kg/hr, so the calculation would be: 12 kg × 2 mL/hr and 12 kg × 3 mL/hr 24 to 36 mL/hr. Since the output is for 12 hours, 24 mL/hr would be multiplied by 12 hours, and 36 mL/hr would also be multiplied by 12 hours. The answer is 288 to 432 mL for the 12-hour shift. The amount the toddler urinated falls within the range.
A preschooler with vomiting and diarrhea lost 0.5 kg of weight since being weighed in the pediatrician's office prior to admission to the hospital. How much fluid would the nurse calculate that this child has lost? a. 250 mL b. 500 mL c. 1000 mL d. 750 mL
b. 500 mL One milliliter of body fluid is approximately equal to 1 g of body weight, so a weight loss or gain of 1 kg represents 1 L, or 1000 mL. A half-kilogram loss would be 500 mL.
A nurse is preparing to teach a mother how to administer 1½ teaspoons of medicine to her 6-month-old child. What should the nurse instruct the mother to use to prepare an accurate dose? a. A household measuring spoon b. A plastic syringe calibrated in teaspoons/milliliters c. A regular silverware teaspoon d. A paper cup measured in 5-mL increments
b. A plastic syringe calibrated in teaspoons/milliliters A plastic syringe (without needle) calibrated in teaspoons/milliliters offers the most accurate measurement. The nurse would teach the mother to give the child 7.5 mL of the medication. Household measuring spoons can be used if other more precise devices are not available, but the dose will vary depending on the viscosity of the medication and how full the spoon is filled. A dinner table utensil is not acceptable because household teaspoons vary greatly in size. A paper cup does not contain calibration for the additional 2.5 mL that is needed.
A child needs medication administered through a gastrostomy tube. Which form of the medication should the nurse use? a. A time-release capsule b. A suspension c. A crushed enteric coated tablet d. A crushed chewable tablet
b. A suspension A suspension is a liquid that must be shaken before given in the tube. The tube should also be flushed before and afterward if tube feeding is currently being given. An enteric coated tablet should never be crushed and administered through a gastrostomy tube, because the coating that protects it from gastric juices is destroyed and the child will not get the entire dose. A crushed chewable tablet is not a good choice. It can clog the tube. A time-release capsule is exactly that: medication that is to be released after a certain period of time.
A preschooler with severe vomiting and diarrhea was admitted to the hospital. The vomiting has stopped, and rehydration was begun intravenously. When should the nurse begin feeding the child solid food? a. When the parents give their permission to feed their child b. After the child has been rehydrated c. When the IV rehydration can be stopped d. After the diarrhea has stopped for 24 hours
b. After the child has been rehydrated Feeding of solids or formula is started as soon as the child is rehydrated. Children should be encouraged to eat frequently—every 3 to 4 hours. Parents should be instructed that although stool output may increase, feeding will not prolong diarrhea, and the child will be absorbing necessary nutrients and calories. Parents should be instructed that although stool output may increase, feeding will not prolong diarrhea, and the child will be absorbing necessary nutrients and calories. The intravenous solutions may run a little longer to ensure that the child remains hydrated. It is not up to the parents to decide when resumption of solid food begins.
Which mechanism of labor occurs when the largest diameter of the fetal presenting part passes the pelvic inlet? a. Internal rotation b. Engagement c. Extension d. External rotation
b. Engagement Engagement is when the fetal presenting part at its widest diameter reaches the level of the ischial spines of the mother's pelvis. Extension occurs as the fetal head passes beneath the mother's symphysis pubis. Internal rotation occurs to allow the largest fetal head diameters to match the largest maternal pelvic diameters. External rotation occurs to allow the shoulders to rotate internally to fit the mother's pelvis.
The nurse educator is explaining how to assess pain in infants to a group of new nurses. Which behaviors should be explained as the most consistent indicators of pain in infants? a. Squirming and jerking b. Facial expression and withdrawing c. Increased heart rate d. Increased respirations
b. Facial expression and withdrawing Facial expression and withdrawing are the most consistent behavioral manifestations of pain in infants. Increased heart rate, squirming and jerking, and increased respirations depends on the specific infant and on the characteristics of the pain.
A 4-year-old child is to have a pulse oximeter used. Teaching by the nurse is correct if which explanation is given to the preschooler? a. It is much better than arterial blood gases. b. It goes on the finger or foot and doesn't hurt. c. It is more accurate than capnography. d. It provides intermittent measurements of oxygen saturation.
b. It goes on the finger or foot and doesn't hurt. Pulse oximetry is a painless noninvasive method with an oximeter that goes on the finger or foot. Preschoolers are fearful of physical injury or pain and need to know it is painless. They are not as interested in what it does or if it is a better method. Capnography measures carbon dioxide exhalation. It does not reflect oxygen perfusion. A preschooler is not interested in whether it is a better method and does not understand carbon dioxide exhalation. Pulse oximetry is less invasive and easier to test than arterial blood gases, but the preschooler wants to know that it doesn't hurt. Pulse oximetry provides continuous or intermittent measurements of oxygen saturation. This is a detailed explanation that omits the fact that it is painless.
During a pelvic exam the nurse feels the fetal posterior fontanel toward the woman's left side and anterior. The nurse would report the position as a. ROA. b. LOA. c. LOP. d. ROP.
b. LOA. The posterior fontanel is located at the fetal occipital area. Because it is toward the woman's left side and anterior, the position would be left, occipital, anterior (LOA).
A woman received 25 mg of meperidine (Demerol) intravenously 1 hour before delivery. What drug should the nurse have readily available at delivery? a. Butorphanol (Stadol) b. Naloxone (Narcan) c. albuphine (Nubain) d. Promethazine (Phenergan)
b. Naloxone (Narcan) Naloxone reverses narcotic-induced respiratory depression, which may occur with the administration of narcotic analgesia. Promethazine is used for nausea and vomiting during labor. Nalbuphine is used for pain relief and to relieve pruritis due to opioids. Butorphanol is used for pain relief.
The nurse sees a pattern on the fetal monitor that looks similar to early decelerations, but the deceleration begins near the acme of the contraction and continues well beyond the end of the contraction. Which nursing action indicates the proper evaluation of this situation? a. This pattern reflects variable decelerations. No interventions are necessary at this time. b. This deceleration pattern is associated with utero-placental insufficiency, so the nurse acts quickly to improve placental blood flow and fetal oxygen supply. c. Continue to monitor these early decelerations, which occur as the fetal head is compressed during a contraction. d. Document this reassuring fetal heart rate pattern, but decrease the rate of the intravenous fluid.
b. This deceleration pattern is associated with utero-placental insufficiency, so the nurse acts quickly to improve placental blood flow and fetal oxygen supply. This is a description of a late deceleration. Oxygen should be given via snug face mask. The nurse should position the woman on her side to increase placental blood flow. An early deceleration would end when the contraction phase is over. This pattern continues beyond the end of the contraction. Variable decelerations drop suddenly and return to baseline suddenly. They are caused by cord compression. A vaginal examination should be performed to identify this potential emergency. This pattern is nonreassuring. The intravenous fluid should be increased to increase the woman's blood volume.
When administering intravenous opioids to a laboring woman, the nurse should give the medication a. 30 seconds after the contraction has ended. b. at the beginning of the contraction. c. at the end of the contraction. d. during the peak of the contraction.
b. at the beginning of the contraction. Starting the injection at the beginning of the contraction, when blood flow to the placenta is normally reduced, limits transfer of the medication to the fetus. Giving the injection at the end of the contraction or after the contraction has ended will increase the transfer of the medication to the fetus because the uterine blood flow increases after the contraction is over.
The nurse is timing her patient's contractions. The following pattern occurs: Contraction starts: 7:32 Contraction ends: 7:32 (lasts 30 seconds) Contraction starts: 7:37 Contraction ends: 7:38 (lasts 30 seconds) Contraction starts: 7:42 Contraction ends: 7:42 (lasts 30 seconds) The nurse records the frequency of the contraction as a. lasting 30 seconds. b. every 5 minutes. c. lasting 30 seconds to 1 minute. d. every 4 to 5 minutes.
b. every 5 minutes. Frequency of contractions is the period from the beginning of one contraction to the beginning of the next contraction. Duration of the contraction is the length of the contraction from the beginning to the end. Thirty seconds is the duration of the contractions.
A woman is admitted to the birthing unit in labor. Upon assessment, it is noted that she is 3 cm dilated and 80% effaced with intact membranes. The nurse understands that her fetal monitoring will be done by a. posterior electrode. b. external electrode. c. anterior electrode. d. internal electrodes.
b. external electrode. To use internal electrodes, the woman must be 2 cm dilated and have ruptured membranes. Her membranes are intact. Therefore, external electrode monitoring is the choice for her.
Prior to a woman's receiving an epidural block during labor, an important nursing measure is to administer at least 500-1000 mL of non-dextrose solution. The rationale behind this nursing measure is to a. hydrate the fetus prior to the epidural block to prevent hypoxia. b. fill the vascular system with fluid to prevent hypotension due to vasodilation. c. ensure hydration of the woman because she will not be able to take anything by mouth until the block wears off. d. ensure the intravenous route is patent in case emergency medications are indicated after the epidural block is given.
b. fill the vascular system with fluid to prevent hypotension due to vasodilation. An epidural block may block the sympathetic nerves; also, this results in vasodilation and hypotension. Increasing the woman's IV fluid intake prior to the block will help prevent hypotension. The woman will still be able to take PO fluids after an epidural. It is important to maintain a patent IV route for emergency medication during labor, but it is not the reason for the fluid bolus. Hydration of the woman does not alter the hydration status of the fetus. Maternal hypotension may produce nonreassuring signs of the electronic fetal monitor strip. Preventing maternal hypotension will decrease the risk of fetal hypoxia.
The most important nursing intervention for the woman who has received an epidural narcotic is a. monitoring blood pressure every 4 hours. b. monitoring respiratory rate hourly. c. assessing the level of anesthesia. d. administering analgesics as needed.
b. monitoring respiratory rate hourly. The possibility of respiratory depression exists for up to 24 hours after administration of an epidural narcotic. An epidural narcotic does not affect the patient's blood pressure. Pain assessment should occur, but the patient will not have loss of sensation with epidural narcotics and may not need other analgesics.
The nurse is preparing to admit a woman in labor. The nurse notices on the prenatal record that the fetus is in an occiput posterior position. This position means the woman may have a. a shorter labor. b. more back pain with the labor. c. a less painful labor. d. more pain in the upper region of the uterus.
b. more back pain with the labor. When the fetus is in this position, the contractions push the fetal occiput against the woman's sacrum. This causes intense back discomfort that persists between contractions. Labor is usually longer with a posterior position. The fetus needs to rotate in a wider arc before extension can occur. Labor is more painful because the contractions push the fetal occiput against the woman's sacrum.
The best distinction between true labor and false labor is the a. increase in pain with contractions. b. progressive changes in the cervix. c. increase in frequency of contractions.
b. progressive changes in the cervix. The increase in frequency of contractions and pain with contractions is indicative of true labor, but the best distinction is the progressive changes in the cervix.
After monitoring the fetal heart rate for 10 minutes, the nurse notices the rate is staying at 175 bpm. The nurse is correct in classifying this baseline rate as a. bradycardia. b. tachycardia. c. normal. d. acceleration.
b. tachycardia. Tachycardia is a heart rate greater than 160 bpm, persisting for at least 10 minutes. A normal rate averages between 110 and 160 bpm. Bradycardia is a rate less than 110 bpm for at least 10 minutes. An acceleration is an increase in the heart rate that lasts for a short period of time before returning to baseline.
A woman is 2 cm dilated and requesting pain medication. Because of the early stage of labor, pain medication is not recommended. What can the nurse offer the woman to assist in managing pain? a. Teaching the pattern-paced breathing technique b. Nothing is available for this stage of labor c. A massage d. An epidural
c. A massage A massage is a nonpharmacologic technique that can assist the woman to relax. It can be used during any stage of labor. It may be too early for an epidural. They are given after labor is well established. Pattern-based breathing is used in the late active and transitional stage of labor.
The nurse is preparing to administer an intramuscular injection to a toddler in the vastus lateralis muscle, and there is not time for EMLA cream to be used. Which approach by the nurse is best in this situation? a. Distract the toddler while giving the injection alone. b. Promise the toddler a surprise if there is cooperation. c. Ask another staff member to help hold the toddler's legs still. d. Ask the parents to help hold the toddler's legs still.
c. Ask another staff member to help hold the toddler's legs still. Asking another staff member to help hold the toddler's legs still is best. Distracting the toddler while giving the injection alone is not safe. The toddler could move and the needle could cause harm to the leg. Promising the toddler a surprise if there is cooperation is not realistic for a potentially painful procedure. The parents should be in a comforting role, not holding their child still.
The nurse is assessing a preschooler who has intermittent chest pain. Which action should the nurse take when a cardiac arrhythmia is suspected? a. Count the radial rate at 1-minute intervals, for 2 consecutive minutes. b. Call for an immediate electrocardiogram. c. Count the apical rate and radial rate for 1 minute and compare. d. Have someone else take the radial rate while the nurse simultaneously checks the apical rate.
c. Count the apical rate and radial rate for 1 minute and compare. Counting the apical and radial rates for 1 minute and comparing them is the nurse's first action. If a cardiac arrhythmia is occurring, the radial pulse may be lower than the apical rate. It is the responsibility of the nurse to check both rates simultaneously to assess for differences. An electrocardiogram may be indicated after conferring with the health care practitioner. The radial pulse needs to be compared with the apical rate.
A child has been given too much opioid pain medications and now requires a reversal agent. Which medication should the nurse expect to administer? a. Neurontin b. Naproxen c. Naloxone d. Nortriptyline
c. Naloxone Naloxone (Narcan) will reverse opioid-related analgesia and respiratory depression. Neurontin is an anticonvulsant. Nortriptyline is a tricyclic antidepressant. Naproxen sodium is a nonsteroidal anti-inflammatory drug.
The nurse suspects a child is having an adverse reaction to a blood transfusion. What should be the first action by the nurse? a. Recheck the vital signs. b. Increase the flow of normal saline. c. Stop the transfusion. d. Notify the physician.
c. Stop the transfusion. It is the priority nursing action to stop the transfusion, then obtain new tubing and normal saline, and maintain a patent IV line with normal saline solution. If an adverse reaction is occurring, it is essential to minimize the amount of blood that is infused. The nurse should notify the physician after the blood transfusion is stopped and infusion of normal saline solution has begun. The nurse should take vital signs and compare them with the baseline after the blood transfusion is stopped and infusion of normal saline solution has begun. The blood should not be diluted; it should be returned to the blood bank if an adverse reaction has occurred, and first-voided urine and a new blood sample drawn from the patient for typing should be sent to the laboratory.
What should the nurse include in the teaching plan when discussing pain management with a child and his or her parents? a. Telling the parents that they will need to talk with the physician if the pain medication is not effective b. The possibility of addiction to pain medication c. Telling the parents that pain medication and management is to control pain but has limitations d. Assurance that the child will be kept pain-free
c. Telling the parents that pain medication and management is to control pain but has limitations Children and parents need to understand the limitations of pain medications and management. Telling the parents that they will need to talk with the physician if the pain medication is not effective is not appropriate. If pain medication management is not working, the nurse needs to know first. Discussing addiction to pain medication is not an ideal starting point in the teaching plan. Keeping the child free of pain is inaccurate and misleading, not realistic.
A nurse is caring for an infant with a tracheostomy when accidental decannulation occurs. The nurse is unable to reinsert the tracheostomy tube. Which should be the next action by the nurse? a. Try inserting a larger-sized tracheostomy tube. b. Notify the surgeon. c. Try inserting a smaller-sized tracheostomy tube. d. Perform oral intubation.
c. Try inserting a smaller-sized tracheostomy tube. A smaller-sized tracheostomy tube should always be close at hand. Inserting it will keep the stoma open and provide an airway until further action can be taken. Notify the surgeon after the emergency situation is handled. Oral intubation is done if a tube cannot be inserted. A larger tube would cause trauma to the trachea.
Following an amniotomy, the priority nursing intervention is to a. assess the color and amount of amniotic fluid. b. place dry sheets and pads under the woman. c. assess the fetal heart rate. d. assess the maternal vital signs including temperature.
c. assess the fetal heart rate. An immediate and continuing risk is that the umbilical cord will slip down in the gush of fluid. The cord can be compressed between the fetal presenting part and the woman's pelvis. Non-reassuring FHR patterns may occur. Assessing the color and amount of amniotic fluid, monitoring maternal temperature, and keeping the woman dry are important interventions but not the priority intervention.
During labor, a woman has been hyperventilating. She begins to complain of tingling in her hands and dizziness. The next action by the nurse should be to a. help the woman onto her side and check her vital signs. b. assess the need for pain control. c. help the woman slow her breathing and to breathe into a paper bag. d. continue to monitor the woman; this is considered normal.
c. help the woman slow her breathing and to breathe into a paper bag. Hyperventilation causes a loss of too much carbon dioxide, which produces the symptoms of tingling and numbness in the hands and feet and dizziness. By slowing the breathing down and rebreathing the carbon dioxide, the symptoms should subside. Turning the woman on her side and checking vital signs will not correct the hyperventilation. Hyperventilation can occur during labor due to pain, but nursing actions can alleviate the symptoms while waiting on pain interventions.
Pregnant women can usually tolerate the normal blood loss associated with childbirth because they have a. a higher hematocrit. b. increased leukocytes. c. increased blood volume. d. a lower fibrinogen level.
c. increased blood volume. Pregnant women have an increased blood volume during pregnancy by 1 to 2 L. Because of the high fluid volume level with pregnancy, the hematocrit level normally decreases. Fibrinogen levels normally increase during pregnancy to prevent excessive bleeding with delivery. Leukocytes do increase during labor and delivery; however, they have no effect on the woman's tolerance of blood loss.
In order to monitor for one of the side effects of oxytocin, it is important for the nurse to note the patient's a. respiratory rate. b. temperature. c. intake and output. d. deep tendon reflexes.
c. intake and output. Prolonged administration may cause fluid retention. Recording intake and output identifies fluid retention, which precedes water intoxication. Infection, respiratory depression, and alterations in deep tendon reflexes are not a side effect of oxytocin use.
The nurse is monitoring the fetal heart rate periodically with Doppler auscultation. At the end of a contraction, the fetal heart rate is 100 and gradually increases to 140 within 30 seconds. The nurse would need to assess the rate further, because this is an indication of a. early deceleration. b. low variability. c. late deceleration. d. variable deceleration.
c. late deceleration. A late deceleration shows a pattern of fetal heart decelerations that begin late in the contraction phase and go back to baseline after the contraction has ended. Low variability cannot be assessed with Doppler auscultation. With early decelerations, the fetal heart rate would be returned to normal by the end of the contraction. With variable deceleration, the nurse would hear a sudden drop in the fetal heart rate and a sudden return to normal rate.
The best time to teach nonpharmacologic pain control methods to an unprepared laboring woman is during the a. active phase. b. second stage. c. latent phase. d. transition phase.
c. latent phase. The latent phase of labor is the best time for intrapartum teaching because at this time the woman is usually anxious enough to be attentive yet comfortable enough to understand the teaching.
Excessive anxiety during labor heightens the woman's sensitivity to pain by increasing a. blood flow to the uterus. b. rest time between contractions. c. muscle tension. d. the pain threshold.
c. muscle tension. Anxiety and fear increase muscle tension, diverting oxygenated blood to the woman's brain and skeletal muscles. Prolonged tension results in general fatigue, decreased pain threshold, increased pain perception, and reduced ability to use coping skills.
The nurse has just started a new shift and is reviewing the chart for her assigned patient. The patient is 6 cm dilated, 100% effaced, -3 station with intact membranes. Ten minutes later, the patient informs the nurse that her membranes have just ruptured. The nurse notices variable decelerations on the monitor. The nurse's next action should be to a. notify the nurse-midwife. b. nothing, this is normal immediately after membranes rupture. c. perform a vaginal exam. d. increase the intravenous fluids and start oxygen.
c. perform a vaginal exam. A vaginal exam may be performed to check for a prolapsed cord, with a pattern of variable decelerations. If the pattern had been caused by utero-placental insufficiency, then increasing the intravenous fluids and starting oxygen would be appropriate. It is important to notify the primary care provider of this pattern; however, it is not the first priority. Variable decelerations are nonreassuring and not a normal pattern after membranes rupture.
Internal version might be used to manipulate the a. fetus from a breech to a cephalic presentation before labor begins. b. second twin from an oblique lie to a transverse lie before labor begins. c. second twin from a transverse lie to cephalic during vaginal birth. d. fetus from a transverse lie to a longitudinal lie before cesarean birth.
c. second twin from a transverse lie to cephalic during vaginal birth. Internal version is used during vaginal birth to manipulate the fetus into a longitudinal lie (cephalic or breech) that allows it to be born vaginally.
After the use of forceps during labor, the nurse should assess the woman for signs of a. uterine atony. b. bladder distention. c. vaginal lacerations. d. deep vein thrombosis.
c. vaginal lacerations. Maternal risks include laceration or hematoma of the vagina, perineum, or periurethral area. Bladder distention, uterine atony, and deep vein thrombosis are not effects of forceps.
The parents of a child who just had experienced severe trauma ask how their child's pain will be managed. Which response by the nurse is most accurate? a. "We will give pain medications early to keep her comfortable." b. "We withhold medication until it is absolutely needed." c. "Giving the maximum dosage initially should alleviate her pain." d. "We will give medication to minimize the pain experienced."
d. "We will give medication to minimize the pain experienced." Preventing pain from becoming severe is the best approach, because once the pain becomes severe, controlling it becomes more difficult. Administering the minimum, not the maximum, dosage should be done initially based on the assessment of the pain level and the child's response to pain medication. Prevention of pain is the best approach, not giving medication early. Withholding medication is not only unethical but it is also not the best approach to pain management.
A child with a chronic respiratory condition needs chest physiotherapy throughout the day. Teaching by the nurse has been successful if the child's father states that chest physiotherapy (postural drainage) should be performed when? a. 30 minutes after meals and at bedtime b. Immediately on arising and at bedtime c. Immediately before all aerosol therapy d. 1 hour before meals and at bedtime
d. 1 hour before meals and at bedtime The most effective and safest time for chest physiotherapy (postural) drainage is 1 hour before meals and before bedtime. It is more effective AFTER other respiratory therapy, such as bronchodilators or nebulizer treatments. The procedure should be done three to four times each day. When drainage is done after meals, it may cause the child to vomit.
A child weighs 18 kg and is to receive a medication that is 6 mg/kg/day in two divided doses. How much medication should the nurse administer per dose? a. 36 mg b. 6 mg c. 108 mg d. 54 mg
d. 54 mg 18 mg x 6 mg/kg/day =108 mg per day. Since it is in 2 divided doses, each dose would contain half of the daily medication dose, which would be 54 mg per dose.
The patient has been diagnosed with hydramnios. When an amniotomy is performed, the nurse is aware that the patient is at risk for which complication? a. Infection b. Placenta previa c. Fetal hypoxia d. Abruptio placentae
d. Abruptio placentae Abruptio placentae may occur after an amniotomy if the uterus is distended. Hydramnios will distend the uterus. Placenta previa is not a risk factor associated with hydramnios and/or amniotomy. Infection is a risk factor associated with amniotomy; however, having hydramnios does not increase the risk factor. Fetal hypoxia may occur if abruptio placentae occurs, but it is not a risk factor associated with amniotomy.
A child with terminal bone cancer is in severe pain. Based on the nurse's knowledge of terminal cancer and pain control, what action should the nurse take? a. Give small amounts of pain medication, since narcotic addiction is common in terminally ill children. b. Try to distract the child since children tend to be overmedicated for pain. c. Give large doses of opioids regardless of the side effects. d. Administer large doses of opioids when there are no other treatment options.
d. Administer large doses of opioids when there are no other treatment options. Large doses may be needed, because the child has become physiologically tolerant to the drug, requiring higher doses to achieve the same degree of pain control. Distraction doesn't work for severe pain. Continuing studies report that children are consistently undermedicated for pain. The dose is titrated to relieve pain. Addiction refers to a psychological dependence on the medication, which does not happen in terminal care.
A 2-month-old breastfed infant is successfully rehydrated with oral rehydration solutions (ORS) for acute diarrhea. What instructions to the mother about breastfeeding should be included by the nurse? a. Express breast milk, and dilute with sterile water before feeding. b. Stop breastfeeding until diarrhea is absent for 24 hours. c. Stop breastfeeding until breast milk is cultured. d. Continue breastfeeding.
d. Continue breastfeeding. Breastfeeding should continue. Culturing the breast milk is not necessary. Breastfeeding can continue along with ORS to replace the continuing fluid loss from the diarrhea. Breast milk should not be diluted.
A school-age child with acute diarrhea and mild dehydration is being given oral rehydration solutions (ORS). The child's mother calls the clinic nurse to report the child has occasional vomiting. What is the appropriate recommendation by the nurse? a. Alternate giving the child ORS and carbonated drinks. b. Maintain the child on NPO for 8 hours and resume ORS if vomiting subsides. c. Bring the child to the hospital for intravenous fluids. d. Continue to give the child ORS frequently in small amounts.
d. Continue to give the child ORS frequently in small amounts. Vomiting is not a contraindication to the use of ORS unless it is severe. The mother should continue to give the ORS in small amounts and at frequent intervals. NPO status is not indicated. Frequent intake of ORS in small amounts is recommended. A school-age child with mild dehydration can be rehydrated safely at home with oral solutions. Carbonated drinks should not be given to the child. They may have a high carbohydrate content and contain caffeine, which is a diuretic.
A toddler is hospitalized with severe dehydration. The nurse should assess the child for which possible complication? a. Hypertension b. A rapid, bounding pulse c. Decreased specific gravity d. Hypokalemia
d. Hypokalemia Hypokalemia is a concern in severe dehydration. A rapid, thready pulse would be seen in severe dehydration. The urine would be concentrated, so the specific gravity would increase. The child needs to be monitored for hypotension.
A 2-month-old infant has been brought to the emergency department because of diarrhea and vomiting for the past 48 hours. Why should the pediatric nurse expect the infant to be at a greater risk for fluid and electrolyte imbalances than older children? a. Infants have a lower metabolic rate than older children. b. Infants have a decreased surface area. c. The infants' daily exchange of extracellular fluid is decreased. d. Immature renal function is common in infants.
d. Immature renal function is common in infants. Infants' kidneys are unable to concentrate or dilute urine, conserve or excrete sodium, and acidify urine, and their bodies have a higher percentage of fluid per weight than older children. There is an increased amount of extracellular fluid in the infant. Forty percent of a neonate's body fluid is extracellular fluid, compared with 20% in an adult. Fluid is lost from the extracellular space first. Infants have a higher metabolic rate. Infants have a proportionately greater body surface area, which allows for greater insensible water loss.
A neonate had corrective surgery 3 days ago for esophageal atresia. The nurse notices that after each gastrostomy feeding there is a backup of formula feeding into her gastrostomy tube. What is the most appropriate action for the nurse to take? a. Leave the gastrostomy tube clamped after feedings. b. Position the child supine after feedings. c. Position the child on her left side after feedings. d. Leave the gastrostomy tube open and suspended after feedings.
d. Leave the gastrostomy tube open and suspended after feedings. The formula is backing up into the tube because of the delayed emptying. By keeping the tube open to air, the buildup of pressure on the operative site will be prevented. The child should be positioned on the right side with her head elevated at approximately 30 degrees. The child should be positioned on the right side with her head elevated at approximately 30 degrees. Leaving the tube clamped will create pressure at the operative site, and she's being positioned on the wrong side.
The nurse is doing preoperative teaching with a young child and his parents. The parents say that their child is "dreading the shot" for premedication. What information should the nurse take into consideration when responding to the parent's concern? a. The child will have no memory of the injection because of amnesia. b. The IM route is safer than the IV route in young children. c. Preanesthetic medication should be given intramuscularly (IM). d. Other routes to administer preanesthetic medication can be non-traumatic.
d. Other routes to administer preanesthetic medication can be non-traumatic. The necessity of premedication is being investigated. If necessary, numerous drug regimens and routes exist. Atraumatic care can be provided even for premedication. Preanesthetic medicines can be given in a variety of routes other than intramuscular. The IV route is preferable. The muscle may be sore after an injection.
A nurse observes erythema, pain, and edema at a child's intravenous (IV) site. What action should the nurse take initially? a. Increase the IV rate for 1 minute, and then recheck. b. Check for an adequate blood return. c. Ask another nurse to check the IV site. d. Stop the infusion.
d. Stop the infusion. Erythema, pain, and edema at a child's intravenous (IV) site describes an extravasation/infiltration and possible phlebitis. The IV must be stopped to prevent further damage to the child. A blood return would indicate that the IV catheter is still within the vein, but the description here is a definition of an infiltrated IV and phlebitis. The site can be checked after the IV is stopped. The nurse should not increase the IV rate for one minute and recheck. It will add additional fluid to the child's tissue.
A nurse is evaluating an infant brought to the clinic with severe diarrhea. What signs and symptoms should the nurses identify as indicating the infant has severe dehydration? a. Tachycardia, decreased tears, 5% weight loss and skin tenting b. Normal pulse rate, decreased blood pressure, intense thirst, and increased crying c. Irritability, moderate thirst, a flat fontanel, and sucking on his hands d. Tachycardia, capillary refill greater than 3 seconds, and sunken eyes and fontanel
d. Tachycardia, capillary refill greater than 3 seconds, and sunken eyes and fontanel Tachycardia, capillary refill greater than 3 seconds, and sunken eyes and fontanel are the symptoms of severe dehydration. In severe dehydration, tachycardia, decreased tears, a 15% weight loss, and skin tenting are present. Tachycardia, orthostatic hypotension and shock, and intense thirst would be expected. Crying may or not be present or increased due to lack of energy. The infant would be extremely irritable, with sunken eyes and fontanel.
The physician noted that the woman was 7 cm dilated and 100% effaced. The nurse is aware that the woman is in which phase of labor? a. Second b. Latent c. Active d. Transition
d. Transition The transition phase of the first stage is from about 7 or 8 cm to complete. The latent phase of the first stage is from the beginning of labor until about 3 cm dilated. The active phase of the first stage is between 4 to 6 cm. There is no second phase of labor. The second stage of labor begins with complete dilation until the birth of the baby.
After seeing the physician, the woman is confused about her upcoming induction. She states to the nurse, "The doctor said I would need a gel inserted prior to going into labor. What does that mean?" The nurse's response should be based on knowledge that a. a lubricating gel is inserted prior to induction to facilitate the insertion of the electronic monitoring devices. b. a lubricating gel is inserted so that it will not need to be reapplied prior to each vaginal exam during labor. c. a gel is inserted prior to induction to stimulate the rupture of the membranes. d. a gel is inserted prior to induction to ripen the cervix.
d. a gel is inserted prior to induction to ripen the cervix. Prostaglandin E2 gel can be inserted prior to induction. This ripens the cervix so that it dilates easier. Lubrication for insertion of electronic monitoring devices is done at the time of insertion, not prior to induction. The prostaglandin gel does not stimulate the rupture of the membranes. Lubrication for vaginal exams needs to be used with each exam.
After a cesarean section, the woman received a dose of an epidural opioid. Two hours later the nurse is assessing the woman and noted she was rubbing her face and neck and complaining of itching. The nurse's next action should be to a. prepare for an allergic reaction to the opioid. b. prepare for a respiratory emergency due to the opioid. c. notify the anesthesiologist. d. administer a prescribed medication to relieve the itching.
d. administer a prescribed medication to relieve the itching. Pruritus of the face and neck is a harmless but annoying side effect of epidural opioids. Administering diphenhydramine or small doses of naloxone or nalbuphine may help relieve some of the pruritus. This is not an emergency situation.
Proper placement of the tocotransducer for electronic fetal monitoring is a. over the mother's lower abdomen. b. inside the uterus. c. on the fetal scalp. d. over the uterine fundus.
d. over the uterine fundus. The tocotransducer monitors uterine activity and should be placed over the fundus where the most intensive uterine contractions occur. The internal scalp electrode is placed on the fetal scalp. The intrauterine pressure catheter is placed inside the uterus.
During labor, the nurse is aware that the woman's vital signs are best assessed between contractions. The rationale for this is that a. it is impossible to hear the fetal heart rate through the contracted muscles of the uterus. b. the pain of the contractions will alter her vital signs. c. the mother is more comfortable and will comply. d. the contractions decrease blood flow to the placenta, therefore increasing the woman's blood volume and altering her vital signs.
d. the contractions decrease blood flow to the placenta, therefore increasing the woman's blood volume and altering her vital signs. This increase in the woman's blood volume during a contraction will increase her blood pressure slightly and slow her pulse rate. The mother is more comfortable between contractions. Pain may have an altering factor with vital signs with some women. However, the best answer deals with the physiologic changes that occur with contractions and how they alter the vital signs. The fetal heart rate is more difficult to auscultate during a contraction but not impossible.
One side effect of oxytocin stimulation is hypertonic contractions. This can be detrimental to the fetus because a. it increases maternal renal blood flow. b. it produces a prolapsed cord. c. it decreases maternal blood pressure. d. there is a reduction of placental blood flow.
d. there is a reduction of placental blood flow. Hypertonic contractions can reduce placental blood flow and therefore reduce fetal oxygenation. Hypertonic contractions do not increase the risk for prolapsed cord, increased maternal renal blood flow, or decreased blood pressure.
