intrapartum complications

A woman has been in labor for the past 8 hours, and she has progressed to the second stage of labor. However, after 2 hours with no further descent, the provider diagnoses an "arrested descent." The woman asks, "Why is this happening?" Which response is the best answer to this question? "More than likely you have cephalopelvic disproportion (CPD) where baby's head cannot make it through the canal." "Maybe your uterus is just tired and needs a rest." "It is likely that your body has not secreted enough hormones to soften the ligaments so your pelvic bones can shift to allow birth of the baby." "Maybe your baby has developed hydrocephaly and the head is too swollen."

"More than likely you have cephalopelvic disproportion (CPD) where baby's head cannot make it through the canal."

Which statement describes why hypertonic contractions tend to become very painful? More than one contraction may begin at the same time, as receptor points in the myometrium act independently of each other. The myometrium becomes sensitive from the lack of relaxation and anoxia of uterine cells. The number of uterine contractions is very low or infrequent. There is an increase in the length of labor because so many contractions are needed to achieve cervical dilation.

The myometrium becomes sensitive from the lack of relaxation and anoxia of uterine cells.

A woman experiences an amniotic fluid embolism as the placenta is delivered. The nurse's first action would be to: tell the woman to take short, catchy breaths. administer oxygen by mask. increase her intravenous fluid infusion rate. put firm pressure on the fundus of her uterus.

administer o2 by mask

A woman gave birth to a newborn via vaginal birth with the use of a vacuum extractor. The nurse would be alert for which possible effect in the newborn? central nervous system injury asphyxia clavicular fracture cephalhematoma

cephalhematoma

A 16-year-old client has been in the active phase of labor for 14 hours. An ultrasound reveals that the likely cause of delay in dilatation is cephalopelvic disproportion. Which intervention should the nurse most expect in this case? administration of oxytocin darkening room lights and decreasing noise and stimulation cesarean birth administration of morphine sulfate

cesarean birth

A client is giving birth when shoulder dystocia occurs in the fetus. The nurse recognizes that which condition in the client is likely to increase the risk for shoulder dystocia? diabetes nullipara preterm birth pendulous abdomen

diabates

A pregnant patient is prescribed to have labor induced with oxytocin. How should the nurse prepare to administer this medication? Diluted in the main intravenous fluid In two divided intramuscular sites Diluted as a "piggyback" infusion In a 20-cc bolus of saline

diluted as a piggyback infusion

The nurse is monitoring a woman who is receiving oxytocin IV to assist with uterine irritability. Which action should the nurse prioritize if the woman's contractions are determined to be 80 seconds in length after 1 hour of administration of the oxytocin? Slow the infusion to under 10 gtts per minute. Continue to monitor contraction duration every 2 hours. Discontinue the oxytocin infusion. Increase the flow rate of the main line infusion.

discontinue the oxytocin infusion (If uterine contractions lengthen beyond 70 seconds, there is apt to be an interference with fetal circulation. Discontinuing the infusion allows contractions to shorten in length and allow fetal nourishment. The nurse would not increase the flow rate of the main line infusion or slow the infusion without the primary care provider's prescription. Uterine contractions are monitored continuously.)

A patient in labor has a spinal cord injury and is unable to effectively push with contractions. Forceps will be used. What should the nurse do to prepare the patient for this type of delivery? Select all that apply. Begin an intravenous infusion of replacement fluid Ensure that the patient's membranes have ruptured. Validate that the cervix is fully dilated. Provide oxygen 2 L via face mask. Determine that the patient's bladder is empty.

ensure the patients membranes have ruptured validate that the cervix is fully dilated determine the patient's bladder is empty

A client in week 38 of her pregnancy has an ultrasound performed at a routine office visit and learns that her fetus has not moved out of a breech position. Which intervention does the nurse anticipate for this client? forceps birth vacuum extraction external cephalic version trial labor

external cephalic version

A nurse is caring for a pregnant client whose fetus has been diagnosed with macrosomia. When reviewing the client's history, which information would the nurse expect to find? preterm pregnancy gestational diabetes maternal rickets small body size of mother

gestational diabetes

After spontaneous rupture of membranes, the nurse notices a prolapsed cord. The nurse immediately places the woman in which position? supine side-lying sitting knee-chest

knee to chest

The nurse is caring for a client suspected to have a uterine rupture. The nurse predicts the fetal monitor will exhibit which pattern if this is true? Early decelerations Mild decelerations Variable decelerations Late decelerations

late decels

What terminology would the nurse use to document a newborn who weighs 4,000 grams (8.13 lb) or more at birth? meconia macrosomia microsomia hydrocephalus

macrosomia

A nurse assesses a client in labor and suspects hypotonic uterine dysfunction. Which intervention would the nurse expect to include in the plan of care for this client? administering oxytocin encouraging the woman to assume a hands-and-knees position providing a comfortable environment with dim lighting preparing the woman for an amniotomy

oxytocin

During their experience in L & D, a group of nursing students are observing a woman who is having uncoordinated contractions where the monitor shows some contractions close together, followed by a long period without any contractions. The nurse asks the students, "Which medication may help to stimulate a more effective, consistent pattern of contractions?" Which medication would be considered the best answer? terbutaline morphine sulfate betamethasone oxytocin

oxytocin (Oxytocin administration may be helpful in uncoordinated labor to stimulate a more effective and consistent pattern of contractions with a better, lower resting tone.)

A woman in labor for over 12 hours has very little progress. The health care provider thinks that her contractions lack the force needed to propel the infant downward through the birth canal. The provider asks a group of nursing students which hormone may need to be given to increase the force of the contraction. Which hormone would be the best answer? oxytocin, a posterior pituitary hormone antidiuretic hormone, a posterior pituitary hormone luteinizing hormone, an anterior pituitary hormone growth hormone, an anterior pituitary hormone

oxytocin, a posterior pituitary hormone

A woman at 39 weeks' gestation is brought to the emergency department in labor following blunt trauma from an vehicle accident. The labor has been progressing well after the epidural when suddenly the woman reports severe pain in her back and shoulders. Which potential situation should the nurse suspect? Dystocia Uterine rupture Fractured ribs Placental abruption

uterine rupture

A woman in active labor with a history of two previous cesarean births is being monitored frequently as she tries to have a vaginal birth. Suddenly, the woman grabs the nurse's hand and states, "Something inside me is tearing." The nurse notes her blood pressure is 80/50 mm Hg, pulse rate is 130 bpm and weak, the skin is cool and clammy, and the fetal monitor shows bradycardia. The nurse activates the code team because the nurse suspects the client may be experiencing which complication? an undiagnosed abdominal aorta aneurysm uterine rupture an amniotic embolism to the lungs compression on the inferior vena cava

uterine rupture

A woman with a history of crack cocaine use disorder is admitted to the labor and birth area. While caring for the client, the nurse notes a sudden onset of fetal bradycardia. Inspection of the abdomen reveals an irregular wall contour. The client also reports acute abdominal pain that is continuous. Which condition would the nurse suspect? uterine rupture umbilical cord prolapse amniotic fluid embolism shoulder dystocia

uterine rupture

A woman in labor is experiencing hypotonic uterine dysfunction. Assessment reveals no fetopelvic disproportion. Which group of medications would the nurse expect to administer? corticosteroids sedatives uterine stimulants tocolytics

uterine stimulants