CH 21 prepU - PTL, tocolytics, & OB emergencies
The experienced labor and delivery nurse knows to evaluate progress in active labor by using which simple rule? a) 1 cm/hour for cervical dilation b) 1/4 cm/hour for cervical dilation c) 1/2 cm/hour for cervical dilation d) 2 cm/hour for cervical dilation
a) 1 cm/hour for cervical dilation
A woman experiences an amniotic fluid embolism as the placenta is delivered. Your first action would be to a) increase her intravenous fluid infusion rate. b) administer oxygen by mask. c) put firm pressure on the fundus of her uterus. d) tell the woman to take short, catchy breaths.
b) administer oxygen by mask.
Which finding would lead the nurse to suspect that the fetus of a woman in labor is in a persistent occiput posterior position? a) Lack of cervical dilation past 2 cm b) Complaints of severe back pain c) Fetal buttocks as the presenting part d) Contractions most forceful in the middle of uterus rather than the fundus
b) Complaints of severe back pain
A woman's nurse-midwife tells her that the woman has developed dystocia. You would explain that this term means a) Muscle weakness related to prolonged labor. b) High blood pressure related to difficult labor. c) Difficult or abnormal labor. d) Potential for placental detachment.
c) Difficult or abnormal labor.
A nursing student correctly identifies the most desirable position to promote an easy delivery as which of the following? a) breech b) occiput anterior c) face and brow d) shoulder dystocia
b) occiput anterior
After teaching a class about various methods for cervical ripening, the instructor determines that the teaching was successful when the class identifies which of the following as a surgical method? a) Laminaria b) Prostaglandin c) Amniotomy d) Breast stimulation
c) Amniotomy
A client has been in labor for 10 hours, with contractions occurring consistently about 5 minutes apart. The resting tone of the uterus remains at about 9 mm Hg, and the strength of the contractions averages 21 mm Hg. The nurse recognizes which of the following conditions in this client? a) Hypertonic contractions b) Braxton Hicks contractions c) Uncoordinated contractions d) Hypotonic contractions
d) Hypotonic contractions
A woman near term presents to the clinic highly agitated because her membranes have just ruptured and she felt something come out when they did. You are alone with her and notice that the umbilical cord is hanging out of the vagina. What should you do next? a) Prep the woman for a vaginal delivery. b) Go find assistance to confirm that the cord is in the vagina. c) With the woman in lithotomy position, hold her legs and sharply flex them toward her shoulders. d) Put her in bed immediately, call for help, and hold the presenting part of the cord.
d) Put her in bed immediately, call for help, and hold the presenting part of the cord.
The nurse would prepare a client for amnioinfusion when which of the following occurs? a) Severe variable decelerations are due to cord compression b) Maternal pushing is compromised due to anesthesia c) The fetus shows non-reassuring fetal heart rate patterns d) Fetal presenting part fails to rotate fully and descend in the pelvis
a) Severe variable decelerations are due to cord compression
Which of the following interventions would be most important when caring for the client with breech presentation confirmed by ultrasound? a) Noting the space at the maternal umbilicus b) Continuing to monitor maternal and fetal status c) Applying suprapubic pressure against the fetal back d) Auscultating the fetal heart rate at the level of the umbilicus
b) Continuing to monitor maternal and fetal status
A woman is to undergo labor induction. The nurse determines that the woman most likely requires cervical ripening if her Bishop score is: a) 9 b) 7 c) 6 d) 5
d) 5
Before calling the physician to notify him or her of a slow progression or an arrest of labor several assessments need to be made. What other maternal assessment do you need to make prior to calling the physician? a) Check for a full bladder. b) Make sure the epidural medication is turned down. c) Make sure the patient is lying on their left side. d) Assess vital signs every 30 minutes.
a) Check for a full bladder.
Tocolytic therapy will help to prevent preterm birth. a) False b) True
a) False Rationale: Tocolytic therapy does not typically prevent preterm birth, but instead it may delay it.
The client is 35 weeks of gestation and is being admitted for vaginal bleeding. The patient is stable at the time of admission. The priority nursing assessment for the client is for: a) Fetal heart tones. b) Signs of shock. c) Infection. d) Uterine stabilization
a) Fetal heart tones.
A nurse is caring for a pregnant client whose fetus has been diagnosed with macrosomia. When reviewing the client's history, which of the following would the nurse expect to find? a) Gestational diabetes b) Maternal rickets c) Small body size of mother d) Pre-term pregnancy
a) Gestational diabetes
The nurse is monitoring a patient in labor who has had a previous cesarean section and is trying a vaginal birth with epidural. The nurse observes a sudden drop in blood pressure, increased heart rate, and deep variable deceleration on the fetal monitor. The patient reports severe pain in her abdomen and shoulder. What should the nurse prepare to do? a) Prepare the patient for a cesarean section. b) Place the patient in a knee-chest position. c) Bolus the patient with another dose of medication through the epidural. d) Turn the patient on her left side.
a) Prepare the patient for a cesarean section.
The second-year nursing student taking an obstetrics course correctly attributes which of the following to the term dystocia? (Check all that apply.) a) Progress of labor deviates from normal. b) Labor is slow. c) Labor progresses normally. d) Labor is fast.
a) Progress of labor deviates from normal. b) Labor is slow. Rationale: Dystocia is said to exist when the progress of labor deviates from normal and is slow.
Which intervention would be most appropriate for the woman experiencing dystocia related to problems involving the psyche? a) Providing a comfortable environment with dim lighting b) Preparing the woman for an amniotomy c) Administering oxytocin d) Encouraging the woman to assume a hands-and-knees position
a) Providing a comfortable environment with dim lighting
Labor dystocia is an abnormally progression of labor. It is the most common cause of primary caesarian delivery. When is it most common for labor dystocia to occur? a) Second stage of labor b) Third stage of labor c) Fourth stage of labor d) First stage of labor
a) Second stage of labor
Which of the following would be appropriate for the use of low forceps? a) The leading point of fetal skull is at or above station +2, not on the pelvic floor b) The fetal head is engaged but the leading point of the skull is less than +2 c) The fetal skull has reached the pelvic floor, with the fetal head at the perineum d) The fetal scalp is visible at the introitus without spreading the labia
a) The leading point of fetal skull is at or above station +2, not on the pelvic floor
A client in the first stage of labor is diagnosed with dystocia involving the powers of labor. Which of the following would the nurse identify as the problem? a) Uterine contractions are too weak or uncoordinated b) Contractions are insufficient to cause fetus descent c) Fetus is in a different position or presentation d) Pelvis is either android type or platypelloid type
a) Uterine contractions are too weak or uncoordinated
After an hour of oxytocin therapy, a woman in labor states she feels dizzy and nauseated. Your best action would be to a) assess the rate of flow of the oxytocin infusion. b) assess her vaginally for full dilation. c) administer oral orange juice for added potassium. d) instruct her to breathe in and out rapidly.
a) assess the rate of flow of the oxytocin infusion.
The nursing student correctly identifies which of the following as risk factors for developing dystocia? (Check all that apply.) a) excessive analgesia b) maternal exhaustion c) maternal diabetes d) high fetal station at complete cervical dilation e) multiple gestation f) epidurals g) shoulder dystocia
a) excessive analgesia b) maternal exhaustion d) high fetal station at complete cervical dilation e) multiple gestation f) epidurals g) shoulder dystocia
A nursing instructor is teaching students about fetal presentations during delivery. The most common cause for increased incidence of shoulder dystocia is: a) increasing birth weight b) increased number of overall pregnancies c) poor quality of prenatal care d) longer lengths of labor
a) increasing birth weight.
A nurse is preparing to teach a class to pregnant women about the signs of preterm labor and what to do if these occur. Which of the following should the nurse include in the presentation? (Select all that apply.) a) leaking of fluid from the vagina b) uterine contractions, cramping, low back pain c) feeling of pelvic pressure or fullness d) feelings of stress e) nausea, vomiting, and diarrhea f) increase in vaginal discharge
a) leaking of fluid from the vagina b) uterine contractions, cramping, low back pain c) feeling of pelvic pressure or fullness e) nausea, vomiting, and diarrhea f) increase in vaginal discharge
A nursing instructor teaching about risk factors associated with PTL includes which of the following demographic and lifestyle issues? (Select all that apply.) a) smoking b) infection c) hypertension d) low socioeconomic status e) high level of stress f) alcohol use
a) smoking d) low socioeconomic status e) high level of stress f) alcohol use
A pregnant woman delivers a term fetus who has died in utero. She requests time after the birth to hold her baby. What is the best response by the nurse? a) "This was nature's way of taking care of a defective baby." b) "Hold your baby as long as you like. Please let me know what I can do to help you." c) "You can hold your baby for a few minutes, but then I must take it to the nursery to do the paperwork." d) "You don't want to see your baby like this. I will take the baby away for you."
b) "Hold your baby as long as you like. Please let me know what I can do to help you."
A nursing student has learned that precipitous labor is when the uterus contracts so frequently and with such intensity that a very rapid birth will take place. This means the labor will be completed in which span of time? a) < 5 hours b) < 3 hours c) < 8 hours d) < 4 hours
b) < 3 hours
Why is it important for the nurse to thoroughly assess maternal bladder and bowel status during labor? a) A full rectum can cause diarrhea. b) A full bladder or rectum can impede fetal descent. c) If the woman has a full bladder, labor may be uncomfortable for her. d) If the woman's bladder is distended, it may rupture.
b) A full bladder or rectum can impede fetal descent.
You assess that the fetus of a woman is in an occiput posterior position. Which of the following identifies the way you would expect her labor to differ from others? a) Need to have the baby manually rotated. b) Experience of additional back pain. c) Shorter dilatational stage of labor. d) Necessity for vacuum extraction for delivery.
b) Experience of additional back pain.
A primigravida at 28 weeks' gestation comes to the clinic for a check-up. She tells the nurse that her mother delivered both of her children prematurely, and she is afraid that the same will happen to her. What can the nurse inform her about the risk factors associated with premature births? (Select all that apply.) a) Large-for-gestational age fetus b) History of previous preterm birth c) Current multiple gestation pregnancy d) Uterine or cervical abnormalities e) Previous Cesarean section
b) History of previous preterm birth c) Current multiple gestation pregnancy d) Uterine or cervical abnormalities
At the hospital, a client is attached to the fetal monitor for uterine rupture. The nurse would assess for which pattern indicating change in the uterus impacting the fetus? a) Variable decelerations. b) Late decelerations. c) Mild decelerations. d) Early decelerations.
b) Late decelerations.
Which of the following actions could you initiate to reduce the discomfort of a woman in labor whose fetus is in an occiput posterior position? a) Apply ice packs to her lower back. b) Massage her lower back. c) Place her in a Trendelenburg position. d) Urge her to maintain a prone position.
b) Massage her lower back.
A laboring patient has been pushing without delivering the fetal shoulders. The physician determines the fetus is experiencing shoulder dystocia. What intervention can the nurse assist with to help with the delivery? a) Lamaze position b) McRobert's maneuver c) Fundal pressure d) Positioning the woman prone
b) McRobert's maneuver
A nurse preceptor asks a student to list commonly used diagnostic tests for preterm labor risk assessment. Which of the following tests should the student include? (Select all that apply.) a) thyroid level b) U/A c) CBC d) arterial blood gases e) amniotic fluid analysis
b) U/A c) CBC e) amniotic fluid analysis
A nursing instructor highlights risk factors associated with preterm labor that include which of the following? (Select all that apply.) a) weight of pregnant mother b) current multiple gestation pregnancy c) history of previous preterm birth d) weight of fetus e) uterine or cervical abnormalities
b) current multiple gestation pregnancy c) history of previous preterm birth e) uterine or cervical abnormalities
The nurse preceptor explains that several factors are involved with the "powers" that can cause dystocia. She focuses on the dysfunction that occurs when the uterus contracts so frequently and with such intensity that a very rapid birth will take place. This is known as which of the following? a) hypertonic contractions b) precipitous labor c) hypotonic contractions d) none of the above
b) precipitous labor
A woman you are caring for during labor is having contractions 2 minutes apart but rarely > 50 mm Hg in strength; the resting tone is high, 20 to 25 mm Hg. She asks what she can do to make contractions more effective. Your best response would be that a) hypotonic contractions of this kind will strengthen by themselves. b) she needs to rest because her contractions are hypertonic. c) walking around will make her contractions more regular. d) her physician will order oxytocin to strengthen contractions.
b) she needs to rest because her contractions are hypertonic.
A patient who has been in prolonged labor reports extreme back pain. She asks why her back hurts so much. The best response by the nurse would be which of the following? a) "Let me help you out of bed to try walking it off." b) "Perhaps you have been in one position for too long." c) "Different fetal positions can cause prolonged labor and back pain." d) "This is just a normal part of labor."
c) "Different fetal positions can cause prolonged labor and back pain."
A multigravida presents at 31 weeks' gestation with signs and symptoms of PTL. The diagnosis is confirmed and she is admitted and given magnesium sulfate. What must you report as part of her care? a) Severe lower back pain, leg cramps, sweating b) Pain in the abdomen, shoulder, or back c) Respiratory depression, hypotension, absent tendon reflexes d) Low potassium or elevated glucose, tachycardia, chest pain
c) Respiratory depression, hypotension, absent tendon reflexes
A patient is 32 weeks gestation and sent home on modified bedrest for PTL. She is on tocolyitics and wants to know when she can have intercourse again with her husband. What is the most appropriate response by the nurse? a) "You will not be able to have intercourse again until 6 weeks after you deliver." b) "The need to keep the infant safe should be of more concern than when to have sex." c) "That is a question to ask your health care provider, at this point you are on pelvic rest to try and stop any further labor." d) "Intercourse has nothing to do with preterm labor; you can have sex with your husband."
c) "That is a question to ask your health care provider, at this point you are on pelvic rest to try and stop any further labor."
A woman is going to have labor induced with oxytocin. Which statement below reflects the induction technique you anticipate her primary-care provider will order? a) Administer Pitocin in a 20 cc bolus of saline. b) Administer Pitocin in two divided intramuscular sites. c) Administer oxytocin diluted as a "piggyback" infusion. d) Administer oxytocin diluted in the main intravenous fluid.
c) Administer oxytocin diluted as a "piggyback" infusion.
Immediately after delivering a full-term infant, a patient develops dyspnea and cyanosis. Her blood pressure decreases to 60/40 mm Hg, and she becomes unresponsive. What does the nurse suspect is happening with this patient? a) Aspiration b) Placental separation c) Amniotic fluid embolism d) Congestive heart failure
c) Amniotic fluid embolism
The nurse identifies a nursing diagnosis of risk for injury related to possible effects of oxytocin therapy. Which of the following would the nurse do to ensure a positive outcome for the client? a) Turn down oxytocin administration by half b) Administer hydration and sedation frequently c) Assess contractions by using external monitor d) Start administering tocolytic therapy
c) Assess contractions by using external monitor
A client's membranes have just ruptured. Her fetus is presenting breech. Which of the following should the nurse do immediately to rule out prolapse of the umbilical cord in this client? a) Administer oxygen at 10 L/min by face mask b) Administer amnioinfusion c) Assess fetal heart sounds d) Place the woman in Trendelenburg position
c) Assess fetal heart sounds
A woman at 32 weeks' gestation is admitted in preterm labor. On your admission assessment, which of following findings should cause the nurse to question the administration of a tocolytic agent? a) Strong, regular contractions. b) A spontaneous abortion in an earlier pregnancy. c) Cervical dilation of 5 cm. d) Fetus in a breech presentation.
c) Cervical dilation of 5 cm.
A woman is admitted to the labor suite with contractions every five minutes lasting one minute. She is post-term and has oligohydramnios. What does this increase the risk of during delivery? a) Shoulder dystocia b) Macrosomia c) Cord compression d) Fetal hydrocephalus
c) Cord compression
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? a) Forceps birth b) Trial labor c) External cephalic version d) Vacuum extraction
c) External cephalic version
A client in labor has been diagnosed with shoulder dystocia. Which of the following risk factors would the nurse expect to assess in the client? Select all that apply. a) Incompetent cervix b) Intrauterine growth restriction c) Fetal macrosomia d) Post-term pregnancy e) Maternal diabetes
c) Fetal macrosomia d) Post-term pregnancy e) Maternal diabetes
At 31 weeks' gestation, a 37-year-old woman who has a history of preterm birth reports cramps, vaginal pain, and low, dull backache accompanied by vaginal discharge and bleeding. Her cervix is 2.1 cm long; she has fetal fibronectin in her cervical secretions, and her cervix is dilated 3 to 4 cm. For what do you prepare her? a) Careful monitoring of fetal kick counts b) Bed rest and hydration at home c) Hospitalization, tocolytic therapy, and IM corticosteroids d) An emergency cesarean section
c) Hospitalization, tocolytic therapy, and IM corticosteroids
A physician orders oral tocolytic therapy for a woman with preterm labor. Which agent would the nurse be least likely to administer? a) Nifedipine b) Terbutaline c) Magnesium sulfate d) Indomethacin
c) Magnesium sulfate
You are assisting with delivery of the second child of a healthy young woman. Her pregnancy has been uneventful, and labor has been progressing well. The fetal head begins to deliver but instead of continuing to emerge, it retracts into the vagina. What should you try first? a) Attempt to push one of the fetus' shoulders in a clockwise or counterclockwise motion. b) Zavanelli's maneuver c) McRobert's maneuver d) Apply pressure to the fundus.
c) McRobert's maneuver
A 26-year-old primigravida has brought her doula to the birthing center for support during her labor and delivery. The doula has been helping her through the past 16 hours of labor. The laboring woman is now 6 cm. dilated. She continues to report severe pain in her back with each contraction. The patient finds it comforting when her doula uses the ball of her hand to put counterpressure on her lower back. What is the likely cause of the woman's back pain? a) Nongynecoid pelvis b) Breech presentation c) Occiput posterior position d) Fetal macrosomia
c) Occiput posterior position
A patient is 23 weeks gestation and was admitted for induction and delivery after noting the infant was an intrauterine fetal death. The patient had fallen 3 days prior to the diagnosis and landed on her side. What is the most likely attributable cause to the fetal death? a) Genetic abnormality b) Preeclampsia c) Placental abruption d) Premature rupture of membranes
c) Placental abruption
Which action by the nurse would be least effective in assisting a couple who have experienced intrauterine fetal demise? a) Give the parents a lock of the infant's hair b) Assist the family in making arrangements for their stillborn infant c) Refrain from discussing the situation with the couple d) Allow the couple to spend as much time as they want with their stillborn infant.
c) Refrain from discussing the situation with the couple
While in labor a woman with a prior history of cesarean birth complains of light-headedness and dizziness. The nurse assesses the patient and notes an increase in pulse and decrease in blood pressure from the vital signs 15 minutes prior. What might the nurse consider as a possible cause for the symptoms? a) Placentea previa b) Hypertonic uterus c) Uterine rupture d) Umbilical cord compression
c) Uterine rupture
While in labor a woman with a prior history of cesarean birth complains of light-headedness and dizziness. The nurse assesses the patient and notes an increase in pulse and decrease in blood pressure from the vital signs 15 minutes prior. What might the nurse consider as a possible cause for the symptoms? a) Umbilical cord compression b) Hypertonic uterus c) Uterine rupture d) Placentea previa
c) Uterine rupture
When a woman in labor has reached 8 cm dilation, you notice the fetal heat rate suddenly slows. On perineal inspection, you observe the fetal cord has prolapsed. Your first action would be to a) replace the cord with gentle pressure. b) cover the exposed cord with a dry, sterile wrap. c) place her in a knee-chest position. d) turn her to her left side.
c) place her in a knee-chest position. Rationale: Keeping the pressure of the fetus off the cord improves fetal circulation. Placing the woman in a knee-chest position accomplishes this. Replacing the cord could knot it; allowing it to dry would constrict cord blood vessels.
The nursing student doing a rotation in obstetrics is talking to her preceptor about dystocia. She asks what is meant by the term "expulsive forces," better known as the "powers." The preceptor correctly tells her that the "powers" include which of the following? (Check all that apply.) a) mother's age b) analgesia c) position d) fetal development e) presentation
c) position d) fetal development e) presentation
The nursing student demonstrates an understanding of dystocia with which of the following statements? a) "Dystocia is not diagnosed until after the delivery." b) "Dystocia cannot be diagnosed until just before delivery." c) "Dystocia is diagnosed at the start of labor." d) "Dystocia is diagnosed after labor has progressed for a time."
d) "Dystocia is diagnosed after labor has progressed for a time."
A woman whose fetus is in the OP position is experiencing increased back pain. Which is the best way for the nurse to help alleviate this back pain? a) Performing acupuncture on the back b) Applying a heating pad to the back c) Applying ice to the back d) Applying counter pressure to the back
d) Applying counter pressure to the back
The nurse is assessing the woman who has a forceps-assisted birth for complications. Which of the following would be least likely to occur in the mother? a) Perineal hematoma b) Cervical lacerations c) Infection of episiotomy d) Caput succedaneum
d) Caput succedaneum
A nurse is working with a client who has just begun labor and who has given birth vaginally five previous times. Which of the following interventions will the nurse most likely need to implement to meet the needs of this particular client? a) Prepare the client for cesarean birth b) Prepare to administer oxytocin c) Darken the room lights d) Convert the birthing room to birth readiness before full dilatation is obtained
d) Convert the birthing room to birth readiness before full dilatation is obtained
A client in the active phase of labor is diagnosed as having a protracted labor pattern. Which of the following would the nurse assess as indicative of a protracted labor pattern? a) Secondary arrest of cervical dilation b) Arrest of the descent of the fetal head c) Prolonged deceleration phase d) Delayed descent of the fetal head
d) Delayed descent of the fetal head
A nurse working with a woman in preterm labor receives a telephone report for the fetal fibronectin test done 10 hours ago. The report indicates an absence of the protein, which the nurse knows indicates: a) Delivery is likely within the next 2 weeks. b) Infection is present. c) No infection is present. d) Delivery is unlikely within the 2 next weeks.
d) Delivery is unlikely within the 2 next weeks.
A client is giving birth when shoulder dystocia occurs in the fetus. The nurse recognizes that which of the following conditions in the client is likely to increase the risk for shoulder dystocia? a) Pendulous abdomen b) Preterm delivery c) Nullipara d) Diabetes
d) Diabetes
The nurse providing care for a woman with preterm labor on terbutaline (Brethine) would include which of the following assessments for safe administration of the drug? a) Deep tendon reflexes. b) Breath sounds. c) For elevated blood glucose d) For tachycardia
d) For tachycardia
Shoulder dystocia is a true medical emergency that can cause fetal demise because the baby cannot be delivered. Stuck in the birth canal, the infant cannot take its first breath. What is the first maneuver tried to deliver an infant with shoulder dystocia? a) McGeorge maneuver b) McDonald maneuver c) McRonald Maneuver d) McRoberts maneuver
d) McRoberts maneuver
When caring for a client requiring a forceps-assisted birth, the nurse would be alert for which of the following? a) Increased risk for cord entanglement b) Increased risk for uterine rupture c) Damage to the maternal tissues d) Potential lacerations and bleeding
d) Potential lacerations and bleeding
The nurse is admitting the patient in labor. The physician determines that the fetus is in a transverse lie and not responsive to Leopold's maneuvers. What intervention should the nurse provide for the patient? a) Prepare for a precipitous vaginal birth. b) Prepare to assist the physician with an amniotomy. c) Administer an analgesic to the patient. d) Prepare the patient for a Cesarean section.
d) Prepare the patient for a Cesarean section.
A woman receiving an oxytocin infusion for labor induction develops contractions that occur every minute and last 75 seconds. Uterine resting tone remains at 20 mm Hg. Which action would be most appropriate? a) Notify the birth attendant. b) Slow the oxytocin infusion to the initial rate. c) Continue to monitor contractions and fetal heart rate. d) Stop the infusion immediately.
d) Stop the infusion immediately.
Which of the following describes why hypertonic contractions tend to become very painful? a) More than one contraction may begin at the same time, as receptor points in the myometrium act independently of each other. b) There is an increase in the length of labor because so many contractions are needed to achieve cervical dilation. c) The number of uterine contractions is very low or infrequent. d) The myometrium becomes sensitive from the lack of relaxation and anoxia of uterine cells.
d) The myometrium becomes sensitive from the lack of relaxation and anoxia of uterine cells.
Mrs. M. has been admitted to the delivery suite in labor. She has been in labor for 12 hours and is dilated to 4 cm. The physician notes that Mrs. M. is in hypotonic labor. What does this mean? a) The uterine contractions may or may not be regular, but the quantity or quality or strength is sufficient to dilate the cervix. b) The uterine contractions are irregular, but the quantity or quality or strength is insufficient to dilate the cervix. c) The uterine contractions are regular, but the quantity or quality or strength is insufficient to dilate the cervix. d) The uterine contractions may or may not be regular, but the quantity or quality or strength is insufficient to dilate the cervix.
d) The uterine contractions may or may not be regular, but the quantity or quality or strength is insufficient to dilate the cervix.
A nurse is assessing a full-term patient in labor and determines the fetus is occiput posterior. The patient states that all her discomfort is in her lower back. What intervention can the nurse provide that will help alleviate this discomfort? a) Have the physician administer a pudendal block. b) Place the patient supine with the head of bed elevated 30 degrees. c) Apply a warm washcloth to the lower back. d) Use a fist to apply counter pressure to the lower back.
d) Use a fist to apply counter pressure to the lower back.
After an hour of administering oxytocin intravenously, you assess a woman's contractions to be 80 seconds in length. Your first action would be to a) continue to monitor contraction duration every 2 hours. b) slow the infusion to under 10 gtt per minute. c) increase the flow rate of the main line infusion. d) discontinue the oxytocin infusion.
d) discontinue the oxytocin infusion.
The nursing student doing a clinical rotation in labor and delivery has noticed numerous women expressing various emotions during labor. The student's preceptor informs the student that these emotions can lead to psychological stress, which in turn can cause which of the following complications? a) deep vein thrombosis b) pulmonary emboli c) premature labor d) dystocia
d) dystocia
A gravida 7, para 6 woman is in the hospital only 15 minutes when she begins to deliver precipitously. The fetal head begins to deliver as you walk into the labor room. Your best action would be to a) attach a fetal monitor to determine fetal status. b) ask her to push with the next contraction so delivery is rapid. c) assess blood pressure and pulse to detect placental bleeding. d) place a hand gently on the fetal head to guide delivery.
d) place a hand gently on the fetal head to guide delivery.
A nursing instructor identifies which of the following as increasing the chances of infection when coupled with prolonged labor? a) age of mother b) number of previous pregnancies c) multiple births d) ruptured membranes
d) ruptured membranes
