EAQ #2

Dinoprostone (Cervidil)

-cervical ripening; produces contractions, dilation & effacement of cervix, initiate labor or expulsion of fetus. -S/E: abnormal contractions, warmth in vagina, back pain, amniotic fluid embolism, fever

Age older than 35 years The risk for placental insufficiency A history of stillbirth from her last pregnancy Hypertension Type 1 diabetes

A 37-year-old G3P2001 client with hypertension and type 1 diabetes with good glycemic control is seen in the antepartum testing unit for a nonstress test (NST) at 36 weeks. Her obstetric (OB) history includes an intrauterine fetal death at 38 weeks. What risk factors in the client's history indicate the need for an NST?

Alerting others regarding the need for immediate cesarean delivery

A multiparous client with a history of gestational hypertension and previous history of abruption is in the transition phase of labor. The electronic fetal monitor shows bradycardia, and a change is seen in the contour of the client's abdomen. Which is the nurse's immediate action?

hypotension

After delivery, a client who received oxytocin to induce labor complains of tiredness and spinning sensation. Which effect of oxytocin would the nurse infer from these symptoms?

G6 P5 5cm dilated

After receiving report, which client would the nurse manager assess first?

A viral load of 1,200 copies/mL A vaginal birth in the case of a woman with a viral load of more than 1,000 copies/mL (1,200 copies/mL) has a high chance of perinatal transmission, so cesarean birth is the preferred method. A viral load less than 1,000 copies/mL (800 copies/mL) is not threatening and lessens the chances of perinatal transmission via vaginal birth.

An HIV-infected pregnant adolescent does not want a cesarean birth. Which finding would indicate the increased risk of perinatal transmission via vaginal birth?

first

During the assessment of a client in labor, the cervix is determined to be dilated 4cm. Which stage of labor would the nurse record?

Clomiphene

Estrogen partial agonist: synthetic used in infertility to induce ovulation

Early Stage of Labor

When the cervix is dilated 6 cm, the individual is beyond the

uterine atony

inability of the uterus to contract effectively

Transition

is not a stage of labor; it is the last phase of the first stage of labor, which begins when the cervix is dilated 8 cm.

Left Occiput Posterior (LOP)

occiput is toward the left side of moms pelvis but lies toward posterior surface of her pelvis

The second stage

of labor begins when the cervix is fully dilated and 100% effaced.

Gravidity

total number of pregnancies

Firmly contracted uterine fundus

Which is the desired outcome for the intrapartum client during the 3rd stage of labor?

Massage the uterine fundus

while assessing a client during the 4th stage of labor, the nurse notes that the perineal pad is soaked with approximately 75mL of lochia rubra. Which nursing action is the priority?

GTPAL

G = gravidity, T = term deliveries, P = preterm deliveries, A = abortions or miscarriages, L = live births

Record the fetal response to contractions and continue to monitor the heart rate

Which action would the nurse take when a 15-beat-per-minute acceleration of the fetal heart rate above the baseline occurs during a contraction?

promotes milk ejection during lactation, controls uterine bleeding after delivery, induces labor when uterine contractions are weak

Which are the actions of oxytocin?

Cephalopelvic disproportion

Which common indication for a cesarean birth would the nurse discuss in a class for expectant parents?

Repeatedly drops abruptly to 90 beats/min unrelated to contractions

Which fetal heart rate pattern on a client in labor would require immediate action from the nurse?

Giving birth to a baby weighing 9 lb 8 oz

Which factor puts a client at increased risk for postpartum hemorrhage?

Midway through first stage of labor

a vaginal examination reveals that a client's cervix is 90% effaced and dilated to 6cm. The fetus's head is at station 0, and the fetus is in a right occiput anterior position. The contractions are occurring every 3-4 minutes, are lasting 60 seconds, and are of moderate intensity. Which description is appropriate to use when reporting on the client's condition?

Menotropins

fertility medicine. It is used to stimulate the ovaries.

parity

the number of times that she has given birth to a fetus with a gestational age of 24 weeks or more, regardless of whether the child was born alive or was stillborn.

Methylergonovine

which medication may be used to treat postpartum hemorrhage? Contraindicated in pregnancy, Category C Administered orally for a maximum of 1 week postpartum to control uterine bleeding. Do not breastfeed

a vaginal birth is possible

which response would the nurse give to a client who asks what having a fetus in longitudinal lie means in relation to her labor and birth of the baby?

Fetal Tone Fetal Movement Amniotic Fluid Index Fetal Breathing Movements nonstress test

which variables are scored on a biophysical profile?

The most comfortable position can be assumed

Which information would be given to a client about her position while an internal fetal monitor is in place?

Discontinuing the oxytocin infusion decreases uterine stimulation and eases intrauterine pressure; continuing the oxytocin may lead to fetal hypoxia, placental separation, or uterine rupture. Turning the client on her side increases oxygen perfusion to the fetus. The primary healthcare provider should be notified to obtain additional prescriptions. Contractions lasting longer than 90 seconds warrant stopping the oxytocin infusion to prevent uterine rupture. Magnesium sulfate is prescribed for preterm labor to inhibit contractions; this client needs to continue with labor. The goal is to decrease the length of contractions, not to stop them.

Oxytocin is prescribed for a client in labor after a period of ineffective contractions. Which nursing interventions are most important if strong contractions that last 90 seconds or longer occur.