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Exam (elaborations)

Uworld Maternity Practice Frequently Tested Questions And Verified Answers

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UWORLD MATERNITY PRACTICE FREQUENTLY TESTED QUESTIONS AND VERIFIED ANSWERS

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UWORLD MATERNITY PRACTICE
FREQUENTLY TESTED QUESTIONS
AND VERIFIED ANSWERS
Terms in this set (349)

>> Which actions should the labor and delivery nurse perform when caring for a client who
has decided to relinquish her newborn to an adoptive parent? SATA

--avoid discussing the adoption details until after birth

--encourage the birth mother to hold the newborn

--notify other staff who may interact with the client of the adoption plan

--offer the birth mother a chance to say goodbye to the newborn

--use phrases that illustrate adoption as a decision of love, not abandonment

--notify other staff who may interact with the client of the adoption plan

--offer the birth mother a chance to say goodbye to the newborn

--use phrases that illustrate adoption as a decision of love, not abandonment


- correct answer- --encourage the birth mother to hold the newborn




>> The nurse is monitoring a client who is in active labor with a cervical dilation of 6 cm.
Which uterine assessment finding requires an intervention by the nurse?

--contraction duration of 95 seconds

--contraction frequency of every 3 minutes

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--contraction intensity of 45 mm Hg

--uterine resting tone of 10 mm Hg - correct answer-contraction duration of 95 seconds



---normal contraction duration is 45-80 seconds and should not exceed 90 seconds. Uterine
Frequency is 2-5 contractions Q 10 min and should not occur more than every two minutes.




>> What is a normal uterine contraction duration during the first stage of labor?
- correct answer- 45-80 seconds not exceeding 90 seconds




>> What is a normal uterine contraction frequency during the first stage of labor?
- correct answer- 2-5 contractions every 10 minutes, not to occur more frequently than every 2
minutes




>> What is a normal uterine contraction intensity during the first stage of labor?
- correct answer- 25-50 mm Hg and should not exceed 80 mm Hg




>> Define intensity (used to describe labor contractions)
- correct answer- strength of the contraction at its peak




>> Define resting tone (used to describe labor contractions)
- correct answer- tension in the uterine muscle between contractions




>> Function of the resting tone during labor
- correct answer- allow fetal oxygenation between contractions

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>> What is a normal resting tone during the first stage of labor?
- correct answer- average is 10 mm Hg and should not exceed 20 mm Hg




>> What does a duration of uterine contractions greater than 90 seconds during the first stage
of labor result in?
- correct answer- reduction of blood flow to the placenta due to uterine hypertonicity




>> What can occur if uterine contractions occurs less than 2 minutes apart?
- correct answer- fetal distress due to uteroplacental insufficiency




>> What is a sign of hypertonicity of the uterus?
- correct answer- an intrauterine pressure more than 80 mm Hg




>> A client gives birth within an hour of arriving at labor and delivery unit and delivers the
placenta 5 minutes later. During assessment, the nurse notes that the uterus is midline and
boggy. Which action should the nurse take FIRST?

--check for pooled blood under buttocks

--increase IV oxytocin infusion rate

--monitor blood pressure and pulse

--perform firm fundal massage
- correct answer- perform firm fundal massage




>> What are the clinical features of postpartum uterine atony?
- correct answer- enlarged, soft, boggy, poorly contracted uterus

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>> What are the risk factors for postpartum uterine atony?
- correct answer- --uterine fatigue from prolonged, induced, or precipitous labor

--intramniotic infection

--uterine overdistention (multiple gestation, macrosomia, polyhydramnios)

--retained placenta

--grand multiparity (>5 prior deliveries)




>> What are the interventions for postpartum uterine atony?
- correct answer- --bimanual uterine massage (INITIAL NURSING ACTION)

--correction of bladder distension

--high-dose oxytocin, misoprostol

--tranexamic acid

--carboprost, methylergonovine (uterotonics)

--intrauterine balloon tamponade

--possible surgical interventions (if unresolved)




>> What is the function of uterotonics?
- correct answer- stimulate the uterus to contract. Administration is indicated if the uterus fails to
contract despite massage




>> A client in labor has reached 8 cm dilation, is fully effaced, and feels an urge to push. The
nurse observed thick, blood-tinged mucus during the vaginal examination. What is the nurse's
BEST action?

--administer prescribed IV meperidine for pain relief

--encourage client to bear down with spontaneous urges to push

--place client in the lithotomy position in preparation for birth

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