RNSG 1412 - L&D complications Questions With Complete
Solutions
A woman is 6 cm dilated. Her labor had been progressing as
expected until about 2 hours ago. At that time she stated that the
contractions were not as painful, the nurse noted the abdomen
was easy to indent. A vaginal exam showed no progression of
dilation in 2 hours. Some nursing measurers to help correct
hypotonic contractions are to increase fluid intake and:
1) Assist her to walk
2) Request an epidural
3) Administer pain medication
4) Assist her to her side and have her lie in that position for the
next hour Correct Answer 1)
Moving around will assist the labor progression and is more
comfortable for the woman
Define Amniotomy. Correct Answer The artificial rupture of
the amniotic sac with a tool called the amniohook (a long
crochet type hook, with a pricked end) or an amnicot (a glove
with a small pricked end on one finger).
Define prolapse of the umbilical cord. Correct Answer
Definition: (PP) Prolapse of the umbilical cord through the
cervical canal along side of the presenting part
(book) Cord slips down after membrane rupture, subjecting it to
compression b/t fetus and pelvis. May slip immediately with
fluid gush or long after membranes rupture.
,Discuss the nursing considerations related to the woman having
a cesarean birth. Correct Answer OPERATIVE
PROCEDURE IN WHICH THE FETUS IS DELIVERED
THROUGH AN INCISION IN THE ABDOMEN
REMEMBER -- IT IS A BIRTH !
Mom may feel less than normal, so may need support
May have option of a VBAC the next time
During a precipitate labor it is important for the nurse to:
Correct Answer ***-Promote fetal O2 and maternal comfort
(breathing techniques, pain meds (be careful of the timing of
pain meds, can cause fetal resp depression if given too close to
birth)
-Side lying helps slow fetal descent
-Admin O2 to mom
-Maintain blood volume with nonadditive IV fluids
-Stop Oxytocin if being used
-Can start Tocolytic drugs
-Do not leave patient's side
Following an amniotomy, the priority nursing intervention is to:
1) Assess the fetal heart rate
2) Assess the color and amount of amniotic fluid
3) Assess the maternal vital signs including temperature
4) Place dry sheets and pads under the woman Correct Answer
1)
The fetus is at risk for cord compression after an amniotomy.
Assessing the fetal heart rate will detect persistent bradycardia
, How do each of the following relate to a complicated labor?
a) Rotation abnormalities
b) Deflexion abnormalities
c) Breech presentation
d) Multifetal Pregnancy Correct Answer **All may interfere
with cervical dilation or fetal descent**
a) (OP) occiput posterior, (OT) occiput transverse = "back
labor" sensations, labor is longer/ more uncomfortable
b) Poorly flexed fetal head presents larger diameter to pelvis
c) cervical dilation and effacement slower b/c buttocks and feet
are not smooth, round form
d)Uterine over distention, contributes to hypOtonic contractions,
and abnormal presentation. Risk of fetal hypoxia, hemorrhage
resulting in uterine atony
How does a full bladder impede fetal descent? Correct Answer
It reduces available space in the pelvis and intensifies maternal
discomfort. Encourage voiding every 1-2 hrs.
How does the Bishop's Score determine readiness for labor? (5
things) Correct Answer Estimates cervical readiness (Each is
scored 0 - 3)
1. Dilation
2. Effacement
3. Cervical Consistency (Firm, Medium, Soft)
4. Cervical Position ( Posterior, middle, anterior)
5. Fetal station
** Higher scores are associated with greater likelihood for
successful induction**
Solutions
A woman is 6 cm dilated. Her labor had been progressing as
expected until about 2 hours ago. At that time she stated that the
contractions were not as painful, the nurse noted the abdomen
was easy to indent. A vaginal exam showed no progression of
dilation in 2 hours. Some nursing measurers to help correct
hypotonic contractions are to increase fluid intake and:
1) Assist her to walk
2) Request an epidural
3) Administer pain medication
4) Assist her to her side and have her lie in that position for the
next hour Correct Answer 1)
Moving around will assist the labor progression and is more
comfortable for the woman
Define Amniotomy. Correct Answer The artificial rupture of
the amniotic sac with a tool called the amniohook (a long
crochet type hook, with a pricked end) or an amnicot (a glove
with a small pricked end on one finger).
Define prolapse of the umbilical cord. Correct Answer
Definition: (PP) Prolapse of the umbilical cord through the
cervical canal along side of the presenting part
(book) Cord slips down after membrane rupture, subjecting it to
compression b/t fetus and pelvis. May slip immediately with
fluid gush or long after membranes rupture.
,Discuss the nursing considerations related to the woman having
a cesarean birth. Correct Answer OPERATIVE
PROCEDURE IN WHICH THE FETUS IS DELIVERED
THROUGH AN INCISION IN THE ABDOMEN
REMEMBER -- IT IS A BIRTH !
Mom may feel less than normal, so may need support
May have option of a VBAC the next time
During a precipitate labor it is important for the nurse to:
Correct Answer ***-Promote fetal O2 and maternal comfort
(breathing techniques, pain meds (be careful of the timing of
pain meds, can cause fetal resp depression if given too close to
birth)
-Side lying helps slow fetal descent
-Admin O2 to mom
-Maintain blood volume with nonadditive IV fluids
-Stop Oxytocin if being used
-Can start Tocolytic drugs
-Do not leave patient's side
Following an amniotomy, the priority nursing intervention is to:
1) Assess the fetal heart rate
2) Assess the color and amount of amniotic fluid
3) Assess the maternal vital signs including temperature
4) Place dry sheets and pads under the woman Correct Answer
1)
The fetus is at risk for cord compression after an amniotomy.
Assessing the fetal heart rate will detect persistent bradycardia
, How do each of the following relate to a complicated labor?
a) Rotation abnormalities
b) Deflexion abnormalities
c) Breech presentation
d) Multifetal Pregnancy Correct Answer **All may interfere
with cervical dilation or fetal descent**
a) (OP) occiput posterior, (OT) occiput transverse = "back
labor" sensations, labor is longer/ more uncomfortable
b) Poorly flexed fetal head presents larger diameter to pelvis
c) cervical dilation and effacement slower b/c buttocks and feet
are not smooth, round form
d)Uterine over distention, contributes to hypOtonic contractions,
and abnormal presentation. Risk of fetal hypoxia, hemorrhage
resulting in uterine atony
How does a full bladder impede fetal descent? Correct Answer
It reduces available space in the pelvis and intensifies maternal
discomfort. Encourage voiding every 1-2 hrs.
How does the Bishop's Score determine readiness for labor? (5
things) Correct Answer Estimates cervical readiness (Each is
scored 0 - 3)
1. Dilation
2. Effacement
3. Cervical Consistency (Firm, Medium, Soft)
4. Cervical Position ( Posterior, middle, anterior)
5. Fetal station
** Higher scores are associated with greater likelihood for
successful induction**
