Childbirth at Risk NCLEX Questions from powerpoints

Childbirth at Risk NCLEX Questions (from powerpoints) Leave the first rating Students also studied Terms in this set (6) Save OB Postpartum NCLEX Questions 52 terms ashley_coots7 Preview Maternity Ch. 4 Prenatal Care and A...13 terms Thavy_Seng-Willars Preview MN Exam3 High Risk Neonatal NCL...30 terms gmomma3618 Preview Prenata 10 terms kath A 29-week pregnant patient is admitted to the birth unit with vaginal bleeding. To differentiate between placenta previa and abruptio placenta, the nurse should assess which of the following?

• Leopold's maneuver results
• Quantity of vaginal bleeding
• Presence of abdominal pain
• Maternal blood pressure
• Presence of abdominal pain

TIP: The difference between placenta previa and abruption placenta is the

absence or presence of pain. Because the bleeding from a previa flows freely, that complication is virtually pain free. At least some of the blood from an abruptio placenta is trapped behind the placenta, women complain of intense, unrelenting pain A baby is entering the pelvis in a cephalic presentation with the head extended. Which of the following positions determined by the nurse is consistent with this situation?

• LMA (left mentum anterior)
• LSP (left sacral posterior)
• RST (right scapular transverse)
• ROP (right occiput posterior)
• LMA (left mentum anterior)

Tip: The nurse must understand attitude, presentation and position. In a cephalic presentation the head presents first. This eliminates B, a breech, and C, transverse lie. With an extended attitude the chin (mentum) is not flexed against the chest.This eliminates D, an attitude of flexion with the occiput toward the right posterior wall of the pelvis. A is the correct answer.Immediately after a woman spontaneously ruptures her membranes, the nurse notes a large loop of umbilical cord protruding from the woman's vagina. Which of the following actions should the nurse perform first?

• Assess the fetal heart rate
• Administer oxygen by face mask
• Put the woman in the knee chest position
• Report the findings to the physician
• Put the woman in the knee chest position

TIP: All of the options are correct nursing actions in this situation, however, C should be implemented first. It is most critical to relieve pressure on the umbilical cord and maintain blood flow to the fetus. Think A, B, C's - airway - in this obstetrical emergency.

A woman is scheduled for an external version. The nurse would expect to prepare which of the following medications to be administered prior to the procedure?

• Oxytocin (Pitocin)
• Ergonovine (Methergine)
• Betamethasone (Celestone)
• Terbutaline (Brethine)
• Terbutaline (Brethine)

TIP: A tocolytic such as Terbutaline is given to relax the uterus prior to external version. Pitocin and Methergine are oxytocics and would contract the uterus.Betamethasone is used to facilitate fetal lung maturity.The physician has ordered oxytocin (Pitocin) for induction of labor for 4 women. In which of the following situations should the nurse refuse to comply with the order?

• Primigravida who is 14 years old
• Multigravida with cerebral palsy
• Primigravida with a transverse lie
• Multigravida who has type 1 diabetes
• Primigravida with a transverse lie

TIP: Induction is safe in A, B and D. In a transverse lie the shoulder is presenting and a vaginal birth is impossible. When vaginal birth is contraindicated, induction is also contraindicated.A woman is receiving oxytocin (Pitocin) via IV pump at 3 milliunits per minute. Her contractions are every 3 minutes lasting 45 seconds of moderate intensity. The FHR is 150 beats per minute with moderate variability. Which of the following actions should the nurse take at this time?

• Stop the oxytocin infusion
• Administer oxygen by mask
• Change the woman's position
• Monitor the woman's labor
• Monitor the woman's labor

Tip: Normal data is given in the question and it is appropriate to continue the

oxytocin and monitor the labor. A, B and C infer the nurse should take action because of a complication. There is no abnormal data given. D is the one response different from the other options and is the correct answer.