Assessing and Managing Complications During Labor | Study notes Nursing

1. A client is experiencing shoulder dystocia during birth. The nurse would placepriorityon performing which

assessment post birth?

respiratory assessment of the newborn

extensive lacerations

assess for cleft palate

brachial plexus assessment



2. A woman calls the health care facility stating that she is in labor. The nurse would urge the client to come to

the facility if the client reports which symptom?

pink-tinged vaginal secretions and irregular contractions lasting about 30 seconds over the last 2 hours

leaking of green tinged fluid from the vagina

increased energy level with alternating strong and weak contractions

contractions noted in the front of abdomen that are barely palpable



3. The nurse clarifies that the type of monitor that will assess the intensity of the contractions is

a(n):

maternal 02 saturation monitor

external monitor tocodynamometer

handheld Doppler

internal uterine pressure catheter (IUPC)



4. A nurse is teaching a prenatal class and is asked the purpose of amniotic fluid. Which

statements are correct?Select all that apply

Sufficient amounts of amniotic fluid cushion the fetus from trauma.

Sufficient amounts of amniotic fluid help the fetus maintain a constant body temperature.

Amniotic fluid allows the fetal umbilical cord to be relatively free from compression.

The amount of amniotic fluid does not fluctuate throughout pregnancy

Amniotic fluid promotes fetal movement enhancing musculoskeletal development.



5. The nurse interprets the initial assessment data for Ms. Patton, who was admitted in active labor. Which of

the following assessments would the nurse communicate to the provider as soon as possible?

Rupture of fetal membranes 2 hours ago

Maternal temperature 100.6 F (38.1 C)

FHR 140 bpm with moderate variability

Cervix 50% effaced and dilated 4 cm



6. When a young primigravida asks about how to adjust her diet for her pregnancy, the nurse outlines that the

diet should be modified to include increases in:

leafy green vegetables and fruit.

bread and grains.

beef and poultry.

foods high in sodium and potassium.



7. The mother is admitted in active labor. The nurse assesses the fetal heart rate (FHR) at 170

beats per minute; based on that assessment the nurse will:

reassure the mother the rate is within normal limits

position her on her left side.

notify the physician at once.

Check the mother's temperature



8. A nurse at a prenatal class discusses the evolution of obstetrical care. Which statements

wouldbestdescribe birth in America presently?Select all that apply.

Primary care providers remain the safest birth attendants for most women

Certified nurse midwives (CNMs) assist with births safely in many settings.

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A client is experiencing shoulder dystocia during birth. The nurse would place priority on performing which assessment post birth? respiratory assessment of the newborn extensive lacerations assess for cleft palate brachial plexus assessment
A woman calls the health care facility stating that she is in labor. The nurse would urge the client to come to the facility if the client reports which symptom? pink-tinged vaginal secretions and irregular contractions lasting about 30 seconds over the last 2 hours leaking of green tinged fluid from the vagina increased energy level with alternating strong and weak contractions contractions noted in the front of abdomen that are barely palpable
1. The nurse clarifies that the type of monitor that will assess the intensity of the contractions is a(n): maternal 02 saturation monitor external monitor tocodynamometer handheld Doppler internal uterine pressure catheter (IUPC)
2. A nurse is teaching a prenatal class and is asked the purpose of amniotic fluid. Which statements are correct? Select all that apply Sufficient amounts of amniotic fluid cushion the fetus from trauma. Sufficient amounts of amniotic fluid help the fetus maintain a constant body temperature. Amniotic fluid allows the fetal umbilical cord to be relatively free from compression. The amount of amniotic fluid does not fluctuate throughout pregnancy Amniotic fluid promotes fetal movement enhancing musculoskeletal development.
The nurse interprets the initial assessment data for Ms. Patton, who was admitted in active labor. Which of the following assessments would the nurse communicate to the provider as soon as possible? Rupture of fetal membranes 2 hours ago Maternal temperature 100.6 F (38.1 C) FHR 140 bpm with moderate variability Cervix 50% effaced and dilated 4 cm
When a young primigravida asks about how to adjust her diet for her pregnancy, the nurse outlines that the diet should be modified to include increases in: leafy green vegetables and fruit. bread and grains. beef and poultry. foods high in sodium and potassium.
1. The mother is admitted in active labor. The nurse assesses the fetal heart rate (FHR) at 170 beats per minute; based on that assessment the nurse will: reassure the mother the rate is within normal limits position her on her left side. notify the physician at once. Check the mother's temperature
A nurse at a prenatal class discusses the evolution of obstetrical care. Which statements would best describe birth in America presently? Select all that apply. Primary care providers remain the safest birth attendants for most women Certified nurse midwives (CNMs) assist with births safely in many settings.

The United States has one of the lowest infant mortality rates in the world. The maternal death rate has steadily risen since in the United States since the year 2000 Approximately, one in three women (33%) in the United States undergoes a surgical birth (cesarean).

Which statement made by a nursing student would best indicate that their education on family-centered care was fully understood? “Mothers are the only family member affected by childbirth.” “Families are usually not capable of making health care decisions for themselves, especially in stressful situations.” “Since childbirth is a medical procedure, it may affect everyone.” “Childbirth affects the entire family. Whoever the patient identifies as family should be treated as such by the hospital staff. ”
A patient is admitted to the labor and delivery unit at 40 weeks gestation. Which of the following pieces of information collected during the patient interview would be the most significant in alerting the nurse to the potential for shoulder dystocia? Select all that apply. religious preference previous delivery of 7.5 lb. (3400 gram) baby. maternal height 5 ft, 5 in (165 cm). maternal weight gains greater than 50 lb. (23 kg) estimated fetal weight of 8 lbs., 13 oz (4000 grams) or more.
A nurse caring for a pregnant client in labor observes that the fetal heart rate (FHR) is below 110 beats per minute. Which interventions should the nurse perform? Select all that apply. Reduce intravenous (IV) fluid rate. Assess client for underlying causes. Turn the client on her left side. Ignore questions from the client.
A nurse is conducting a childbirth class for a group of primigravida’s. She explains that the fetal skull is able to pass through the pelvis by molding. The skull is able to do this because: the skull has fontanels the skull bones are not fused the skull has no bones the skull is not made of bone
A pregnant woman with gestational diabetes at 39 weeks is admitted to the labor ward for induction of labor. Which of the following assessments would the nurse expect to be ordered? blood glucose level pre-eclampsia blood panel amniocentesis a biophysical profile
During a routine prenatal visit, a client is found to have 3+ lower extremity edema, proteinuria and a blood pressure rise to 165/92 mm Hg. The patient states she sees spots when she stands up and as an unrelenting headache. The nurse recognizes that the client has which condition? chronic gestational hypertension eclampsia preeclampsia without severe features preeclampsia with severe features
During a nonstress test, while monitoring the fetal heart rate, the nurse notes that when the expectant mother reports no fetal movement, the heart rate remains at a steady rate without increases. The fetal heart rate shows minimal variability. The nurse interprets this as: fetal tachycardia

A national campaign to improve the health of the people in the United States has as one of its goals to "eliminate health disparities." What is the name of this national campaign? National Maternal and Child Health Bureau (MCHB) Center for Child Death Review Pregnancy Risk Assessment Monitoring System (PRAMS) National Health and Nutrition Examination Survey (NHANES) Healthy People 2030
Brenda Patton was admitted in labor 30 minutes ago and she has no known drug allergies. Her group B streptococcus (GBS) status is positive. There are orders for her to receive intrapartum antibiotics. Which of the following would the nurse anticipate administering to Ms. Patton? Cefazolin (Ancef), 1 gram Penicillin G potassium (Pfizerpen), 5 million units Cefazolin (Ancef), 2 grams Penicillin G potassium (Pfizerpen), 2.5 million units
Assessment of a woman in labor reveals cervical dilation of 6 cm, cervical effacement of 50%, and contractions occurring every 3 to 4 minutes, lasting about 60-80 seconds. The nurse determines that this client is in: latent phase of the first stage. transition phase of the first stage. perineal phase of the second stage. active phase of the first stage.
1. Answer the following question: "When I graduate nursing school, I plan to be..." Group of answer choices "a nurse who shows up ten minutes late while holding his/her coffee." "a safe competent entry level nurse, that functions as a good team player." "an unsafe, lazy nurse who takes shortcuts." "a cranky, uncivil nurse who does not participate in teamwork."
The nurse is interpreting the external fetal monitoring strips for Ms. Patton while she is in active labor. Which findings indicate that the fetus is not tolerating labor? Select all that apply. Repetitive variable decelerations. Late decelerations Accelerations Early Accelerations Absent variability
1. Assessment of a pregnant woman reveals oligohydramnios. The nurse would be alert for the development of which condition? Placental insufficiency Maternal diabetes Fetal gastrointestinal malformations Neural tube defects
A woman is at 20 weeks' gestation. The nurse would expect to find the fundus at which area? midway between the pubis and umbilicus at the level of the umbilicus just above the symphysis pubis midway between the umbilicus and xiphoid process
A prenatal nurse is conducting a class on healthy pregnancy and included signs and symptoms that should be reported immediately to a healthcare provider. Which of the following would she include as warning signs of pregnancy? Select all that apply. Visual disturbances including seeing spots or loss of peripheral vision.

Temperature over 101.5 F Decreased or absent fetal movement The fetus has occasional hiccups. Severe vomiting

The nurse understands which of the following statements are accurate regarding the prenatal laboratory tests. Select all that apply. Rh status is to determine if the client will need administration of Rhogam to prevent her from producing antibodies. Hepatitis titer to determine if the antibody surface antigen is present indicating active infection with the virus (this is not a desired outcome) HIV antibodies to determine if the client has an active HIV infection (This is not a desired outcome) Blood typing is to determine if the client has type O, A, AB or B type blood. Rubella titer is to determine if maternal antibodies are present to the German measles indicating developed immunity (This is a desired outcome)
When the patient is diagnosed with a tubal pregnancy, the nurse is aware that in this pregnancy the outcome will be: spontaneously abort this ectopic pregnancy carry the pregnancy to term and have a cesarean delivery have to remain in bed for the remainder of the pregnancy. require surgery to remove the pregnancy.
After spontaneous rupture of membranes, the nurse notices a prolapsed cord. The nurse immediately places the woman in which position? supine knee-chest sitting side-lying
A nurse is providing care to several pregnant women at different weeks of gestation. The nurse would expect to screen for group B streptococcus infection in the client who is at: 32 weeks’ gestation 36 weeks’ gestation 16 weeks’ gestation 28 weeks’ gestation
A nurse is conducting an assessment of a woman who has experienced PROM (premature rupture of membranes) Which finding would lead the nurse to suspect infection as the cause of a client's PROM? Select all that apply yellow-green fluid foul odor fetal heart rate has moderate variability and accelerations present Maternal temp of 102.1 °F Extreme constant abdominal pain
A nurse is assessing a client who may be pregnant. The nurse reviews the client's history for presumptive signs. Which sign would the nurse most likely note? Select all that apply. amenorrhea nausea fatigue fetal heart sounds Braxton-Hicks contractions

Shoulder dystocia is a complication of labor related to which of these factors? Decreased volume of amniotic fluid. Length of the active phase of labor. Strength of the uterine contractions. Prolonged second stage of labor.
A 24-year-old client who is planning to become pregnant comes to the clinic for an evaluation. When assessing the client, which finding would alert the nurse to implement measures to reduce the client's risk for problems during pregnancy? Select all that apply. has a BMI of 22 drinks wine 3 to 4 times/week quit smoking 4 years ago uses ibuprofen daily exercises daily
The pregnant woman who has been diagnosed with gestational hypertension is asking the nurse what caused it. the nurse explains that there are many theories, but the cause is: too much salt in the diet too many sexual partners diabetes unknown
The nurse is conducting a presentation for a young adult community group about fetal development and pregnancy. The nurse determines that the teaching was successful when the group identifies that the sex of offspring is determined at which time? during meiosis cell division when the morula forms during oogenesis at fertilization
The client is experiencing back labor and reporting intense pain in the lower back. The nurse might recommend which intervention that the patient may find will be effective at this point? Effleurage of the abdomen during the contraction Pant-blow (breaths and puffs breathing techniques) Conscious relaxation/guided imagery in low Fowler's Counterpressure against the sacrum

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