Ch. 20, Mckinney 3rd Nursing Care During Obstetric Procedures

Question 1

The nurse knows that a urinary catheter is added to the instrument table if a forceps-assisted birth is anticipated. Choose the correct rationale for this intervention.

Answer 1

An empty bladder provides more room in the pelvis.

Question 2

After a forceps-assisted birth, the mother is observed to have continuous bright red lochia but a firm fundus. What other data would indicate the presence of a potential vaginal wall hematoma?

Answer 2

Edema and discoloration of the labia and perineum

Question 3

When positioning the Foley catheter before cesarean birth, the nurse knows that the catheter drainage tube and catheter bag should be:

Answer 3

placed near the head of the table.

Question 4

To provide safe care for the woman, the nurse understands that which condition is a contraindication for an amniotomy?

Answer 4

–2 station

Question 5

Which client status is an acceptable indication for serial oxytocin induction of labor?

Answer 5

Past 42 weeks of gestation

Question 6

The standard of care for obstetrics dictates that an internal version might be used to manipulate the:

Answer 6

second twin from a transverse lie to a breech presentation during vaginal birth.

Question 7

An indication for a mediolateral episiotomy would be a woman who:

Answer 7

has a short perineum.

Question 8

The greatest risk to the newborn after an elective cesarean birth is:

Answer 8

prematurity due to miscalculation of gestation.

Question 9

The nurse practicing in a labor setting knows that the woman most at risk for a uterine rupture is:

Answer 9

a gravida 4 who had a classic cesarean incision.

Question 10

The nurse caring for a woman in labor understands that the primary risk associated with an amniotomy is:

Answer 10

prolapse of the umbilical cord.

Question 11

Before the physician performs an external version, the nurse should expect an order for a:

Answer 11

tocolytic drug.

Question 12

A maternal indication for the use of vacuum extraction is:

Answer 12

maternal exhaustion.

Question 13

The priority nursing intervention after an amniotomy is to:

Answer 13

assess the fetal heart rate.

Question 14

For which client should the oxytocin (Pitocin) infusion be discontinued immediately?

Answer 14

A woman in transition with contractions every 2 minutes lasting 90 seconds each

Question 15

The priority nursing care associated with an oxytocin (Pitocin) infusion is:

Answer 15

monitoring uterine response.

Question 16

Which event indicates a complication of an external version?

Answer 16

Fetal bradycardia persisting 10 minutes after the version

Question 17

Immediately after the forceps-assisted birth of an infant, the nurse should:

Answer 17

assess the infant for signs of trauma.

Question 18

When preparing a woman for a cesarean birth, the nurse’s care should include:

Answer 18

administration of an oral antacid.

Question 19

A woman who is gravida 2 para 1 is admitted to the labor and delivery unit in labor. She states that she had a cesarean delivery with her first pregnancy. The most critical information the nurse must obtain at this point is:

Answer 19

the type of uterine incision she had.

Question 20

What is an appropriate response to a woman’s comment that she is worried about having a cesarean birth?

Answer 20

“What are your feelings about having a cesarean birth?”

Question 21

While assisting with a vacuum extraction birth, what should the nurse immediately report to the physician?

Answer 21

Persistent fetal bradycardia below 100 bpm

Question 22

To monitor for potential hemorrhage in the woman who has just had a cesarean birth, the recovery room nurse should:

Answer 22

assess the uterus for firmness every 15 minutes.

Question 23

Induction of labor is considered an acceptable obstetric procedure if it is a safe time to deliver the fetus. The charge nurse on the labor and delivery unit is often asked to schedule clients for this procedure and therefore must be cognizant of the specific conditions appropriate for labor induction, including: (Choose those that apply.)

Answer 23

rupture of membranes at or near term, chorioamnionitis (inflammation of the amniotic sac), postterm pregnancy, fetal death

Question 24

As an adjunct to inductions, a number of procedures to ripen the cervix are employed. One of these methods is the vaginal administration of preparations using prostaglandins. Before administering this medication, the nurse should be aware that this class of drug is an appropriate choice for women who have had a prior cesarean birth.

Answer 24

fulse

Question 25

A popular preinduction cervical ripening agent that is Food and Drug Administration (FDA) approved for the treatment of peptic ulcers is ____________________.

Answer 25

misoprostol (Cytotec)