Flashcards in Ch. 20, Mckinney 3rd Nursing Care During Obstetric Procedures Deck (25):
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.
An empty bladder provides more room in the pelvis.
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?
Edema and discoloration of the labia and perineum
When positioning the Foley catheter before cesarean birth, the nurse knows that the catheter drainage tube and catheter bag should be:
placed near the head of the table.
To provide safe care for the woman, the nurse understands that which condition is a contraindication for an amniotomy?
Which client status is an acceptable indication for serial oxytocin induction of labor?
Past 42 weeks of gestation
The standard of care for obstetrics dictates that an internal version might be used to manipulate the:
second twin from a transverse lie to a breech presentation during vaginal birth.
An indication for a mediolateral episiotomy would be a woman who:
has a short perineum.
The greatest risk to the newborn after an elective cesarean birth is:
prematurity due to miscalculation of gestation.
The nurse practicing in a labor setting knows that the woman most at risk for a uterine rupture is:
a gravida 4 who had a classic cesarean incision.
The nurse caring for a woman in labor understands that the primary risk associated with an amniotomy is:
prolapse of the umbilical cord.
Before the physician performs an external version, the nurse should expect an order for a:
A maternal indication for the use of vacuum extraction is:
The priority nursing intervention after an amniotomy is to:
assess the fetal heart rate.
For which client should the oxytocin (Pitocin) infusion be discontinued immediately?
A woman in transition with contractions every 2 minutes lasting 90 seconds each
The priority nursing care associated with an oxytocin (Pitocin) infusion is:
monitoring uterine response.
Which event indicates a complication of an external version?
Fetal bradycardia persisting 10 minutes after the version
Immediately after the forceps-assisted birth of an infant, the nurse should:
assess the infant for signs of trauma.
When preparing a woman for a cesarean birth, the nurse’s care should include:
administration of an oral antacid.
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:
the type of uterine incision she had.
What is an appropriate response to a woman's comment that she is worried about having a cesarean birth?
"What are your feelings about having a cesarean birth?"
While assisting with a vacuum extraction birth, what should the nurse immediately report to the physician?
Persistent fetal bradycardia below 100 bpm
To monitor for potential hemorrhage in the woman who has just had a cesarean birth, the recovery room nurse should:
assess the uterus for firmness every 15 minutes.
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.)
rupture of membranes at or near term, chorioamnionitis (inflammation of the amniotic sac), postterm pregnancy, fetal death
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.