Exam 16: Intrapartum Complications

A 20-year-old gravida 1, para 0 woman, is evaluated to be at 42 weeks' gestation on admission to the labor and birth unit. The patient is not in labor at the current time; however, she has been sent over by the physician to be admitted for the induction of labor. The patient indicates to you that she would rather go home and wait for natural labor to start. How should the nurse respond to the patient's request?

Birth for the nulliparous patient with a fetus in a breech presentation is usually

Which assessment finding indicates a complication in the patient attempting a vaginal birth after cesarean (VBAC)?

Which finding on vaginal examination would be a concern if a spontaneous rupture of the membranes has occurred?

A patient who is 32 weeks pregnant telephones the nurse at her obstetrician's office and complains of constant backache. She asks what pain reliever is safe for her to take. The best nursing response is

A laboring patient in the latent phase is experiencing uncoordinated irregular contractions of low intensity. How should the nurse respond to complaints of constant cramping pain?

Which intervention should be incorporated in the plan of care for a labor patient who is experiencing hypertonic labor? Vaginal exam is unchanged from prior exam-3 cm, 80% effaced, and 0 station presenting part vertex.

Which intervention would be most effective if the fetal heart rate drops following a spontaneous rupture of the membranes?

After birth, the nurse monitors the mother for postpartum hemorrhage secondary to uterine atony. Which clinical finding would increase the nurse's concern regarding this risk?

A patient who has had two previous cesarean births is in active labor when she suddenly complains of pain between her scapulae. Which should be the nurse's priority action?

Which factor is most likely to result in fetal hypoxia during a dysfunctional labor?

Which action by the nurse prevents infection in the labor and birth area?

A pregnant patient who has had a prior obstetric history of preterm labors is pregnant with her third child. The physician has ordered a fetal fibronectin test. Which instructions should be given to the patient regarding this clinical test?

Which pelvic shape is most conducive to vaginal labor and birth?

Which clinical finding during assessment indicates uterine rupture?

A pregnant woman develops hypertension. The nurse monitors the patient's blood pressure closely at subsequent visits because the nurse is aware that hypertension is associated with which complication?

An obstetric patient has been identified as being high risk. The patient has had activities restricted (placed on bed rest) until the end of the pregnancy. Currently, she is at 32 weeks' gestation and has two other children at home, ages 3 and 6. The patient's husband works at home. A nursing diagnosis of Impaired Home Maintenance is noted. Which statement potentially identifies a long-term goal?

A patient with polyhydramnios is admitted to a labor-birth-recovery-postpartum (LDRP) suite. Her membranes rupture and the fluid is clear and odorless; however, the fetal heart monitor indicates bradycardia and variable decelerations. Which action should be taken next?