Chapter 26 Birth-Related Procedures

Chapter 26   Birth-Related Procedures

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1) The client is undergoing an emergency cesarean birth for fetal bradycardia. The client’s partner has not been allowed into the operating room. What can the nurse do to alleviate the partner’s emotional distress?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Allow the partner to wheel the baby’s crib to the newborn nursery.
2. Allow the partner to be near the operating room where the newborn’s first cry can be heard.
3. Have the partner wait in the client’s postpartum room.
4. Encourage the partner to be in the nursery for the initial assessment.
5. Teach the partner how to take the client’s blood pressure.

Answer:  1, 2, 4

Explanation:  1. Effective measures include allowing the partner to take the baby to the nursery.

2. Effective measures include allowing the partner to be in a place near the operating room, where the newborn’s first cry can be heard.
3. Effective measures include involving the partner in postpartum care in the recovery room.

Page Ref: 646

Cognitive Level:  Applying

Client Need/Sub:  Psychosocial Integrity: Coping Mechanisms

Standards:  QSEN Competencies: I. C. 13. Acknowledge the tension that may exist between patient rights and the organizational responsibility for professional, ethical care. | AACN Essentials Competencies: IX. 3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings. | NLN Competencies: Relationship-Centered Care: Promote and accept the patient’s emotions; accept and respond to distress in patient and self; facilitate hope, trust, and faith. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome:  9 Explain the indications for cesarean birth, impact on the family unit, preparation and teaching needs, and associated nursing management.

MNL LO:  3.5.2 Explain the management of the childbearing family undergoing a cesarean birth.

 

2) The client tells the nurse that she has come to the hospital so that her baby’s position can be changed. The nurse would begin to organize the supplies needed to perform which procedure?

1. A version
2. An amniotomy
3. Leopold maneuvers
4. A ballottement

Answer:  1

Explanation:  1. Version, or turning the fetus, is a procedure used to change the fetal presentation by abdominal or intrauterine manipulation.

Page Ref: 621

Cognitive Level:  Understanding

Client Need/Sub:  Physiological Integrity: Reduction of Risk Potential

Standards:  QSEN Competencies: I. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | AACN Essentials Competencies: I. 3. Use skills of inquiry, analysis, and information literacy to address practice issues. | NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome:  2 Contrast the methods of external cephalic version and internal version and the related nursing management.

MNL LO:  3.5.4 Describe external version, its indications, and associated nursing considerations.

 

3) A woman has been admitted for an external version. She has completed an ultrasound exam and is attached to the fetal monitor. Prior to the procedure, why will terbutaline be administered?

1. To provide analgesia
2. To relax the uterus
3. To induce labor
4. To prevent hemorrhage

Answer:  2

Explanation:  2. Terbutaline is administered to achieve uterine relaxation.

Page Ref: 624

Cognitive Level:  Understanding

Client Need/Sub:  Physiological Integrity: Pharmacological and Parenteral Therapies

Standards:  QSEN Competencies: V. B. 1. Demonstrate effective use of technology and standardized practices that support safety and quality. | AACN Essentials Competencies: IX. 3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings. | NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome:  2 Contrast the methods of external cephalic version and internal version and the related nursing management.

MNL LO:  3.5.4 Describe external version, its indications, and associated nursing considerations.

 

4) The nurse is scheduling a client for an external cephalic version (ECV). Which finding in the client’s chart requires immediate intervention?

1. Previous birth by cesarean
2. Frank breech ballotable
3. 37 weeks, complete breech
4. Failed ECV last week

Answer:  1

Explanation:  1. Any previous uterine scar is a contraindication to ECV. Prior scarring of the uterus may increase the risk of uterine tearing or uterine rupture.

Page Ref: 623, 624

Cognitive Level:  Applying

Client Need/Sub:  Safe and Effective Care Environment: Management of Care

Standards:  QSEN Competencies: V. B. 1. Demonstrate effective use of technology and standardized practices that support safety and quality. | AACN Essentials Competencies: IX. 12. Create a safe environment that results in high quality patient outcomes. | NLN Competencies: Quality and Safety: Communicate potential risk factors and actual errors. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome:  2 Contrast the methods of external cephalic version and internal version and the related nursing management.

MNL LO:  3.5.4 Describe external version, its indications, and associated nursing considerations.

 

 

5) A woman is scheduled to have an external version for a breech presentation. The nurse carefully reviews the client’s chart for contraindications to this procedure, including which of the following?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Station -2
2. 38 weeks’ gestation
3. Abnormal fetal heart rate and tracing
4. Previous cesarean section
5. Rupture of membranes

Answer:  3, 4, 5

Explanation:  3. An abnormal fetal heart rate or tracing would be a contraindication to performing a version. A nonreassuring FHR pattern might indicate that the fetus is already stressed and other action needs to be taken.

4. A previous cesarean is a contraindication for version.
5. Rupture of membranes is a contraindication for version because of insufficient amniotic fluid.

Page Ref: 623, 624

Cognitive Level:  Applying

Client Need/Sub:  Safe and Effective Care Environment: Safety and Infection Control

Standards:  QSEN Competencies: V. B. 1. Demonstrate effective use of technology and standardized practices that support safety and quality. | AACN Essentials Competencies: IX. 8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan. | NLN Competencies: Quality and Safety: Communicate potential risk factors and actual errors. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome:  2 Contrast the methods of external cephalic version and internal version and the related nursing management.

MNL LO:  3.5.4 Describe external version, its indications, and associated nursing considerations.