Chapter 22 Contemporary Maternal Newborn Nursing 7th Edition by Patricia W. Ladewig

Chapter 22 Contemporary Maternal Newborn Nursing 7th Edition by Patricia W. Ladewig

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

Chapter 22_LO01_Q01

Which client should the Labor and Delivery nurse care for first?

1. 26-year-old primip with a history of depression stating that she knows she can’t labor successfully and will need a cesarean
2. 28-year-old multip with a diagnosis of schizophrenia who is oriented to person, place, time, and location
3. 24-year-old primip diagnosed six years ago with bipolar disease who is moving constantly and refusing to lie in the bed
4. 30-year-old multip with an anxiety disorder who experienced tachycardia and tachypnea on the last shift

Correct Answer: 3

Rationale:

1. This client is exhibiting a lack of hope and negative thoughts, which are common with depression but not life-threatening.
2. Although she has a history of schizophrenia, there are currently no abnormal findings with this client.
3. This client is in the manic phase of her disease. It is difficult to auscultate fetal heart tones and difficult to monitor the fetus of a pregnant woman in constant motion. If the fetus is not monitored, fetal intolerance to labor might not be detected, with the possibility of fetal death as a result.
4. Tachycardia and tachypnea are signs of an anxiety disorder; however, currently this client is not experiencing any problems.

Cognitive level: Analysis

Category of Client Need: Health Promotion and Maintenance

Nursing Process: Assessment

Learning Outcome: 22.1 Explain the psychological factors that can contribute to complications during labor and birth in determining the nursing care management of the woman during labor and birth.

Chapter 22_LO01_Q02

A pregnant client was in an auto accident. She presents to the labor suite from the Emergency Department after she presented there with a deep gash to her forearm from the auto accident. She had no seat belt on, and was traveling at a high rate of speed. She seems very agitated, is walking continuously, and is talking very rapidly. The nurse should suspect that the client has what type of psychological disorder?

1. Schizophrenia
2. Bipolar, manic phase
3. Social anxiety disorder
4. Obsessive-compulsive disorder

Answer: 2

Rationale:

1. Schizophrenia is characterized by withdrawal and altered perception of reality, often with hallucinations or delusions.
2. Agitation, constant movement, and rapid talking are symptoms of the manic phase of bipolar disorder.
3. Social anxiety disorder is fear of social activities, like being in a group.
4. Obsessive-compulsive disorder is characterized by the repetitive performance of a ritual activity.

Cognitive Level: Application

Category of Client Need: Psychosocial Integrity

Nursing Process: Assessment

Learning Outcome: 22.1 Explain the psychological factors that can contribute to complications during labor and birth in determining the nursing care management of the woman during labor and birth.

Chapter 22 _LO02 _Q03

The nurse is making client assignments for the next shift. Which client is most likely to experience a complicated labor pattern?

1. 34-year-old gravida 6 at 39 weeks’ gestation with twins
2. 22-year-old gravida 1 at 23 weeks’ gestation with ruptured membranes
3. 30-year-old gravida 3 at 41 weeks’ gestation and estimated fetal weight 7 pounds, 8 ounces
4. 43-year-old gravida 2 at 37 weeks’ gestation with hypertension

Correct Answer: 1

Rationale:

1. Twins at term will cause overdistention of the uterus, putting the client at risk for development of a hypotonic labor pattern. Her high parity also increases the risk for a hypotonic labor pattern.
2. Although this client is high-risk, especially for infection, neonatal lung immaturity and respiratory distress syndrome, this client has no risk factors for an abnormal labor pattern.
3. This client has an average-sized fetus and no risk factors for either hypertonic or hypotonic labor pattern development.
4. Hypertension does not impact labor pattern; this client has no risk factors for either hypertonic or hypotonic labor pattern development.

Cognitive level: Application

Category of Client Need: Health Promotion and Maintenance

Nursing Process: Assessment

Learning Outcome: 22.2 Compare hypertonic and hypotonic labor patterns, including risks, clinical therapy, and nursing care management.

Chapter 22 LO02 Q04

Two hours ago, the 39-weeks’-gestation client was 3 cm dilated, 40% effaced, and +1 station. Frequency of contractions was every five minutes with duration 40 seconds and intensity 50 mmHg. The current assessment is 4 cm dilated, 40% effaced, and +1 station. Frequency of contractions is now every three minutes with 40–50 seconds’ duration with intensity of 40 mmHg. The priority intervention would be:

1. Begin oxytocin after assessing for CPD.
2. Give Terbutaline to stop the preterm labor.
3. Start oxygen at 8 L/min.
4. Have Anesthesia give the client an epidural.

Correct answer: 1

Rationale:

1. The client is having hypertonic contractions. The presence of CPD can prolong labor, so it is important to rule this out. Oxytocin (Pitocin) can create a more productive labor pattern by strengthening the contractions.
2. Terbutaline would not be recommended. The contraction pattern is incoordinate, but they need to be enhanced, not stopped.
3. Oxygen will not hurt, but it is not the priority.
4. An epidural will not change the incoordinate contraction pattern.

Cognitive Level: Analysis

Category of Client Need: Health Promotion and Maintenance

Nursing Process: Assessment

Learning Outcome: 22-2 Compare hypertonic and hypotonic labor patterns, including risks, clinical therapy, and nursing care management.