Chapter 25 Childbirth at Risk: Labor-Related Complications

Chapter 25   Childbirth at Risk: Labor-Related Complications

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1) What would be a normal cervical dilatation rate in a first-time mother (“primip”)?

1. 1.5 cm per hour
2. Less than 1 cm cervical dilatation per hour
3. 1 cm per hour
4. Less than 0.5 cm per hour

Answer:  1

Explanation:  1. Dilatation in a “multip” is about 1.5 cm per hour.

Page Ref: 596

Cognitive Level:  Remembering

Client Need/Sub:  Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

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: Assessment

Learning Outcome:  1 Discuss dysfunctional labor patterns.

MNL LO:  3.4.3 Discuss abnormalities of conditions associated with, and management of labor dystocia.

 

2) Dystocia encompasses many problems in labor. What is the most common?

1. Meconium-stained amniotic fluid
2. Dysfunctional uterine contractions
3. Cessation of contractions
4. Changes in the fetal heart rate

Answer:  2

Explanation:  2. The most common problem is dysfunctional (or uncoordinated) uterine contractions that result in a prolongation of labor.

Page Ref: 596

Cognitive Level:  Understanding

Client Need/Sub:  Physiological Integrity: Physiological Adaptation

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: Assessment

Learning Outcome:  1 Discuss dysfunctional labor patterns.

MNL LO:  3.4.3 Discuss abnormalities of conditions associated with, and management of labor dystocia.

 

3) Risk factors for tachysystole include 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. Cocaine use
2. Placental abruption
3. Low-dose oxytocin titration regimens
4. Uterine rupture
5. Smoking

Answer:  1, 2, 4

Explanation:  1. Cocaine use is a risk factor for tachysystole.

2. Placental abruption is a risk factor for tachysystole.
3. Uterine rupture is a risk factor for tachysystole.

Page Ref: 597

Cognitive Level:  Applying

Client Need/Sub:  Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn 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: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome:  1 Discuss dysfunctional labor patterns.

MNL LO:  3.4.3 Discuss abnormalities of conditions associated with, and management of labor dystocia.

 

4) A woman has been having contractions since 4 a.m. At 8 a.m., her cervix is dilated to 5 cm. Contractions are frequent, and mild to moderate in intensity. Cephalopelvic disproportion (CPD) has been ruled out. After giving the mother some sedation so she can rest, what would the nurse anticipate preparing for?

1. Oxytocin induction of labor
2. Amnioinfusion
3. Increased intravenous infusion
4. Cesarean section

Answer:  1

Explanation:  1. Oxytocin is the drug of choice for labor augmentation or labor induction and may be administered as needed for hypotonic labor patterns.

Page Ref: 598

Cognitive Level:  Applying

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. 12. Create a safe environment that results in high quality patient outcomes. | NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome:  2 Explain potential risk factors associated with oxytocin induction of labor.

MNL LO:  3.5.1 Discuss methods of labor induction and augmentation including implications for nursing care.

5) Nonreassuring fetal status often occurs with a tachysystole contraction pattern. Intrauterine resuscitation measures may become warranted and can include which of the following measures?

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

Select all that apply.

1. Position the woman on her right side.
2. Apply oxygen via face mask.
3. Call for anesthesia provider for support.
4. Increase intravenous fluids by at least 700 mL bolus.
5. Call the physician/CNM to the bedside.

Answer:  2, 3, 4

Explanation:  2. The nurse would apply oxygen via face mask.

3. The nurse would call for anesthesia provider for support.
4. The nurse would increase intravenous fluids by at least 500 mL bolus.

Page Ref: 598

Cognitive Level:  Applying

Client Need/Sub:  Physiological Integrity: Physiological Adaptation

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: Planning

Learning Outcome:  1 Discuss dysfunctional labor patterns.

MNL LO:  3.4.3 Discuss abnormalities of conditions associated with, and management of labor dystocia.