Labor & Delivery Saunders NCLEX
questions 80Qw/exp
A purchaser arrives at a birthing middle in lively labor. Her membranes are still intact, and
the fitness care provider prepares to perform an amniotomy. What will the nurse relay to the
patron as the most possibly outcome of the amniotomy?
1.
Less pressure on her cervix
2.
Decreased quantity of contractions
three.
Increased performance of contractions
four.
The need for expanded maternal blood pressure tracking - ANS-3
Amniotomy (synthetic rupture of the membranes) can be used to induce exertions whilst the
situation of the cervix is favorable (ripe) or to enhance labor if the progress starts to sluggish.
Rupturing of the membranes allows the fetal head to touch the cervix greater directly and
can growth the efficiency of contractions. Increased monitoring of maternal blood strain
makes no sense following this system. The fetal coronary heart rate wishes to be monitored
frequently, however.
A patron in labor is dilated 10 cm. At this point in the hard work procedure, at least how
regularly need to the nurse plan to evaluate and report the fetal coronary heart rate?
1.
Hourly
2.
Every 15 minutes
three.
Every half-hour
four.
Before each contraction - ANS-2
he 2d stage of labor begins while the cervix is dilated completely (10 cm). Maternal pulse,
blood stress, and fetal coronary heart rate are assessed each 5 to fifteen minutes, relying on
employer protocol; a few agency protocols recommend assessment after each contraction.
,Hourly and every 30 minutes represent prolonged time intervals for assessment in this
degree of exertions.
A client in labor is receiving oxytocin (Pitocin) with the aid of intravenous infusion to stimulate
uterine contractions. Which finding indicates that the price of the infusion desires to be
reduced?
1.
Increased urinary output
2.
A fetal coronary heart fee of 180 beats/min
3.
Three contractions taking place in a 10-minute period
four.
Adequate resting tone of the uterus palpated between contractions - ANS-2
A ordinary fetal coronary heart rate is 120 to 160 beats/min. Acute hypoxia is a not unusual
cause of fetal tachycardia. The dosage of oxytocin must be reduced in the presence of fetal
tachycardia, which can arise from excessive uterine pastime. The goal of hard work
augmentation is to reap three correct-excellent contractions (appropriate intensity and
length) in a ten-minute duration. The uterus need to return to resting tone between
contractions, and there must be no proof of fetal distress. Increased urinary output is
unrelated to the use of oxytocin.
A patron in hard work is transported to the shipping room and organized for a cesarean
transport. After the customer is transferred to the delivery room table, the nurse have to area
the customer wherein role?
1.
Supine function with a wedge beneath the proper hip
2.
Trendelenburg's position with the legs in stirrups
three.
Prone position with the legs separated and accelerated
four.
Semi-Fowler's position with a pillow under the knees - ANS-1
Vena cava and descending aorta compression by way of the pregnant uterus impedes blood
go back from the lower trunk and extremities. This results in lowering cardiac return, cardiac
output, and blood glide to the uterus and subsequently the fetus. The best position to save
you this would be side-lying, with the uterus displaced off the belly vessels. Positioning for
belly surgical procedure necessitates a supine role, but; a wedge positioned under the
proper hip provides displacement of the uterus. Trendelenburg's function places pressure
from the pregnant uterus on the diaphragm and lungs, lowering respiratory ability and
,oxygenation. A semi-Fowler's function or susceptible role isn't always practical for this sort of
belly surgery.
A customer with a 38-week twin gestation is admitted to a birthing center in early labor. One
of the fetuses is a breech presentation. Which intervention is least appropriate in making
plans the nursing care of this patron?
1.
Measure fundal peak.
2.
Attach electronic fetal monitoring.
3.
Prepare the customer for a probable cesarean section.
4.
Visually look at the perineum and vaginal beginning. - ANS-1
The correct alternative is least suitable because fundal height need to be measured at each
antepartum hospital visit, no longer within the intrapartum length. All other options are
priorities. Intrapartum management and assessment require cautious attention to maternal
and fetal repute. The fetuses have to be monitored via twin digital fetal monitoring, and any
signs and symptoms of distress ought to be suggested to the health care issuer. A cesarean
segment may be important if a fetus is breech. The nurse ought to observe the perineum
and vaginal beginning visually for signs of the cord, which now and again prolapses via the
cervix.
A hard work room nurse is appearing an evaluation on a patron in hard work and notes that
the fetal coronary heart rate (FHR) is 158 beats/min and normal. The patron's contractions
are each 5 mins, with a duration of forty seconds and of mild intensity. On the idea of those
evaluation findings, what is the best nursing motion?
1.
Contact the obstetrician.
2.
Continue to display the client.
Three.
Report the FHR to the anesthesiologist.
4.
Prepare for coming near near transport of the fetus. - ANS-2
The FHR normally is 110 to one hundred sixty beats/min. Signs of potential complications of
labor are contractions continually lasting 90 seconds or longer, or constantly happening 2
mins or much less apart; fetal bradycardia, tachycardia, or consistently reduced variability;
and irregular FHR. The evaluation findings identified in the query are not signs and
symptoms of potential headaches.
, A nurse assists within the vaginal shipping of a new child. Following the delivery, the nurse
observes the umbilical twine prolong and a spurt of blood from the vagina. The nurse have to
file those observations as signs of which circumstance?
1.
Hematoma
2.
Uterine atony
three.
Placenta previa
4.
Placental separation - ANS-four
As the placenta separates, it settles downward into the decrease uterine segment. The
umbilical wire lengthens, and a surprising trickle or spurt of blood seems. The other options
are not characterized with the aid of these findings.
A nurse assists the fitness care company to perform an amniotomy on a client in exertions.
Which is the concern nursing movement after this manner?
1.
Assess the fetal heart charge.
2.
Check the consumer's temperature.
Three.
Change the pads beneath the consumer.
Four.
Check the client's respiration price. - ANS-1
After amniotomy or rupture of the membranes inside the delivery setting, the nurse straight
away assesses the fetal coronary heart charge for at least 1 minute to stumble on
modifications associated with prolapse or compression of the umbilical wire. The amount,
coloration, and smell of the amniotic fluid are also stated. The customer's temperature need
to be assessed every 2 to 4 hours, and the nurse additionally would test the customer's
critical signs and symptoms. The pads underneath the customer have to be changed
regularly to sell comfort and reduce the wet environment that favors bacterial increase, but
this is not the concern.
A nurse has accumulated the following facts on a client in labor. The fetal heart rate (FHR) is
154 beats/min and is regular; and contractions have slight intensity, occur every five minutes
and have a duration of 35 seconds. Using this information, what is the most suitable
movement for the nurse to take?
1.
questions 80Qw/exp
A purchaser arrives at a birthing middle in lively labor. Her membranes are still intact, and
the fitness care provider prepares to perform an amniotomy. What will the nurse relay to the
patron as the most possibly outcome of the amniotomy?
1.
Less pressure on her cervix
2.
Decreased quantity of contractions
three.
Increased performance of contractions
four.
The need for expanded maternal blood pressure tracking - ANS-3
Amniotomy (synthetic rupture of the membranes) can be used to induce exertions whilst the
situation of the cervix is favorable (ripe) or to enhance labor if the progress starts to sluggish.
Rupturing of the membranes allows the fetal head to touch the cervix greater directly and
can growth the efficiency of contractions. Increased monitoring of maternal blood strain
makes no sense following this system. The fetal coronary heart rate wishes to be monitored
frequently, however.
A patron in labor is dilated 10 cm. At this point in the hard work procedure, at least how
regularly need to the nurse plan to evaluate and report the fetal coronary heart rate?
1.
Hourly
2.
Every 15 minutes
three.
Every half-hour
four.
Before each contraction - ANS-2
he 2d stage of labor begins while the cervix is dilated completely (10 cm). Maternal pulse,
blood stress, and fetal coronary heart rate are assessed each 5 to fifteen minutes, relying on
employer protocol; a few agency protocols recommend assessment after each contraction.
,Hourly and every 30 minutes represent prolonged time intervals for assessment in this
degree of exertions.
A client in labor is receiving oxytocin (Pitocin) with the aid of intravenous infusion to stimulate
uterine contractions. Which finding indicates that the price of the infusion desires to be
reduced?
1.
Increased urinary output
2.
A fetal coronary heart fee of 180 beats/min
3.
Three contractions taking place in a 10-minute period
four.
Adequate resting tone of the uterus palpated between contractions - ANS-2
A ordinary fetal coronary heart rate is 120 to 160 beats/min. Acute hypoxia is a not unusual
cause of fetal tachycardia. The dosage of oxytocin must be reduced in the presence of fetal
tachycardia, which can arise from excessive uterine pastime. The goal of hard work
augmentation is to reap three correct-excellent contractions (appropriate intensity and
length) in a ten-minute duration. The uterus need to return to resting tone between
contractions, and there must be no proof of fetal distress. Increased urinary output is
unrelated to the use of oxytocin.
A patron in hard work is transported to the shipping room and organized for a cesarean
transport. After the customer is transferred to the delivery room table, the nurse have to area
the customer wherein role?
1.
Supine function with a wedge beneath the proper hip
2.
Trendelenburg's position with the legs in stirrups
three.
Prone position with the legs separated and accelerated
four.
Semi-Fowler's position with a pillow under the knees - ANS-1
Vena cava and descending aorta compression by way of the pregnant uterus impedes blood
go back from the lower trunk and extremities. This results in lowering cardiac return, cardiac
output, and blood glide to the uterus and subsequently the fetus. The best position to save
you this would be side-lying, with the uterus displaced off the belly vessels. Positioning for
belly surgical procedure necessitates a supine role, but; a wedge positioned under the
proper hip provides displacement of the uterus. Trendelenburg's function places pressure
from the pregnant uterus on the diaphragm and lungs, lowering respiratory ability and
,oxygenation. A semi-Fowler's function or susceptible role isn't always practical for this sort of
belly surgery.
A customer with a 38-week twin gestation is admitted to a birthing center in early labor. One
of the fetuses is a breech presentation. Which intervention is least appropriate in making
plans the nursing care of this patron?
1.
Measure fundal peak.
2.
Attach electronic fetal monitoring.
3.
Prepare the customer for a probable cesarean section.
4.
Visually look at the perineum and vaginal beginning. - ANS-1
The correct alternative is least suitable because fundal height need to be measured at each
antepartum hospital visit, no longer within the intrapartum length. All other options are
priorities. Intrapartum management and assessment require cautious attention to maternal
and fetal repute. The fetuses have to be monitored via twin digital fetal monitoring, and any
signs and symptoms of distress ought to be suggested to the health care issuer. A cesarean
segment may be important if a fetus is breech. The nurse ought to observe the perineum
and vaginal beginning visually for signs of the cord, which now and again prolapses via the
cervix.
A hard work room nurse is appearing an evaluation on a patron in hard work and notes that
the fetal coronary heart rate (FHR) is 158 beats/min and normal. The patron's contractions
are each 5 mins, with a duration of forty seconds and of mild intensity. On the idea of those
evaluation findings, what is the best nursing motion?
1.
Contact the obstetrician.
2.
Continue to display the client.
Three.
Report the FHR to the anesthesiologist.
4.
Prepare for coming near near transport of the fetus. - ANS-2
The FHR normally is 110 to one hundred sixty beats/min. Signs of potential complications of
labor are contractions continually lasting 90 seconds or longer, or constantly happening 2
mins or much less apart; fetal bradycardia, tachycardia, or consistently reduced variability;
and irregular FHR. The evaluation findings identified in the query are not signs and
symptoms of potential headaches.
, A nurse assists within the vaginal shipping of a new child. Following the delivery, the nurse
observes the umbilical twine prolong and a spurt of blood from the vagina. The nurse have to
file those observations as signs of which circumstance?
1.
Hematoma
2.
Uterine atony
three.
Placenta previa
4.
Placental separation - ANS-four
As the placenta separates, it settles downward into the decrease uterine segment. The
umbilical wire lengthens, and a surprising trickle or spurt of blood seems. The other options
are not characterized with the aid of these findings.
A nurse assists the fitness care company to perform an amniotomy on a client in exertions.
Which is the concern nursing movement after this manner?
1.
Assess the fetal heart charge.
2.
Check the consumer's temperature.
Three.
Change the pads beneath the consumer.
Four.
Check the client's respiration price. - ANS-1
After amniotomy or rupture of the membranes inside the delivery setting, the nurse straight
away assesses the fetal coronary heart charge for at least 1 minute to stumble on
modifications associated with prolapse or compression of the umbilical wire. The amount,
coloration, and smell of the amniotic fluid are also stated. The customer's temperature need
to be assessed every 2 to 4 hours, and the nurse additionally would test the customer's
critical signs and symptoms. The pads underneath the customer have to be changed
regularly to sell comfort and reduce the wet environment that favors bacterial increase, but
this is not the concern.
A nurse has accumulated the following facts on a client in labor. The fetal heart rate (FHR) is
154 beats/min and is regular; and contractions have slight intensity, occur every five minutes
and have a duration of 35 seconds. Using this information, what is the most suitable
movement for the nurse to take?
1.
