A nurse is admitting a client who is in active labor and has had two prior cesarean births. The nurse should identify that the client is at an increased risk for which of the following complications?

Failure to progress

Abruptio placentae

Precipitous labor

Uterine rupture

Answer and Explanation

The Correct Answer is D

Uterine rupture. When a client has had two prior cesarean births, she is at an increased risk for uterine rupture. Uterine rupture is a serious complication that can occur during labor, where there is a tear in the wall of the uterus. It can lead to significant blood loss for the mother and oxygen deprivation for the fetus. Other risk factors for uterine rupture include a previous uterine surgery, the use of labor-inducing drugs, and multiple gestations.

Failure to progress (choice A) refers to a labor that is not progressing as it should, and can be caused by a variety of factors, including fetal malposition or inadequate contractions. Abruptio placentae (choice B) refers to the separation of the placenta from the uterine wall before delivery, which can cause fetal distress and maternal hemorrhage. Precipitous labor (choice C) refers to a labor that progresses extremely quickly, with contractions lasting less than 3 hours from the onset of active labor. While precipitous labor can be associated with increased risk for perineal lacerations and postpartum hemorrhage, it is not typically associated with prior cesarean births.

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Correct Answer is B

Explanation

administer a bolus infusion of lactated Ringer's. Maternal hypotension is a common complication of epidural anesthesia. A bolus infusion of lactated Ringer's is an appropriate intervention for maternal hypotension due to the increased volume and pressure it provides, which can help to raise the client's blood pressure. The knee-chest position is not an appropriate intervention for maternal hypotension as it can cause a decrease in venous return to the heart. Terbutaline is a tocolytic medication used to stop premature labor, and it is not indicated for maternal hypotension. Oxygen via a nonrebreather face mask at 2 L/min is not an appropriate intervention for maternal hypotension as it does not address the underlying cause of the hypotension.

A. Initiate oxytocin via continuous IV infusion. B. Place the client in the left-lateral position. C. Request that the provider insert an intrauterine pressure catheter. D. Exert continuous upward pressure on the presenting part.

Correct Answer is D

Explanation

A. Initiate oxytocin via continuous IV infusion: Oxytocin stimulates uterine contractions, which would increase pressure on the umbilical cord, further compromising fetal oxygenation. This action is contraindicated in the presence of a prolapsed cord.

B. Place the client in the left-lateral position: Although the left-lateral position improves uteroplacental perfusion, it does not relieve pressure on the prolapsed cord. Instead, the nurse should position the client in a knee-chest or Trendelenburg position to reduce cord compression.

C. Request that the provider insert an intrauterine pressure catheter: Intrauterine pressure catheters are contraindicated in cases of umbilical cord prolapse as they can worsen cord compression and fetal hypoxia.

D. Exert continuous upward pressure on the presenting part: This action helps relieve pressure on the umbilical cord, improving blood flow and oxygen supply to the fetus. The nurse should maintain this position while simultaneously calling for immediate assistance and preparing the client for an emergency cesarean delivery.

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A nurse is admitting a client who is in active labor and has had two prior cesarean births. The nurse should identify that the client is at an increased risk for which of the following complications?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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