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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
: "This test will detect the presence of Rh-positive antibodies in your blood." The indirect Coombs' test is a blood test that is used to detect the presence of antibodies against red blood cells in a person's blood. It is commonly used to determine whether a pregnant woman is at risk of hemolytic disease of the newborn (HDN), a condition in which the mother's antibodies attack the red blood cells of the fetus.
Choice A is incorrect because the amount of amniotic fluid around the fetus is measured by an amniocentesis, not a Coombs' test. Choice B is incorrect because ultrasound studies blood flow in the fetus and placenta using sound waves, not ultrasound waves. Choice D is incorrect because hypoglycemia after birth is not related to the Coombs' test, but may be related to other tests, such as a blood glucose test.
Correct Answer is C
Explanation
A. Discomfort in the lower back (sacral area) is common during labor, particularly during contractions. This is not an unusual finding that would require immediate reassessment.
B. Contractions lasting between 45 to 60 seconds are typical during the active phase of labor. This duration of contractions is expected as labor progresses, and does not require immediate reassessment.
C. This sensation can indicate that the fetus has descended into the birth canal and may be a sign that the client is entering the second stage of labor, or is close to delivery. This requires immediate reassessment by the nurse to check for full cervical dilation and fetal descent.
D. Emotional excitement and changes in skin temperature are typical responses during labor due to the physiological and emotional aspects of childbirth. This does not indicate the need for immediate reassessment.
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