A nurse is reviewing the medical records of four clients who are pregnant and planning to have a vaginal birth after cesarean (VBAC).
Which of the following clients has the highest risk of uterine rupture during labor?
A client who had a low transverse incision for her previous cesarean delivery.
A client who had a vertical incision on her uterus but a low transverse incision on her skin for her previous cesarean delivery.
A client who had two previous cesarean deliveries with low transverse incisions and is now 39 weeks gestation.
A client who had one previous cesarean delivery with a low transverse incision and is now 41 weeks gestation.
The Correct Answer is B
A client who had a vertical incision on her uterus but a low transverse incision on her skin for her previous cesarean delivery has the highest risk of uterine rupture during labor. This is because a vertical incision on the uterus weakens the uterine wall and increases the risk of rupture during contractions.
Normal ranges for uterine rupture during labor are 0.2% to 1.5% for women who have had one previous cesarean delivery with a low transverse incision and 0.9% to 3.7% for women who have had two or more previous cesarean deliveries with low transverse incisions.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The correct answer is choice C. You should drink plenty of fluids and eat high-fiber foods.This will help you prevent constipation and ease your bowel movements, which can be painful after an episiotomy.
Choice A is wrong because you should not avoid taking sitz baths until your stitches dissolve.Sitz baths can help reduce the pain, swelling, and bruising around the wound area.
However, you should consult your doctor before taking a sitz bath.
Choice B is wrong because you should not change your perineal pad from back to front.This can introduce bacteria into your wound and increase the risk of infection.You should change your perineal pad from front to back and use a squirt bottle filled with warm water to cleanse the area every time you use the bathroom.
Choice D is wrong because you should not resume sexual intercourse as soon as you feel comfortable.You should wait until your wound is fully healed and your bleeding has stopped, which may take several weeks.You should also use a lubricant and a condom to prevent irritation and infection.
Correct Answer is A
Explanation
Normal ranges for postpartum psychosis are not applicable, as it is a rare and severe psychiatric disorder that affects 1-2 per 1,000 women.It usually occurs within the first 2 weeks after delivery, but can occur up to 12 months postpartum.
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