A nurse on the labor and delivery unit is assessing four clients.
Which of the following clients is a candidate for an induction of labor with Misoprostol?
A client who has placenta previa.
A client who has active genital herpes.
A client who has a previous uterine incision due to multiple myomectomy.
A client who has gestational hypertension.
The Correct Answer is D
Choice A rationale
Misoprostol is a prostaglandin analog that stimulates uterine contractions. It is contraindicated in clients with placenta previa due to the risk of severe hemorrhage from placental separation if contractions are induced.
Choice B rationale
Active genital herpes is a contraindication for vaginal delivery and therefore also a contraindication for induction of labor with Misoprostol, as it could potentially lead to vertical transmission of the herpes simplex virus to the newborn during passage through the birth canal.
Choice C rationale
A previous uterine incision due to multiple myomectomy can be a contraindication for labor induction with Misoprostol, depending on the type and location of the incisions. The increased risk of uterine rupture with strong contractions stimulated by Misoprostol is a significant concern in such cases.
Choice D rationale
Gestational hypertension, in the absence of other contraindications, can be an indication for induction of labor if the benefits of delivering the baby outweigh the risks of continuing the pregnancy. Misoprostol can be used cautiously in this situation to ripen the cervix and induce labor.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Maintaining a patent airway is the immediate priority in the event of a seizure associated with eclampsia. During a seizure, the client's respiratory muscles may become compromised, leading to airway obstruction and hypoxemia, which can be detrimental to both the mother and the fetus. Ensuring a clear airway allows for adequate oxygenation.
Choice B rationale
While administering oxygen is important in managing eclampsia to address potential hypoxemia, establishing and maintaining a clear airway takes precedence. Without a patent airway, supplemental oxygen delivery will be ineffective. Oxygen administration typically follows ensuring airway patency.
Choice C rationale
Assessing blood pressure and fetal heart rate is crucial in monitoring the progression of preeclampsia and eclampsia, but it is not the immediate first action during an eclamptic seizure. The immediate concern is the client's airway and preventing injury during the seizure. Monitoring follows stabilization of the airway.
Choice D rationale
Magnesium sulfate is the medication of choice to prevent and treat eclamptic seizures. However, during an active seizure, the immediate priority is to ensure the client's safety and airway. Magnesium sulfate administration would follow the initial steps of airway management and seizure precautions.
Correct Answer is A
Explanation
Choice A rationale
Walking and increasing fluid intake can often alleviate the discomfort associated with Braxton Hicks contractions. Movement can sometimes cause the uterus to relax, and adequate hydration helps maintain uterine irritability within normal physiological limits. Dehydration can sometimes exacerbate uterine contractions, so ensuring sufficient fluid intake is a prudent measure.
Choice B rationale
Timing contractions is more relevant when assessing for true labor. Braxton Hicks contractions are irregular and do not follow a consistent pattern of increasing frequency, duration, and intensity. Instructing the client to time them for 30 minutes may cause unnecessary anxiety and is not the primary intervention for discomfort relief.
Choice C rationale
Aspirin is not recommended during pregnancy, especially in the third trimester, due to potential risks to both the mother and the fetus, such as increased bleeding tendencies. Furthermore, aspirin would not address the physiological cause of Braxton Hicks contractions.
Choice D rationale
Going to the hospital is not indicated for irregular, non-painful Braxton Hicks contractions, especially at 36 weeks' gestation. Hospital visits are reserved for signs of true labor, such as regular, increasing contractions, rupture of membranes, or significant bleeding.
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