In addition to oxytocin (Pitocin) administration, what other methods can induce labor?
Prostaglandins
Episiotomy
None of the answers are correct
Amnioinfusion
Correct Answer : A,D
Choice A rationale:
Prostaglandins:
Mechanism of action: Prostaglandins are hormone-like substances that play a crucial role in labor initiation. They act by softening and ripening the cervix, stimulating uterine contractions, and rupturing the amniotic sac.
Types: Prostaglandins used for labor induction include:
Dinoprostone (Cervidil, Prepidil): Inserted into the vagina as a gel or pessary.
Misoprostol (Cytotec): Administered orally or vaginally.
Effectiveness: Generally effective in initiating labor within 24 hours, with success rates ranging from 60-85%.
Advantages:
Can be used when the cervix is unfavorable (not ripe).
Can be administered in a variety of ways to suit the patient's preferences.
May have a lower risk of uterine hyperstimulation compared to oxytocin.
Disadvantages:
Can cause side effects such as nausea, vomiting, diarrhea, and fever.
May increase the risk of uterine rupture, especially in women with a history of cesarean delivery.
Choice D rationale:
Amnioinfusion:
Procedure: Involves the infusion of sterile saline solution into the amniotic sac through a small catheter.
Mechanism of action: Not fully understood, but it's thought to work by:
Increasing amniotic fluid volume, which can help to stimulate contractions.
Stretching the uterine walls, which may trigger the release of prostaglandins.
Reducing pressure on the umbilical cord, which can improve fetal oxygenation.
Effectiveness: Usually used in conjunction with other induction methods, such as oxytocin or prostaglandins. Has a success rate of about 50-60% in initiating labor within 24 hours.
Advantages:
May be helpful in cases of low amniotic fluid (oligohydramnios).
Can decrease the risk of umbilical cord compression.
Disadvantages:
Requires the insertion of a catheter into the uterus, which carries a small risk of infection.
May cause discomfort for the mother.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
Bishop score: A tool used to assess the readiness of the cervix for labor induction. It evaluates factors such as cervical dilation, effacement, consistency, position, and station of the fetal presenting part.
Score ranges from 0 to 13: A higher score indicates a more favorable cervix for induction.
Score of 6 or less: Induction is less likely to be successful.
Score of 9 or higher: Induction is more likely to be successful.
Nurses understand: The importance of the Bishop score in predicting the likelihood of successful induction.
Nurses use this information: To counsel patients about the risks and benefits of induction, to prepare for induction, and to monitor progress during induction.
Choice B rationale:
Not always done for medical reasons: Induction can also be elective, meaning it is chosen for non-medical reasons, such as convenience or a desire to avoid a post-term pregnancy.
Examples of medical reasons:
Gestational hypertension or preeclampsia
Fetal growth restriction
Prolonged pregnancy
Chorioamnionitis
Oligohydramnios
Choice C rationale:
Trial of labor (TOL): A term used to describe a vaginal birth attempt after a previous cesarean delivery.
Not synonymous with induction of labor: TOL can occur spontaneously or be induced.
Choice D rationale:
Not always electively done at 37 weeks' gestation: The decision to induce labor at 37 weeks is made on a case-by-case basis.
Factors considered:
Maternal and fetal health
Bishop score
Patient preferences
Correct Answer is C
Explanation
Choice A rationale:
This statement suggests that the patient has some awareness of infertility treatments, but it does not necessarily indicate a full understanding of infertility itself.
It's important to consider that a few months of trying to conceive may not be indicative of infertility, as it can take up to a year for healthy couples to achieve pregnancy.
Jumping to fertility treatments without a proper evaluation could lead to unnecessary interventions and potential financial and emotional burdens.
Choice B rationale:
This statement is incorrect. Male factor infertility is a common cause of difficulty conceiving, accounting for about 40% of infertility cases.
It's essential to evaluate both partners when assessing fertility issues.
Choice C rationale:
This statement demonstrates the patient's understanding of the relationship between age and fertility.
Female fertility gradually declines with age, especially after the age of 35, due to a decrease in the number and quality of eggs.
This awareness indicates that the patient is realistic about her chances of conceiving and is prepared to seek appropriate help if needed.
Choice D rationale:
While family history can play a role in infertility, it's not a guarantee that someone will experience the same issues as their relatives.
Each case is unique, and multiple factors can contribute to infertility, including genetics, lifestyle, medical conditions, and environmental factors.
It's important to undergo a thorough evaluation to determine the specific causes of infertility in each individual.
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