The least common cause of long. difficult, or abnormal labor (dystocia) is:

Midplane contracture of the pelvis

Disproportion of the pelvis.

Low-lying placenta

Compromised bearing-down efforts as a result of pain medication

Answer and Explanation

The Correct Answer is C

A. Midplane contracture of the pelvis. Pelvic contractures can lead to dystocia by restricting the fetal head's descent. A midplane contracture narrows the pelvic midsection, making labor prolonged and difficult. This is a common cause of dystocia.

B. Disproportion of the pelvis. Cephalopelvic disproportion (CPD), where the fetal head is too large for the maternal pelvis, is a well-known cause of dystocia. It often results in prolonged labor, failure to progress, and the need for cesarean delivery.

C. Low-lying placenta. A low-lying placenta does not directly cause dystocia. Instead, it may lead to placenta previa, which often requires cesarean delivery before labor even begins. Since it does not typically cause prolonged or difficult labor, it is the least common cause of dystocia.

D. Compromised bearing-down efforts as a result of pain medication. Excessive pain medication, especially epidurals or narcotics, can weaken maternal pushing efforts, leading to prolonged second-stage labor. This is a recognized cause of dystocia, particularly in multiparous women.

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Correct Answer is C

Explanation

A. Insert an internal fetal scalp electrode monitor. There is no indication for an internal fetal monitor, as the external monitoring shows a reassuring fetal heart rate pattern with moderate variability and no decelerations. Internal monitoring is typically used when external monitoring is inadequate or when fetal distress is suspected.

B. Contact the doctor at once and reposition the patient. There is no fetal distress or abnormal contraction pattern requiring immediate physician intervention. The fetal heart rate is within the normal range (110-160 bpm), and moderate variability indicates adequate oxygenation.

C. Document the finding in the patient's medical record. This is the correct action because the assessment findings indicate a well-oxygenated fetus and a normal labor progression. Contractions every 3-4 minutes lasting 60 seconds are within the expected range for oxytocin augmentation, and no abnormalities are present.

D. Discontinue the IV fluid containing Pitocin (oxytocin). There is no need to stop the oxytocin infusion, as the contraction pattern is appropriate, and there are no signs of uterine tachysystole or fetal distress.

A. Apply Oxygen B. Increase IV Pitocin C. Apply downward pressure on the woman's fundus D. Flex the woman's thighs sharply toward her abdomen

Correct Answer is D

Explanation

A. Apply oxygen. While oxygen may be administered if fetal distress is present, it does not directly resolve shoulder dystocia, which is a mechanical issue requiring immediate positional maneuvers to free the impacted shoulder.

B. Increase IV Pitocin. Increasing oxytocin (Pitocin) is contraindicated in shoulder dystocia because it can cause stronger contractions, worsening the impaction and increasing the risk of fetal injury or uterine rupture.

C. Apply downward pressure on the woman's fundus. Fundal pressure should never be applied in shoulder dystocia, as it can further wedge the fetal shoulder against the pubic bone, increasing the risk of brachial plexus injury and fetal distress.

D. Flex the woman's thighs sharply toward her abdomen. The McRoberts maneuver, which involves sharply flexing the mother’s thighs to widen the pelvic outlet, is the first-line intervention for shoulder dystocia. This maneuver helps rotate the pelvis and reposition the fetal shoulder, increasing the chances of a successful vaginal delivery.

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The least common cause of long. difficult, or abnormal labor (dystocia) is:

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Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

During a vaginal delivery the midwife tells you that a shoulder dystocia has occurred. Which of the following initial nursing actions is appropriate at this time?

Correct Answer is D

Explanation

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The least common cause of long. difficult, or abnormal labor (dystocia) is:

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