The nurse has received shift report for five clients admitted in labor. Which clients will the nurse anticipate delivering by a cesarean section? Select all that apply.

A previous low transverse uterine incision

Placenta previa

A previous classical uterine incision

Prolapsed umbilical cord

Breast cancer

Answer and Explanation

Correct Answer : B

A.   A previous low transverse uterine incision is a factor that may allow for a trial of labor after cesarean (TOLAC) or a vaginal birth after cesarean (VBAC), rather than an automatic cesarean section.
B.   Placenta previa, where the placenta partially or completely covers the cervix, often requires a cesarean section to avoid complications such as bleeding during labor.

C.   A previous classical uterine incision, especially if it extends into the upper part of the uterus, is a contraindication for a trial of labor or vaginal birth, usually requiring a repeat cesarean
section.

D. Prolapsed umbilical cord, where the cord precedes the presenting part, can lead to cord compression during contractions, necessitating a prompt cesarean section.
E. Breast cancer is not a direct indication for a cesarean section; it does not impact the mode of delivery in the absence of other obstetric indications.

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Correct Answer is D

Explanation

A. Powers refer to uterine contractions and maternal pushing efforts, which seem appropriate based on the given information.
B. Passage refers to the birth canal, and there is no indication that the birth canal is obstructing the progress.
C. Passenger refers to the fetus, and the cephalic presentation is favorable for a vaginal delivery.

D. The client's psychological state, including fear and anxiety, can impact labor progress. The client's emotional and psychological well-being can influence the progression of labor.

A. "With a classical incision, there is an increased risk of uterine rupture in labor, so a vaginal birth is not usually recommended." B. "This depends on whether your next baby is born at full term; if it is another preterm birth, then a repeat cesarean will be advised." C. "There is a decreased risk for complications and easier recovery after a vaginal birth, so a vaginal birth will be recommended for you." D. "As long as there is an 18-month interval for scar healing between births, a vaginal birth after cesarean is generally permitted."

Correct Answer is A

Explanation

A. A classical incision increases the risk of uterine rupture during labor, and a vaginal birth is not typically recommended due to this risk.
B. The type of incision, not the term of the subsequent birth, is the primary consideration for deciding on a mode of delivery.
C. A classical incision is associated with an increased risk of complications, not a decreased risk.

D. The recommendation for a vaginal birth after cesarean (VBAC) depends on factors such as the type of uterine incision and other clinical considerations, not just the time interval.

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The nurse has received shift report for five clients admitted in labor. Which clients will the nurse anticipate delivering by a cesarean section? Select all that apply.

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Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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