The nurse is aware that uterine rupture is considered an obstetric emergency.
Which of the following patients is at an increased risk for uterine rupture?
A patient with polyhydramnios.
A patient experiencing gestational diabetes and carrying a fetus with an estimated fetal weight of 4.5 kg.
A patient with hypotonic uterine dysfunction.
A patient experiencing oxytocin-induction of labor.
The Correct Answer is D
Choice A rationale
Polyhydramnios, an excessive amount of amniotic fluid, is associated with an increased risk of premature rupture of membranes and umbilical cord prolapse. While it can cause uterine overdistention, leading to hypotonic dysfunction, it is not a primary risk factor for uterine rupture. The excess fluid does not directly weaken the uterine wall.
Choice B rationale
Gestational diabetes can lead to macrosomia, a fetus with a birth weight greater than 4.0 kg. While a large fetus can cause a difficult delivery and increase the risk for shoulder dystocia, the primary risk for uterine rupture is related to a scarred uterus from a previous cesarean section, not fetal size alone.
Choice C rationale
Hypotonic uterine dysfunction is characterized by weak, infrequent, or ineffective contractions during active labor. The uterine muscle is not contracting with sufficient force to cause cervical change. This condition primarily prolongs labor but does not increase the risk of uterine rupture, as the uterine wall is not under excessive strain.
Choice D rationale
Uterine rupture is a serious complication, and the risk is significantly elevated with oxytocin induction, especially in patients with a history of a previous cesarean section. Oxytocin stimulates powerful uterine contractions, and if the dose is not carefully titrated, it can overstimulate the uterus, potentially causing the old scar to tear under the intense pressure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","D"]
Explanation
Choice A rationale
Uterine contractions are governed by complex hormonal and mechanical pathways involving oxytocin and prostaglandins. Walking and position changes primarily influence fetal positioning and maternal comfort, not the frequency or duration of contractions. In fact, these activities can sometimes strengthen contractions by utilizing gravity to increase pressure on the cervix.
Choice B rationale
The primary goal of walking and frequent position changes is to reduce pain and increase comfort. By changing positions, the mother can alleviate pressure on specific areas, optimize blood flow, and distract herself from the pain, which scientifically reduces the perception of pain and increases the body's natural endorphin release.
Choice C rationale
Frequent changes in position and ambulation during labor can increase comfort by reducing pressure on the sacrum and perineum, improving blood flow, and allowing the mother to find a more tolerable position. This scientifically reduces pain perception and enhances the mother's coping mechanisms, making the labor process more manageable.
Choice D rationale
Walking and position changes utilize gravity to help the fetus descend into the pelvis and rotate into an optimal position for birth. This can improve the fit of the fetal head in the maternal pelvis, promoting efficient labor progression and helping the fetus navigate the curves of the birth canal more effectively.
Correct Answer is D
Explanation
Choice A rationale
Ritodrine is a beta-mimetic tocolytic that can cause maternal and fetal tachycardia. Betamethasone does not reduce this side effect. The primary purpose of betamethasone is to enhance fetal lung maturity. Tachycardia from ritodrine is a known side effect that is managed by monitoring and dosage adjustment, not by administering corticosteroids.
Choice B rationale
The purpose of betamethasone is not to suppress uterine contractions. Betamethasone is a corticosteroid that enhances the production of surfactant in the fetal lungs. Tocolytic medications like nifedipine or magnesium sulfate are used to suppress uterine contractions in preterm labor, allowing time for the betamethasone to take effect.
Choice C rationale
Magnesium sulfate therapy can cause respiratory depression as a side effect. Betamethasone does not maintain maternal respiratory effort or ventilation during this treatment. Calcium gluconate is the antidote for magnesium toxicity. The role of betamethasone is specific to fetal lung maturity, not maternal respiratory support during magnesium sulfate administration.
Choice D rationale
Betamethasone is a corticosteroid that stimulates the production and release of surfactant in the fetal lungs. Surfactant is a substance that reduces surface tension in the alveoli, preventing them from collapsing and improving gas exchange. Administering this medication to the mother improves fetal lung maturity and reduces the risk of respiratory distress syndrome in preterm infants.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.