The nurse is caring for a client at 42 weeks' gestation arriving for an induction of labor. The provider is planning to use dinoprostone (Cervidil) vaginal insert for cervical ripening. What is the nurse's priority prior to insertion?
Start an IV and begin oxytocin infusion as ordered by the provider
Ensure the client eats a light meal and drink plenty of fluids
Place the catheter and sterile saline at the client's bedside
Continuously monitor the fetal heart rate and uterine activity for 20 minutes
The Correct Answer is D
A. Initiating oxytocin infusion is not the priority before the insertion of dinoprostone. Fetal monitoring is a more immediate concern.
B. Ensuring the client eats a light meal and drinks fluids is important for general well-being but is not the priority before dinoprostone insertion.
C. Placing the catheter and sterile saline at the bedside may be done later but is not the priority before insertion.
D. Continuous monitoring of the fetal heart rate and uterine activity is essential to assess the response to cervical ripening agents, as they can cause uterine hyperstimulation and fetal distress.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Placing the client on her left side is important for optimizing fetal oxygenation but is not the first action when there is a report of a gush of fluid.
B. Notifying the registered nurse (RN) immediately is the first action to ensure prompt assessment and appropriate interventions for possible ruptured membranes.
C. Documenting the time and color of the fluid is important, but immediate notification of the RN takes precedence.
D. Checking fetal heart tones is important but should be done in conjunction with notifying the RN to assess the overall situation and determine the appropriate course of action.
Correct Answer is ["B"]
Explanation
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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