What are the contraindications for a patient wanting to have a TOLAC?
History of uterine rupture.
Previous cesarean section for breech presentation.
Previous low transverse cesarean section birth.
Low-risk pregnancy.
The Correct Answer is A
Choice A rationale
History of uterine rupture poses a significant risk for a trial of labor after cesarean (TOLAC) due to the potential recurrence of uterine rupture, which can be life-threatening for both mother and fetus.
Choice B rationale
Previous cesarean section for breech presentation is not a contraindication for TOLAC. Patients with prior cesarean deliveries can consider TOLAC if there are no additional risk factors.
Choice C rationale
Previous low transverse cesarean section birth is often considered suitable for TOLAC, as the lower segment incision has a lower risk of rupture compared to vertical or classical incisions.
Choice D rationale
Low-risk pregnancy alone is not a contraindication for TOLAC. It is essential to assess other factors such as uterine scarring, maternal health, and fetal status when considering TOLAC eligibility.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","D"]
Explanation
Choice A rationale:
The temperature of 36.7°C (98.1°F) is within the normal range for newborns (36.5-37.5°C). Therefore, it does not require immediate follow-up.
Choice B rationale:
The respiratory rate of 74/min exceeds the normal range for newborns (30-60 breaths/min), indicating potential respiratory distress. Immediate follow-up is crucial to prevent respiratory failure.
Choice C rationale:
The heart rate of 170/min is above the normal range for newborns (120-160 beats/min). Tachycardia can indicate stress, infection, or other underlying conditions that need prompt evaluation.
Choice D rationale:
Work of breathing includes signs such as retractions, nasal flaring, and grunting, which indicate respiratory distress. These signs require immediate follow-up to address any potential respiratory complications.
Choice E
rationale: Blood glucose level is not mentioned in the question or exhibits. Without information on blood glucose, it is not possible to determine if it requires immediate follow-up.
Correct Answer is B
Explanation
Choice A rationale
Blood glucose level changes are unrelated to hyperbilirubinemia and phototherapy, which specifically target bilirubin metabolism in the newborn's liver and skin.
Choice B rationale
A decrease in transcutaneous bilirubin (TcB) levels shows effective phototherapy, as it converts bilirubin into water-soluble isomers that can be excreted.
Choice C rationale
Skin color changes from yellow to normal indicate reduced bilirubin levels, but the most accurate measure of phototherapy efficacy is the decrease in TcB levels.
Choice D rationale
Weight gain is not an indicator of effective phototherapy; it reflects overall nutrition and hydration status rather than bilirubin metabolism and excretion.
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