What do nurses understand about the induction of labor?
It is rated for probability of success by a Bishop score.
It is always done for medical reasons.
It is also known as a trial of labor (TOL).
It can electively be done at 37 weeks’ gestation.
The Correct Answer is A
Choice A rationale:
Bishop score: A tool used to assess the readiness of the cervix for labor induction. It evaluates factors such as cervical dilation, effacement, consistency, position, and station of the fetal presenting part.
Score ranges from 0 to 13: A higher score indicates a more favorable cervix for induction.
Score of 6 or less: Induction is less likely to be successful.
Score of 9 or higher: Induction is more likely to be successful.
Nurses understand: The importance of the Bishop score in predicting the likelihood of successful induction.
Nurses use this information: To counsel patients about the risks and benefits of induction, to prepare for induction, and to monitor progress during induction.
Choice B rationale:
Not always done for medical reasons: Induction can also be elective, meaning it is chosen for non-medical reasons, such as convenience or a desire to avoid a post-term pregnancy.
Examples of medical reasons:
Gestational hypertension or preeclampsia
Fetal growth restriction
Prolonged pregnancy
Chorioamnionitis
Oligohydramnios
Choice C rationale:
Trial of labor (TOL): A term used to describe a vaginal birth attempt after a previous cesarean delivery.
Not synonymous with induction of labor: TOL can occur spontaneously or be induced.
Choice D rationale:
Not always electively done at 37 weeks' gestation: The decision to induce labor at 37 weeks is made on a case-by-case basis.
Factors considered:
Maternal and fetal health
Bishop score
Patient preferences
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","D"]
Explanation
Choice A rationale:
Prostaglandins:
Mechanism of action: Prostaglandins are hormone-like substances that play a crucial role in labor initiation. They act by softening and ripening the cervix, stimulating uterine contractions, and rupturing the amniotic sac.
Types: Prostaglandins used for labor induction include:
Dinoprostone (Cervidil, Prepidil): Inserted into the vagina as a gel or pessary.
Misoprostol (Cytotec): Administered orally or vaginally.
Effectiveness: Generally effective in initiating labor within 24 hours, with success rates ranging from 60-85%.
Advantages:
Can be used when the cervix is unfavorable (not ripe).
Can be administered in a variety of ways to suit the patient's preferences.
May have a lower risk of uterine hyperstimulation compared to oxytocin.
Disadvantages:
Can cause side effects such as nausea, vomiting, diarrhea, and fever.
May increase the risk of uterine rupture, especially in women with a history of cesarean delivery.
Choice D rationale:
Amnioinfusion:
Procedure: Involves the infusion of sterile saline solution into the amniotic sac through a small catheter.
Mechanism of action: Not fully understood, but it's thought to work by:
Increasing amniotic fluid volume, which can help to stimulate contractions.
Stretching the uterine walls, which may trigger the release of prostaglandins.
Reducing pressure on the umbilical cord, which can improve fetal oxygenation.
Effectiveness: Usually used in conjunction with other induction methods, such as oxytocin or prostaglandins. Has a success rate of about 50-60% in initiating labor within 24 hours.
Advantages:
May be helpful in cases of low amniotic fluid (oligohydramnios).
Can decrease the risk of umbilical cord compression.
Disadvantages:
Requires the insertion of a catheter into the uterus, which carries a small risk of infection.
May cause discomfort for the mother.
Correct Answer is ["B","C","E","F"]
Explanation
The correct answers are B, C, E, and F.
Rationale for each choice:
- Albuterol
Mechanism of action: Albuterol is a beta-2 agonist that stimulates beta-2 receptors in the cell membranes of skeletal muscle, liver, and adipose tissue. This stimulation causes an increase in intracellular cyclic AMP (cAMP), which activates protein kinase A (PKA). PKA then phosphorylates a number of proteins, including the sodium-potassium ATPase pump. This pump is responsible for transporting potassium ions into cells and out of the bloodstream. By increasing the activity of this pump, albuterol can help to lower serum potassium levels.
Onset of action: Albuterol has a rapid onset of action, typically within 30 minutes.
Duration of action: The duration of action of albuterol is relatively short, usually 4-6 hours.
Dosage: The dosage of albuterol for hyperkalemia is typically 10-20 mg nebulized every 4-6 hours.
Additional considerations: Albuterol can cause tachycardia and tremors. It should be used cautiously in patients with heart disease or hyperthyroidism.
- Kayexalate
Mechanism of action: Kayexalate is a cation exchange resin that binds to potassium ions in the gastrointestinal tract. This prevents the potassium from being absorbed into the bloodstream.
Onset of action: Kayexalate has a relatively slow onset of action, usually 1-2 hours.
Duration of action: The duration of action of Kayexalate is relatively long, usually 4-6 hours.
Dosage: The dosage of Kayexalate for hyperkalemia is typically 15-30 grams orally or rectally every 6 hours.
Additional considerations: Kayexalate can cause constipation and hypocalcemia. It should be used cautiously in patients with bowel obstruction or kidney disease.
- Insulin & dextrose
Mechanism of action: Insulin promotes the movement of potassium into cells, thus lowering serum potassium levels. Dextrose is given along with insulin to prevent hypoglycemia.
Onset of action: Insulin has a rapid onset of action, typically within 30 minutes.
Duration of action: The duration of action of insulin is relatively short, usually 4-6 hours.
Dosage: The dosage of insulin for hyperkalemia is typically 10 units of regular insulin IV push, followed by an infusion of 5-10 units per hour. The dosage of dextrose is typically 50 grams IV push, followed by an infusion of 10% dextrose at 100 mL/hour.
Additional considerations: Insulin can cause hypoglycemia. It should be used cautiously in patients with diabetes mellitus.
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