What is the primary purpose of using terbutaline in labor for intrauterine resuscitation?
To stimulate uterine contractions
To improve placental blood flow
To decrease fetal heart rate variability
To prevent preterm labor
The Correct Answer is B
A. To stimulate uterine contractions: Terbutaline is a tocolytic (a medication that relaxes the uterus), not a uterotonic. It is not used to stimulate contractions.
B. To improve placental blood flow: Terbutaline relaxes uterine muscles, decreasing contraction frequency and intensity, thereby improving placental blood flow. It is often used in intrauterine resuscitation when there is uteroplacental insufficiency and fetal distress due to excessive contractions (tachysystole).
C. To decrease fetal heart rate variability: Terbutaline does not directly affect fetal heart rate variability. It is used to reduce uterine contractions, which can secondarily improve fetal oxygenation.
D. To prevent preterm labor: While terbutaline can be used to delay preterm labor, in this context, it is being used for intrauterine resuscitation, not for preventing labor.
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Related Questions
Correct Answer is D
Explanation
A. Increase the rate of maintenance IV infusion. Increasing IV fluids may help improve placental perfusion, but it is not the first action. Repositioning the client takes priority to improve blood flow before considering IV adjustments.
B. Administer oxygen using a nonrebreather mask. Oxygen is beneficial in improving fetal oxygenation, but positioning the client laterally should be done first to optimize blood flow before oxygen administration.
C. Elevate the client’s legs. Elevating the legs may be helpful in cases of hypotension, but this scenario describes late decelerations, which are related to uteroplacental insufficiency.
D. Place the client in the lateral position. Late decelerations are caused by uteroplacental insufficiency, leading to fetal hypoxia. The first action is to reposition the client to the lateral position, which improves blood flow to the placenta and enhances fetal oxygenation.
Correct Answer is D
Explanation
A. Antenatal steroid administration: Antenatal steroids (e.g., betamethasone) are used to enhance fetal lung maturity in preterm pregnancies (<34 weeks). At 35 weeks, steroids are generally not indicated.
B. Expectant management protocols: Expectant management (delaying delivery with close monitoring) is considered in mild preeclampsia but is not appropriate in severe preeclampsia due to the risk of maternal and fetal complications.
C. Method of birth: The method of birth (vaginal vs. C-section) is determined based on maternal and fetal conditions. While important, it is not the key consideration in addressing the client's concern about their birth plan.
D. Shared decision-making: Shared decision-making ensures that the client feels heard and involved in their care plan, even in urgent situations. The nurse should acknowledge the client's concerns, explain the rationale for induction, and explore possible accommodations for their birth plan.
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