A nurse is preparing a laboring person for a cesarean birth. What is the most important intervention before the procedure?

Correct Answer: A

Rationale: The correct answer is A because administering preoperative medication is crucial to ensure the patient's comfort and safety during the cesarean birth. Preoperative medications help reduce anxiety, prevent infection, and manage pain. Monitoring vital signs (choice B) is important but not the most critical intervention before the procedure. Ensuring proper incision care (choice C) is postoperative, not preoperative. Performing a vaginal exam (choice D) is unnecessary and potentially harmful before a cesarean birth.

Correct Answer: C

Rationale: The correct answer is C: IUPC (Intrauterine Pressure Catheter). This modality is the only direct and objective measurement of uterine contractions as it provides continuous and precise readings of intrauterine pressure. A: Tocodynamometer measures frequency and duration, but not intensity. B: Fetal spiral electrode monitors fetal heart rate, not uterine contractions. D: Palpation is subjective and not as accurate as IUPC for measuring uterine contractions.

Correct Answer: C

Rationale: The sudden gush of blood and the contracted uterus indicate a separation of the placenta, which is a serious complication called placental abruption. This condition can lead to significant bleeding and jeopardize the health of both the mother and the baby. It is essential for the nurse to recognize this situation promptly and take immediate action to manage the hemorrhage and stabilize the patient. Explanation for incorrect choices: A: Laceration of the genital tract would not typically cause a sudden gush of blood and a contracted uterus. B: The second stage of labor is characterized by the delivery of the baby, not by a sudden gush of blood and a contracted uterus. D: Postpartum hemorrhage could be a consequence of placental separation, but it is not the primary issue indicated by the symptoms described in the scenario.

Correct Answer: C

Rationale: The correct answer is C: Continue to monitor the patient. Early decelerations are benign and occur due to head compression during contractions. They are a normal response to fetal head compression and do not require any intervention as they are self-limiting. Continuing to monitor the patient allows the nurse to observe the pattern of decelerations and ensure they remain early and resolve on their own. Anticipating a cesarean birth (choice A) is unnecessary as early decelerations do not indicate fetal distress. Turning the patient onto the left side (choice B) is typically done for late decelerations, not early decelerations. Notifying the physician or nurse midwife immediately (choice D) is not necessary for early decelerations as they are expected and do not require immediate intervention.

Correct Answer: C

Rationale: The correct answer is C: Give magnesium sulfate to inhibit uterine contractions. Magnesium sulfate is used to delay preterm labor by relaxing the uterine muscles, thus decreasing contractions. This intervention helps to delay delivery and give time for other interventions to be implemented, such as administering corticosteroids to promote fetal lung development. Providing an epidural for pain management (B) does not address the issue of preterm labor. Beginning oxytocin infusion (D) would speed up labor, which is not appropriate in this scenario. Administering corticosteroids (A) is a beneficial intervention but should be done after delaying delivery with magnesium sulfate.