A patient in labor is undergoing an epidural block and is given intravenous fluid. What is the purpose of this?

Correct Answer: D

Rationale: The correct answer is D: To treat hypotension that results from sympathetic blockade. When an epidural block is administered during labor, sympathetic blockade can lead to a drop in blood pressure. By providing intravenous fluid, the goal is to increase preload and maintain blood pressure to counteract the hypotension caused by sympathetic blockade. A: Treating hypotension from hemorrhage is not the primary purpose in this scenario. B: Increasing urine output is not the main goal of giving intravenous fluid during an epidural block. C: Treating insensible fluid losses is not the immediate concern when a patient is experiencing hypotension from sympathetic blockade.

Correct Answer: B

Rationale: The correct answer is B: Placenta previa. In placenta previa, the placenta partially or completely covers the cervix, leading to painless vaginal bleeding. Placental abruption (choice A) presents with painful bleeding. Uterine rupture (choice C) typically causes severe abdominal pain. Cervical laceration (choice D) usually occurs during delivery and is not typically associated with painless bleeding during labor. Placenta previa is the most likely cause in this scenario due to painless bleeding and the absence of contractions.

Correct Answer: C

Rationale: The correct answer is C: Blood glucose levels. During labor, it is crucial to monitor the blood glucose levels of a patient with a history of gestational diabetes to prevent complications such as hyperglycemia or hypoglycemia. Fluctuations in blood glucose levels can impact both the mother and the baby's health. Monitoring maternal blood pressure (A) is important but not the most critical factor in this scenario. Fetal heart rate (B) is essential but does not directly address the specific needs of a patient with a history of gestational diabetes. Maternal temperature (D) is also important but does not take precedence over monitoring blood glucose levels in this case.

Correct Answer: A

Rationale: The correct answer is A: Pulmonary embolism. In a woman in labor experiencing severe chest pain and difficulty breathing, a pulmonary embolism should be suspected. This condition occurs when a blood clot travels to the lungs, causing chest pain and respiratory distress. Other choices are incorrect: B) Pre-eclampsia is characterized by high blood pressure and protein in the urine, not chest pain. C) Anxiety does not typically present with severe chest pain and difficulty breathing. D) Placental abruption involves separation of the placenta from the uterus, leading to vaginal bleeding and abdominal pain, not chest pain.

Correct Answer: D

Rationale: The correct answer is D: Prepare for delivery. At 38 weeks of gestation and in active labor, the most appropriate action is to prepare for delivery as the patient is likely to be close to giving birth. This involves ensuring that all necessary equipment and supplies are ready, notifying the healthcare team, and positioning the patient for delivery. Administering narcotic analgesics (choice A) may not be ideal at this stage as the priority is the imminent delivery. While emotional support and reassurance (choice B) are important, they should be provided alongside preparing for delivery. Assessing the fetal heart rate and contraction patterns (choice C) is crucial but should be done concurrently with preparing for delivery to ensure the safety of both the mother and baby.