For which patient should the oxytocin (Pitocin) infusion be discontinued immediately?

Correct Answer: A

Rationale: The correct answer is A because a patient in transition with contractions every 2 minutes lasting 90 seconds each is experiencing very intense and frequent contractions, indicating high uterine activity. Discontinuing oxytocin infusion is crucial in this scenario to prevent hyperstimulation, which can lead to fetal distress or uterine rupture. Choice B is incorrect because the patient is in early labor and the contractions are less frequent and less intense compared to the correct answer. Choice C is incorrect as the patient in active labor with contractions every 3 minutes lasting 60 seconds each is not as intense as the patient in transition in the correct answer. Choice D is incorrect because although the contractions are frequent and lasting longer, the intensity described in choice A is more concerning and requires immediate discontinuation of oxytocin infusion.

Correct Answer: A

Rationale: The correct answer is A because the priority intervention for a patient receiving oxytocin infusion for labor augmentation is to monitor fetal heart rate and uterine contractions. This is essential to ensure the safety of both the mother and the baby. Increasing the rate of Pitocin infusion (B) can lead to hyperstimulation and fetal distress. Providing oxygen and changing position (C) may be helpful in some situations but are not the priority. Stopping the Pitocin infusion (D) should only be done if there are signs of fetal distress or other complications.

Correct Answer: C

Rationale: The correct answer is C: Posterior fontanel. When a vacuum extractor is used during birth, it can cause swelling or molding of the baby's head, which may affect the assessment of the posterior fontanel. This fontanel is an important landmark for determining head size and shape. Swelling or molding can make it difficult to accurately assess the fontanel's size and shape, potentially impacting the overall assessment of the newborn's head. A: The anterior fontanel is not typically affected by the use of a vacuum extractor. B: The coronal suture lines are not directly impacted by the vacuum extractor. D: The biparietal diameter can still be measured accurately even with molding caused by the vacuum extractor.

Correct Answer: C

Rationale: The correct answer is C: Fetal lung maturity. It is essential to determine fetal lung maturity before induction of labor to ensure that the baby's lungs are developed enough to breathe outside the womb. This is important for the baby's well-being and can help prevent complications. Rationale: 1. Fetal lung maturity is crucial for the baby's ability to breathe independently. 2. Inducing labor without ensuring fetal lung maturity can lead to respiratory distress syndrome in the newborn. 3. A dilated cervix is important for labor progression but does not directly impact the baby's lung maturity. 4. Rupture of membranes may indicate potential labor but does not address the baby's lung development.

Correct Answer: A

Rationale: The correct answer is A: Less maternal fatigue. Waiting for the urge to push during laboring down helps conserve the mother's energy and prevents exhaustion. Pushing without the urge can lead to ineffective pushing efforts, increasing maternal fatigue. Incorrect choices: B: Less birth canal injuries - Pushing without the urge may increase the risk of birth canal injuries due to ineffective pushing efforts. C: Decreased pushing time - Pushing without the urge may actually prolong pushing time as the efforts may be less effective. D: Faster descent of the fetus - Pushing without the urge may not necessarily result in faster descent of the fetus and can lead to prolonged labor.