How long should clamping of the cord be delayed?

Correct Answer: A

Rationale: Delayed cord clamping refers to waiting a certain amount of time before clamping and cutting the umbilical cord after the baby is born. This practice has been shown to have various benefits for the newborn, such as increased iron levels and better cardiovascular stability. The optimal time for delayed cord clamping is typically between 30-60 seconds after birth. Choice A (30-60 seconds) is the correct answer because it falls within the recommended timeframe for delayed cord clamping. Waiting this amount of time allows for the transfer of additional blood from the placenta to the baby, which can be beneficial for their overall health and development. Choice B (15-30 seconds) is incorrect because it is a bit too short of a timeframe for optimal delayed cord clamping. While it is better than immediate clamping, waiting a bit longer can provide more benefits for the baby. Choice C (30 seconds) is also incorrect because it is on the lower end of the recommended timeframe. Waiting just 30 seconds may not allow for as much blood transfer from the placenta to the baby compared to waiting a bit longer. Choice D (Delayed cord clamping is not recommended) is incorrect because delayed cord clamping is actually recommended by many healthcare providers and organizations due to its potential benefits for the newborn. It is important to follow evidence-based practices and recommendations regarding delayed cord clamping to optimize outcomes for the baby.

Correct Answer: D

Rationale: Skin-to-skin contact between a parent and a baby has numerous benefits, making it a crucial practice in newborn care. Option A, improved bonding between parent and baby, is a well-documented benefit of skin-to-skin contact. This physical closeness promotes feelings of security, comfort, and attachment, which are essential for the emotional well-being of both the parent and the baby. Option B, enhanced thermoregulation for the newborn, is another significant benefit of skin-to-skin contact. The warmth provided by the parent's body helps regulate the baby's temperature, preventing hypothermia and promoting physiological stability. Option C, decreased risk of neonatal infections, is also a valid benefit of skin-to-skin contact. The transfer of beneficial skin microbes from the parent to the baby strengthens the baby's immune system, reducing the likelihood of infections. Option D, accelerated uterine involution for the birthing person, is the correct answer as it is NOT associated with skin-to-skin contact. Uterine involution refers to the process of the uterus returning to its pre-pregnancy size after childbirth, and this process is primarily influenced by hormonal changes and breastfeeding, not skin-to-skin contact. In conclusion, skin-to-skin contact offers numerous benefits for both the parent and the newborn, including improved bonding, enhanced thermoregulation, and decreased risk of infections. However, it is important to note that it is not directly linked to the accelerated uterine involution of the birthing person.

Correct Answer: A

Rationale: If prominent ischial spines are palpated during a pelvic exam, the nurse should prepare for pelvic dystocia. Pelvic dystocia refers to a type of obstructed labor where the baby's head is unable to pass through the maternal pelvis due to various reasons, such as the shape or size of the pelvis. Prominent ischial spines indicate a narrow pelvic outlet, which can obstruct the passage of the baby during labor. Incorrect choices: B: Fetal dystocia is related to issues with the fetus itself, such as abnormal presentation or size. Palpating prominent ischial spines does not directly indicate fetal dystocia. C: Contraction dystocia refers to ineffective uterine contractions that can lead to labor complications. Palpating ischial spines is not a sign of contraction dystocia. D: Uterine dystocia involves abnormalities in the uterus that can hinder labor progress. Palpating ischial spines is more indicative of a pelvic issue rather than a uterine problem. In summary, the correct answer is A because prominent ischial spines suggest a potential obstruction in the pelvic outlet, which can lead to pelvic dystocia during labor.

Correct Answer: C

Rationale: Uterine tachysystole is defined as excessively frequent uterine contractions, which can lead to a decrease in perfusion to the placenta and subsequently result in fetal hypoxia. When the uterus contracts too often or too strongly, it can reduce the amount of oxygen and nutrients reaching the fetus, leading to fetal distress and hypoxia. Choice A, Category I fetal heart rate tracing, is incorrect because this refers to a normal fetal heart rate pattern indicating fetal well-being. It is not a complication of uterine tachysystole, but rather a sign of a healthy fetus. Choice B, placenta previa, is incorrect because this condition involves the placenta partially or completely covering the cervix, leading to potential bleeding during pregnancy. It is not directly related to uterine tachysystole. Choice D, prolapsed cord, is incorrect because this occurs when the umbilical cord slips through the cervix ahead of the baby, potentially cutting off the baby's oxygen supply. While this is a serious complication during labor, it is not directly caused by uterine tachysystole. In summary, the correct answer is fetal hypoxia because uterine tachysystole can lead to reduced oxygen supply to the fetus, resulting in fetal distress and hypoxia. The other choices are incorrect as they do not directly result from uterine tachysystole.

Correct Answer: A

Rationale: A precipitous labor is defined as a labor that lasts less than 3 hours from the onset of contractions to delivery. This rapid labor process can lead to various complications for the newborn, including respiratory distress. Choice A: Respiratory distress is a common neonatal complication of precipitous labor because the rapid delivery does not allow for the normal process of fluid being squeezed out of the baby's lungs as it passes through the birth canal. This can result in the baby having difficulty breathing after birth. Choice B: Low birth weight is not typically associated with precipitous labor. The speed of labor does not necessarily impact the baby's weight at birth, as this is more influenced by factors such as maternal nutrition and health during pregnancy. Choice C: Prelabor rupture of membranes refers to the breaking of the amniotic sac before labor begins. While this can lead to complications such as infection, it is not specifically linked to precipitous labor. Choice D: Placenta previa is a condition where the placenta partially or completely covers the cervix, which can cause bleeding during pregnancy and delivery. This is not directly related to the speed of labor, so it is not a neonatal complication of precipitous labor. In conclusion, the correct answer is A because respiratory distress is a common neonatal complication of precipitous labor due to the lack of time for proper fluid clearance in the baby's lungs during delivery.