How often should the nurse assess the fetal heart rate in a person on oxytocin?

Correct Answer: C

Rationale: C is the correct answer because when a person is receiving oxytocin, it is crucial to closely monitor the fetal heart rate due to the potential risk of uterine hyperstimulation, which can lead to fetal distress. Assessing the fetal heart rate every 5 minutes allows the nurse to promptly identify any changes in the heart rate pattern and take appropriate action to prevent harm to the fetus. A (every 30 minutes) is incorrect because this interval is too long when oxytocin is being administered. Waiting 30 minutes between assessments may result in delayed recognition of fetal distress and could lead to adverse outcomes. B (every 15 minutes) is also incorrect as this interval is still too long for close monitoring of fetal well-being in the presence of oxytocin. Waiting 15 minutes between assessments may not provide timely information to intervene if needed. D (every 1 hour) is the furthest from the correct answer. Waiting an hour between assessments is far too infrequent when oxytocin is being used, as uterine hyperstimulation and fetal distress can occur rapidly. This interval does not allow for timely detection and intervention in case of complications. In conclusion, assessing the fetal heart rate every 5 minutes when a person is receiving oxytocin is essential for ensuring the safety and well-being of both the mother and the fetus. This frequent monitoring allows for early detection of any issues and timely intervention to prevent adverse outcomes.

Correct Answer: A

Rationale: Oxytocin (Pitocin) is the correct answer because it is a uterotonic medication that helps prevent postpartum hemorrhage. Oxytocin is a hormone that stimulates uterine contractions, which helps the uterus to clamp down on blood vessels after delivery, reducing the risk of excessive bleeding. It is commonly administered immediately after childbirth to help prevent postpartum hemorrhage. Fentanyl (Sublimaze) is an opioid analgesic used for pain relief, but it does not have any effect on preventing postpartum hemorrhage. It is not indicated for use in preventing or treating postpartum hemorrhage. Epinephrine (Adrenaline) is a medication used to treat severe allergic reactions (anaphylaxis), cardiac arrest, and asthma attacks. It is not used for preventing postpartum hemorrhage. Epinephrine works by constricting blood vessels and increasing heart rate, which is not the mechanism needed to prevent postpartum hemorrhage. Lorazepam (Ativan) is a benzodiazepine medication used to treat anxiety, insomnia, and seizures. It has no role in preventing postpartum hemorrhage. Lorazepam works by enhancing the effects of a neurotransmitter in the brain called GABA, which has no effect on uterine contractions or reducing postpartum bleeding. In summary, oxytocin (Pitocin) is the correct medication to prevent postpartum hemorrhage because it helps stimulate uterine contractions, which is essential for reducing the risk of excessive bleeding after childbirth. Fentanyl, epinephrine, and lorazepam are not indicated for this purpose and do not have the same mechanism of action as oxytocin.

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.