What is a complication of uterine rupture?

Correct Answer: A

Rationale: Uterine rupture is a serious obstetric complication where the uterine wall tears during pregnancy or labor. DIC (Disseminated Intravascular Coagulation) is a known complication of uterine rupture. When the uterus ruptures, it can cause massive bleeding, leading to a systemic response that triggers DIC. This is because the release of tissue factor from the injured uterus activates the coagulation cascade, which can result in both clotting and bleeding abnormalities throughout the body. Nuchal cord, on the other hand, is when the umbilical cord becomes wrapped around the baby's neck. While this can cause fetal distress during labor, it is not directly related to uterine rupture. Polyhydramnios is a condition characterized by an excessive amount of amniotic fluid surrounding the baby in the uterus. While polyhydramnios can increase the risk of uterine rupture due to the increased pressure on the uterine wall, it is not a direct complication of uterine rupture. Oligohydramnios, on the other hand, is a condition characterized by too little amniotic fluid surrounding the baby in the uterus. This can lead to complications such as fetal growth restriction and umbilical cord compression, but it is not directly related to uterine rupture. In summary, DIC is the correct answer because it is a known complication of uterine rupture due to the significant bleeding that can occur when the uterus tears.

Correct Answer: B

Rationale: Postpartum hemorrhage is defined as excessive bleeding following childbirth, usually within the first 24 hours. It is a significant cause of maternal mortality and morbidity if not promptly recognized and managed. The correct answer is B: 500 mL, as this is the generally accepted threshold for defining postpartum hemorrhage. A: 250 mL is too low to be considered postpartum hemorrhage. While some blood loss is normal after childbirth, this amount is not typically concerning unless the woman is showing signs of distress or other symptoms. C: 750 mL is closer to the threshold for postpartum hemorrhage, but it is still higher than the generally accepted definition of 500 mL. At 750 mL, the woman would likely be experiencing significant symptoms and would require immediate medical attention. D: 1,000 mL is well above the threshold for postpartum hemorrhage and would indicate a severe and potentially life-threatening situation. At this level of blood loss, the woman would likely be in shock and would require immediate intervention to prevent further complications. In summary, the correct answer is B: 500 mL, as this is the generally accepted threshold for defining postpartum hemorrhage. Any amount of blood loss above this threshold should be taken seriously and prompt medical attention should be sought to ensure the safety and well-being of the mother.

Correct Answer: D

Rationale: Monitoring for decreased perfusion is crucial in assessing the adequacy of blood flow to tissues and organs. One way to assess perfusion is by monitoring urine output, making choice D the correct answer. Decreased perfusion can lead to decreased renal blood flow, resulting in a decrease in urine output. Monitoring 24-hour urine output can provide valuable information about the patient's renal function and overall perfusion status. Choice A, monitoring lochia, is not directly related to perfusion. Lochia refers to postpartum vaginal discharge and is more indicative of the healing process after childbirth rather than perfusion status. Choice B, measuring blood loss, can provide information about potential hemorrhage but does not directly assess perfusion. Although decreased blood volume can lead to decreased perfusion, monitoring blood loss alone does not provide a comprehensive assessment of perfusion status. Choice C, checking temperature, can be an indicator of infection or inflammation but does not directly assess perfusion. While infection or inflammation can impact perfusion, monitoring temperature alone is not a reliable method for assessing perfusion status.

Correct Answer: B

Rationale: Ethnicity and religion are important factors for the nurse to note from the prenatal record before proceeding with the physical assessment. Ethnicity can provide valuable information about potential genetic predispositions to certain health conditions or diseases that may impact the pregnancy. Additionally, cultural beliefs and practices related to pregnancy and childbirth can influence the care that the nurse provides to the patient. Weight gain is not necessarily crucial information to note before the physical assessment. While weight gain during pregnancy is important to monitor, it is typically a part of the physical assessment itself rather than a prerequisite for proceeding with the assessment. Age is also not essential information to note before the physical assessment. While maternal age can impact pregnancy outcomes, it is not a prerequisite for conducting a physical assessment. Gravidity and parity are important pieces of information to gather from the prenatal record, but they are not necessary before proceeding with the physical assessment. Gravidity refers to the number of times a woman has been pregnant, while parity refers to the number of times a woman has given birth to a viable offspring. This information is important for understanding the patient's obstetric history, but it is not required before conducting the physical assessment.

Correct Answer: C

Rationale: Leopold's maneuvers are a series of four steps used to assess the position of the fetus in the uterus. Step 1: In the first step, the nurse determines which part of the fetus is located in the upper abdomen. This helps to identify the fetal presentation. Step 2: The second step involves palpating both sides of the uterus to determine which side the fetus's back is on. This helps to determine the fetal position. Step 3: In the third step, the nurse determines the location of the presenting part in the pelvis. This helps to determine the fetal station and engagement. Step 4: The final step involves palpating the lower abdomen to determine the position of the fetal back and limbs. This helps to determine the fetal lie. In this scenario, based on Leopold's maneuvers, if the nurse determines that the fetus's back is on the right side of the mother's abdomen and the small parts are felt on the left side, this indicates a longitudinal lie. A vertical lie means that the fetus's long axis is parallel to the mother's long axis. This is the correct answer. Choice A is incorrect because a transverse fetal position means that the fetus is lying horizontally across the mother's abdomen, which would not be determined by Leopold's maneuvers. Choice B is incorrect because the fetal presentation refers to the part of the fetus that is entering the maternal pelvis first. This is usually determined during the vaginal examination, not by Leopold's maneuvers. Choice D is incorrect because fetal attitude refers to the relationship of the fetal body parts to one another. It is not determined by Leopold's maneuvers, which focus on the position of the fetus in the uterus.