What is the initial action for a mother experiencing severe vaginal bleeding during labor?

Correct Answer: C

Rationale: In the scenario of a mother experiencing severe vaginal bleeding during labor, the initial action of administering oxygen at 10L/min via a mask (Option C) is the correct choice. Oxygen therapy helps to improve oxygenation to both the mother and the fetus, stabilizing their conditions in cases of hemorrhage. This intervention supports tissue perfusion and minimizes the risk of hypoxia, which is crucial in a situation of acute blood loss. Monitoring vital signs and providing IV fluids (Option A) is important, but oxygenation takes precedence in addressing the immediate threat of hypoxia. Positioning the mother on her left side (Option B) can help improve blood flow to the placenta but is not the initial priority in managing severe vaginal bleeding. Preparing for an immediate cesarean section (Option D) may be necessary if other interventions fail, but it is not the first step in managing maternal hemorrhage. Educationally, this question highlights the importance of quick and appropriate interventions in emergency obstetric situations. Understanding the rationale behind each option helps nurses and healthcare providers prioritize care effectively to ensure the best outcomes for both the mother and the baby. It emphasizes the significance of rapid assessment and intervention in maternal and newborn care to address potentially life-threatening complications.

Correct Answer: A

Rationale: A history of previous pelvic inflammatory disease (PID) treatment would lead to suspicion of an ectopic pregnancy in a client presenting with abdominal pain and bleeding at 8 weeks' gestation. PID can cause scarring and damage to the fallopian tubes, increasing the risk of an ectopic pregnancy where the fertilized egg implants outside of the uterus, usually in the fallopian tubes. Symptoms of an ectopic pregnancy can include abdominal pain, vaginal bleeding, and signs of shock, making it important to consider this possibility in a client with a history of PID.

Correct Answer: C

Rationale: The foramen ovale is a normal fetal structure that allows blood to bypass the lungs by shunting blood from the right atrium to the left atrium. This is essential during fetal development since the lungs are not functioning until birth. After birth, when the baby takes its first breaths and the lungs start working, the pressure in the left atrium increases due to the increased blood flow from the pulmonary circulation. This increased pressure in the left atrium causes the foramen ovale to close, preventing blood from flowing from the right atrium to the left atrium. Therefore, the closure of the foramen ovale is a result of the increased pressure in the left atrium rather than any other cardiovascular changes.

Correct Answer: C

Rationale: The patient who should be seen first is the 35 weeks' gestation with grade I abruptio placenta in labor who has a strong urge to push. Abruptio placenta is a serious condition where the placenta detaches from the uterine wall before delivery, leading to significant bleeding and potential compromise to both the mother and baby. The strong urge to push indicates that the baby is in distress and immediate intervention is required to prevent potential harm. This patient needs urgent assessment and intervention to ensure the safety of both the mother and the baby.

Correct Answer: C

Rationale: The scenario describes a woman in active labor with frequent, mild to moderate contractions and significant cervical dilation. If cephalopelvic disproportion (CPD) has been ruled out and the progress of labor is slow despite sufficient dilation and descent of the fetus, it may indicate cephalopelvic disproportion, failure to progress, or other complications that could necessitate a cesarean section (c/s). In this case, providing sedation to allow for rest suggests that the medical team is considering the possibility of further intervention, such as a c/s, if the labor does not progress effectively despite sufficient dilation. Therefore, preparing the woman for a c/s would be the anticipated next step in her care.