ATI RN
Intrapartum-Related Complications Questions
Question 1 of 5
What is the most likely cause for this fetal heart rate pattern?
Correct Answer: B
Rationale: The fetal heart rate pattern described in the question, which likely includes decelerations, is indicative of cord compression. Cord compression occurs when there is pressure on the umbilical cord, leading to temporary reduction or blockage of blood flow and oxygen supply to the fetus. This can result in variable decelerations in the fetal heart rate pattern. Common scenarios that can cause cord compression include changes in fetal position, cord prolapse, or excessive uterine contractions. It is important to promptly address cord compression to prevent fetal distress and potential complications during labor and delivery. The other options listed may also influence fetal heart rate, but in this scenario, cord compression is the most likely cause based on the described heart rate pattern.
Question 2 of 5
A patient at 41 weeks' gestation is undergoing an induction of labor with an IV administration of oxytocin (Pitocin). The fetal heart rate starts to demonstrate a recurrent pattern of late decelerations with moderate variability. What is the nurse's priority action?
Correct Answer: A
Rationale: The priority action for the nurse in this situation is to stop the infusion of Pitocin. Late decelerations are a concerning fetal heart rate pattern that indicates uteroplacental insufficiency. Oxytocin (Pitocin) can cause hyperstimulation of the uterus, leading to poor oxygenation of the fetus and resulting in late decelerations. Stopping the Pitocin infusion can help to improve placental perfusion and oxygenation to the fetus, potentially reversing the late decelerations. It is crucial to address the fetal distress promptly to prevent further compromise and ensure the safety of both the mother and the baby. Other interventions, such as repositioning the patient or preparing for a cesarean birth, may also be necessary but should occur after stopping the Pitocin infusion.
Question 3 of 5
The nurse recognizes that fetal scalp stimulation may be prescribed to evaluate the response of the fetus to tactile stimulation. Which conditions contraindicate the use of fetal scalp stimulation? (Select all that apply.)
Correct Answer: A
Rationale: Intrapartum monitoring is crucial to assess fetal well-being during labor. Fetal scalp stimulation is a procedure used to evaluate fetal response to tactile stimulation. In the context of contraindications, a post-term fetus is at risk of decreased amniotic fluid levels and placental insufficiency, making it unsuitable for fetal scalp stimulation as it may further stress the fetus. Maternal fever is a sign of infection, which can lead to fetal distress and compromise fetal well-being, making it a contraindication for fetal scalp stimulation due to the potential exacerbation of the existing condition. Placenta previa, a condition where the placenta partially or fully covers the cervix, poses a risk of hemorrhage during fetal scalp stimulation due to the proximity of the placenta to the cervix. Induction of labor itself is not a contraindication for fetal scalp stimulation. In fact, it may be a reason to perform fetal scalp stimulation to assess fetal well-being during labor induction. Educationally, understanding the contraindications to fetal scalp stimulation is vital for nurses and healthcare providers involved in intrapartum care. It ensures the safety of both the fetus and the mother during labor and delivery. By recognizing these contraindications, healthcare providers can make informed decisions regarding the appropriate interventions for fetal assessment during labor.
Question 4 of 5
The nurse is educating a primigravida patient during her first prenatal clinic appointment about follow-up prenatal care. How often will follow-up prenatal clinic visits be scheduled if the patient has a low-risk pregnancy and develops no complications? Select all that apply.
Correct Answer: C
Rationale: The correct answer is C) Every 4 weeks until 28 weeks. In a low-risk pregnancy with no complications, prenatal care typically involves more frequent visits early on to monitor the initial stages of pregnancy and then gradually spaces them out as the pregnancy progresses. Option A is incorrect because visiting every 2 weeks for the first 28 weeks is too frequent for a low-risk pregnancy without complications. Option B is incorrect because transitioning to every 4 weeks at 30 weeks is too late to start spacing out appointments. Option D is incorrect because increasing the frequency to every 2 weeks after 28 weeks is unnecessary in the absence of complications. Educationally, understanding the appropriate schedule of prenatal visits is essential for ensuring optimal maternal and fetal health outcomes. By spacing out appointments appropriately, healthcare providers can monitor the progress of the pregnancy, address any emerging issues early, and provide necessary support and guidance to the expectant mother. This knowledge empowers both the healthcare provider and the patient to collaborate effectively in promoting a healthy pregnancy and birth.
Question 5 of 5
A pregnant woman is being seen at her first prenatal visit. The RN should correct which action of a student nurse who is preparing the client for a pelvic examination?
Correct Answer: A
Rationale: In this scenario, the correct answer is option A) Asking the client if she needs something to drink. The student nurse should not offer the client something to drink before a pelvic examination as it can lead to complications if the client requires anesthesia during the procedure. Assembling the necessary equipment (option B) is a crucial step in preparing for a pelvic examination, so this action is appropriate. Positioning the client in the lithotomy position (option C) is also a necessary step for a pelvic examination. Explaining the procedure (option D) is an essential part of providing client-centered care and promoting informed consent. However, ensuring the client's safety and well-being by refraining from offering liquids before the examination takes precedence in this situation. Educationally, this question highlights the importance of understanding pre-procedural care and safety considerations in obstetric settings. It emphasizes the significance of adhering to protocols to prevent potential complications and ensure the best possible outcomes for pregnant clients.