What person is at high risk for labor dystocia?

Correct Answer: B

Rationale: Labor dystocia refers to difficult or prolonged labor, which can increase the risk of complications for both the mother and baby. A 41-year-old woman is at high risk for labor dystocia due to advanced maternal age. As women age, their uterine muscles may not contract as effectively, leading to inefficient labor progress. This can result in prolonged labor, increased risk of instrumental deliveries (forceps or vacuum), and higher rates of cesarean sections. Choice A, 38-week gestation, is not necessarily a risk factor for labor dystocia. Full-term pregnancy is considered to be between 37-42 weeks, so a 38-week gestation is within the normal range and does not inherently increase the risk of labor dystocia. Choice C, prenatal anemia, can contribute to maternal fatigue and weakness during labor, but it is not a direct risk factor for labor dystocia. Anemia can be managed with appropriate prenatal care and iron supplementation to reduce its impact on labor. Choice D, no prenatal care, is a significant risk factor for various complications during pregnancy and labor, but it is not directly associated with labor dystocia. Lack of prenatal care can lead to undiagnosed medical conditions, inadequate monitoring of fetal well-being, and missed opportunities for interventions that could prevent labor dystocia. In conclusion, a 41-year-old woman is at high risk for labor dystocia due to advanced maternal age, while the other choices are not directly linked to this specific complication. It is important for healthcare providers to recognize these risk factors and provide appropriate management to optimize outcomes for both the mother and baby.

Correct Answer: A

Rationale: A: Assessing deep tendon reflexes for hyperreflexia is the correct nursing intervention for preeclampsia because hyperreflexia is a common sign of worsening preeclampsia. This assessment helps in early detection of neurological complications such as eclampsia, which is a severe form of preeclampsia characterized by seizures. Prompt identification of hyperreflexia allows for timely intervention to prevent further complications. B: Providing frequent IV fluid boluses is not the appropriate intervention for preeclampsia. In fact, excessive fluid administration can exacerbate hypertension and lead to fluid overload, putting the patient at risk for pulmonary edema. Careful fluid management is crucial in managing preeclampsia, but it should be done judiciously and based on the patient's fluid status. C: Educating the laboring person that preeclampsia is only a concern for pregnancy, not labor, is incorrect. Preeclampsia is a serious pregnancy complication characterized by high blood pressure and signs of damage to other organ systems. It can occur before, during, or after labor, and it requires close monitoring and management throughout the perinatal period to ensure the safety of both the parent and the baby. D: Discouraging pain medication in order to assess for a headache is not a recommended nursing intervention for preeclampsia. Headaches are a common symptom of preeclampsia, and pain management should be provided to alleviate discomfort and improve the patient's overall well-being. Delaying pain relief can lead to unnecessary suffering and does not contribute to the assessment and management of preeclampsia.

Correct Answer: C

Rationale: Intrauterine fetal demise refers to the death of a fetus inside the uterus before birth. One of the signs of intrauterine fetal demise is decreased or absent fetal movement. This occurs because the fetus is no longer alive and therefore cannot move. Fetal movement is a reassuring sign of fetal well-being, so a lack of movement is concerning. Increased fetal heart rate (Choice A) is not a sign of intrauterine fetal demise. In fact, a rapid fetal heart rate can indicate fetal distress or other issues, but it is not typically associated with fetal demise. Vaginal bleeding (Choice B) can be a sign of various complications during pregnancy, such as placental abruption or placenta previa, but it is not a specific sign of intrauterine fetal demise. Macrosomia (Choice D) refers to a baby who is significantly larger than average at birth. This is not a sign of intrauterine fetal demise but rather a risk factor for complications during delivery, such as shoulder dystocia. In summary, the correct answer is C because decreased or absent fetal movement is a significant sign of intrauterine fetal demise, while the other choices are not specific indicators of this condition.

Correct Answer: A

Rationale: Malnutrition during pregnancy is associated with fetal growth restriction. This is because when a pregnant woman does not consume enough essential nutrients, the developing fetus may not receive adequate nourishment for optimal growth and development. This can lead to low birth weight, small for gestational age, or intrauterine growth restriction. Choice B, fetal macrosomia, is incorrect because this condition refers to a baby being significantly larger than average at birth. This is typically associated with maternal diabetes or excessive weight gain during pregnancy, not malnutrition. Choice C, group B strep, is incorrect because this is a type of bacterial infection that can be passed from a mother to her baby during childbirth. It is not directly related to maternal malnutrition during pregnancy. Choice D, precipitous birth, is incorrect because this term refers to an unusually quick labor and delivery, which can occur regardless of the mother's nutritional status during pregnancy. In summary, malnutrition during pregnancy is associated with fetal growth restriction due to the lack of essential nutrients for proper fetal development. It is important for pregnant women to maintain a balanced diet to support the health and growth of their baby.

Correct Answer: A

Rationale: Vacuum extractors are commonly used during vaginal deliveries to assist with the extraction of the baby. One potential complication of vacuum extractor use is a cephalohematoma, which is the collection of blood between the skull bone and its fibrous covering. This can occur due to the pressure exerted on the baby's head during the extraction process, leading to a localized swelling. Choice B, face presentation, is not a fetal complication of vacuum extractor use. Face presentation refers to the position of the baby's head during delivery, where the face presents first instead of the top of the head. This is a different issue unrelated to vacuum extraction. Choice C, fetal growth restriction, is also not a fetal complication of vacuum extractor use. Fetal growth restriction occurs when a baby does not grow at the expected rate inside the womb, leading to a smaller than average size. This is a result of various factors such as maternal health, placental issues, or genetic factors, rather than vacuum extraction. Choice D, scalp fracture, is not a common complication of vacuum extractor use. While it is possible for a scalp fracture to occur during a difficult delivery, it is not specific to vacuum extraction. Scalp fractures are more commonly associated with the use of forceps or other instruments during delivery, rather than vacuum extraction. In summary, the correct answer is A (cephalohematoma) because it is a recognized fetal complication of vacuum extractor use. Face presentation (B), fetal growth restriction (C), and scalp fracture (D) are not directly related to vacuum extraction and do not typically result from its use.