A multiparous woman has been in labor for 8 hours. Her membranes have just ruptured spontaneously. The nurse's priority must be to:
Select one:
Prepare the woman for imminent birth
Assess the fetal heart rate and pattern
Notify the woman's primary health care provider
Document the characteristics of the fluid.
The Correct Answer is B
a. This may be necessary once fetal heart rate and pattern have been assessed, but it is not the initial priority.
b. This is the priority as it will help determine the next steps in the management of labor.
c. This may be necessary once fetal heart rate and pattern have been assessed, but it is not the initial priority.
d. This may be done after assessing the fetal heart rate and pattern, but it is not the initial priority.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
a. While this is important, it is not the priority when admitting a pregnant woman who has experienced a bleeding episode in late pregnancy.
b. This is important for managing the bleeding but is not the priority.
c. Monitoring uterine contractions is important, but assessing fetal heart rate (FHR) and maternal vital signs is the priority to determine the status of the fetus and mother.
d. Bleeding in late pregnancy can indicate placental abruption, which is a life- threatening condition for both the mother and the fetus. The nurse should monitor the FHR and maternal vital signs to assess the severity of the bleeding and the fetal and maternal well-being.
Correct Answer is C
Explanation
a. This is a common cause of variable decelerations, not late decelerations.
b. This is a common cause of variable decelerations, not late decelerations.
c. Late decelerations are caused by decreased blood flow to the placenta during contractions, resulting in a reduced oxygen supply to the fetus.
d. This is a common cause of variable decelerations, not late decelerations.
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