A nurse is admitting a client who is in active labor and has had two prior cesarean births. The nurse should identify that the client is at an increased risk for which of the following complications?
Failure to progress
Abruptio placentae
Precipitous labor
Uterine rupture
The Correct Answer is D
Uterine rupture. When a client has had two prior cesarean births, she is at an increased risk for uterine rupture. Uterine rupture is a serious complication that can occur during labor, where there is a tear in the wall of the uterus. It can lead to significant blood loss for the mother and oxygen deprivation for the fetus. Other risk factors for uterine rupture include a previous uterine surgery, the use of labor-inducing drugs, and multiple gestations.
Failure to progress (choice A) refers to a labor that is not progressing as it should, and can be caused by a variety of factors, including fetal malposition or inadequate contractions. Abruptio placentae (choice B) refers to the separation of the placenta from the uterine wall before delivery, which can cause fetal distress and maternal hemorrhage. Precipitous labor (choice C) refers to a labor that progresses extremely quickly, with contractions lasting less than 3 hours from the onset of active labor. While precipitous labor can be associated with increased risk for perineal lacerations and postpartum hemorrhage, it is not typically associated with prior cesarean births.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C"]
Explanation
A. Labor induction with oxytocin: The use of oxytocin for labor induction can increase the risk of postpartum hemorrhage due to uterine atony, where the uterus fails to contract effectively after delivery.
B. History of human papillomavirus: A history of human papillomavirus does not directly increase the risk of postpartum hemorrhage.
C. Vacuum-assisted delivery: Instrumental deliveries, such as those using a vacuum, are associated with an increased risk of trauma to the birth canal, which can contribute to postpartum hemorrhage.
D. Newborn weight 2.948 kg (6 lb 8 oz): A newborn weight of 2.948 kg is within the normal range and does not by itself increase the risk of postpartum hemorrhage. Larger babies (macrosomia) are more commonly associated with an increased risk.
Correct Answer is D
Explanation
The nurse should explain to the client that amniocentesis is a diagnostic test that is performed between 15 and 20 weeks of gestation to determine if the fetus has genetic or congenital disorders. While the procedure can also determine the sex of the fetus, this is not typically the primary reason for the test. The nurse should clarify any misconceptions the client has about the procedure and provide education on its purpose, risks, and benefits. The nurse should also assess the client's understanding of the information provided and address any questions or concerns the client may have.
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