A nurse is caring for a client who wants to know if it is possible to have a vaginal birth after a cesarean birth (VBAC). Which of the following statements by the nurse is appropriate?
"There are so many variables that you'll have to ask your provider.".
"A repeat cesarean section would be safer for both you and your baby.".
"The primary consideration is what type of incision you had.".
"It's too soon for you to be worrying about that now.".
The Correct Answer is C
Choice A reason:
This statement is not appropriate because it does not provide any information or education to the client who wants to know about VBAC. It also implies that the nurse does not have any knowledge or expertise on the topic, which may undermine the client's trust and confidence in the nurse.
Choice B reason:
This statement is not appropriate because it is not evidence-based and may discourage the client from considering VBAC as a possible option. According to research, VBAC is associated with fewer complications than an elective repeat C-section for many women who had prior
cesarean deliveries. A repeat C-section also carries risks such as infection, bleeding, injury to organs, and placental problems in future pregnancies.
Choice C reason:
This statement is appropriate because it is accurate and informative. The type of uterine incision used for the prior C-section is one of the most important factors that determine the eligibility and success of VBAC. A low transverse or low vertical incision is usually compatible with VBAC, while a high vertical (classical) incision is not recommended due to the risk of uterine rupture.
Choice D reason:
This statement is not appropriate because it dismisses the client's concern and does not address their question. It also implies that the nurse does not respect the client's autonomy and right to make informed decisions about their care. The client may benefit from learning about VBAC early in their pregnancy so that they can weigh the pros and cons and discuss their preferences with their provider.
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Correct Answer is D
Explanation
Choice A reason:
Injury sustained to the perineum during birth is not a perinatal injury, but a perineal injury. The perineum is the area between the anus and the genitals, and it can be torn or cut during vaginal delivery. This is a common complication that affects the mother, not the fetus or newborn.
Choice B reason:
Traumatic injury to the mother during pregnancy is not a perinatal injury, but a maternal injury. This can occur due to accidents, violence, or complications of pregnancy such as preeclampsia or placental abruption. This can affect the mother's health and well-being, and may also have consequences for the fetus or newborn.
Choice C reason:
Traumatic injury to a fetus is not a perinatal injury, but a fetal injury. This can occur due to external forces such as blunt trauma, penetrating trauma, or radiation exposure that affect the fetus in utero. This can cause fetal distress, bleeding, fractures, or organ damage.
Choice D reason:
Injury sustained surrounding birth is a perinatal injury. This occurs in the period shortly before, during, or after delivery. This can be a critical time when the baby has to transition from surviving off oxygen, blood, and nutrients from the mother to separating from the womb and breathing oxygen from the air. Perinatal injuries can include head injuries, nerve injuries, hemorrhages, fractures, or soft-tissue injuries that result from the forces of labor and delivery or medical interventions such as forceps or vacuum extraction. Perinatal injuries can lead to long-term neurodevelopmental challenges for the newborn.
Correct Answer is ["A","C","D"]
Explanation
Choice A reason:
Swimming is one of the best exercises for pregnant women because it provides moderate aerobic conditioning with minimal stress on your joints. It also supports your increased weight and helps you stay cool and comfortable.
Choice B reason:
Scuba diving is not a safe exercise for pregnant women because it poses a high risk of injury to the baby. The baby has no protection against decompression sickness and gas embolism, which are caused by changes in pressure underwater.
Choice C reason:
Walking is a great exercise for beginners and can be done throughout pregnancy. It improves your cardiovascular fitness, strengthens your muscles and bones, and helps prevent excessive weight gain and gestational diabetes.
Choice D reason:
Yoga can be beneficial for pregnant women as it can improve flexibility, balance, posture, breathing and relaxation. It can also reduce stress, anxiety and back pain. However, some yoga poses may not be suitable for pregnancy, so it is advisable to join a prenatal yoga class or consult a qualified instructor.
Choice E reason:
Snow skiing is not recommended for pregnant women because it involves a high risk of falling and affecting your balance. Falls can cause damage to your baby or placenta, especially in the second and third trimesters.
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