A primigravida at 40 weeks of gestation is having uterine contractions every 1.5 to 2 minutes and states that they are very painful. Her cervix is dilated 2 cm and has not changed in 3 hours. The woman is crying and wants an epidural. What is the likely status of this woman's labor?
She is exhibiting hypertonic uterine dysfunction.
She is experiencing a normal latent stage.
She is experiencing precipitous labor.
She is exhibiting hypotonic uterine dysfunction.
The Correct Answer is A
Choice A reason: She is exhibiting hypertonic uterine dysfunction, because she has frequent and painful contractions that are ineffective in dilating the cervix. Hypertonic uterine dysfunction occurs when the uterus contracts too often and too forcefully, resulting in poor oxygenation and fetal distress. The woman may need tocolytic therapy, pain relief, and hydration.
Choice B reason: She is not experiencing a normal latent stage, because her contractions are too frequent and too painful for this phase of labor. The normal latent stage is characterized by irregular and mild contractions that gradually increase in frequency and intensity, and cervical dilation from 0 to 3 cm.
Choice C reason: She is not experiencing precipitous labor, because her labor is not progressing rapidly. Precipitous labor is defined as labor that lasts less than 3 hours from the onset of contractions to the delivery of the baby. It is associated with cervical dilation of more than 5 cm per hour.
Choice D reason: She is not exhibiting hypotonic uterine dysfunction, because her contractions are not weak or infrequent. Hypotonic uterine dysfunction occurs when the uterus contracts too weakly or too rarely, resulting in prolonged labor and increased risk of infection. The woman may need oxytocin augmentation, amniotomy, or cesarean section.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Elevated blood pressure is a hallmark sign of preeclampsia, which is a hypertensive disorder of pregnancy that can cause serious complications, such as eclampsia, HELLP syndrome, or placental abruption. The nurse should monitor the client's blood pressure regularly and report any readings above 140/90 mm Hg to the provider.
Choice B reason: Increased urine output is not a sign of preeclampsia, but rather a normal physiological change of pregnancy, as the renal blood flow and glomerular filtration rate increase. A client with preeclampsia may have decreased urine output, which can indicate renal impairment or oligohydramnios.
Choice C reason: Joint pain is not a sign of preeclampsia, but rather a common discomfort of pregnancy, as the hormones relaxin and progesterone loosen the ligaments and joints. A client with preeclampsia may have epigastric pain, which can indicate liver involvement or impending eclampsia.
Choice D reason: Vaginal discharge is not a sign of preeclampsia, but rather a normal occurrence of pregnancy, as the cervical glands secrete more mucus to protect the uterus from infection. A client with preeclampsia may have vaginal bleeding, which can indicate placental abruption or disseminated intravascular coagulation.
Correct Answer is C
Explanation
Choice A reason: Glipizide is not an appropriate medication for the client, because it is a sulfonylurea that can cross the placenta and cause fetal hypoglycemia, hyperinsulinemia, and macrosomia. Glipizide is contraindicated in pregnancy.
Choice B reason: Acarbose is not an appropriate medication for the client, because it is an alpha-glucosidase inhibitor that can cause gastrointestinal side effects, such as flatulence, diarrhea, and abdominal pain. Acarbose is not recommended in pregnancy.
Choice C reason: Glyburide is an appropriate medication for the client, because it is a sulfonylurea that has a low placental transfer and a minimal risk of fetal hypoglycemia. Glyburide is considered safe and effective in pregnancy.
Choice D reason: Repaglinide is not an appropriate medication for the client, because it is a meglitinide that can cross the placenta and cause fetal hypoglycemia and teratogenic effects. Repaglinide is contraindicated in pregnancy.
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