During a vaginal delivery, the obstetrician declares that a shoulder dystocia has occurred.Which of the following actions by the nurse is appropriate at this time?

Administer oxytocin.

Flex the client's thighs sharply toward her abdomen.

Apply oxygen using a tight-fitting face mask.

Apply downward pressure on the client's fundus.

Answer and Explanation

The Correct Answer is B

Choice A rationale

Administering oxytocin during shoulder dystocia can exacerbate the problem by increasing uterine contractions, making it harder to deliver the baby's shoulder.

Choice B rationale

Flexing the client's thighs sharply toward her abdomen, known as the McRoberts maneuver, helps to widen the pelvis and can often resolve shoulder dystocia by changing the angle of the pelvic bones.

Choice C rationale

While applying oxygen is a standard practice to improve maternal and fetal oxygenation, it does not specifically address shoulder dystocia and is not a primary intervention.

Choice D rationale

Applying downward pressure on the fundus is contraindicated as it can worsen shoulder dystocia by further impacting the shoulder against the pelvic bone.

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Correct Answer is A

Explanation

Choice A rationale

Blood pressure of 160/110 indicates severe preeclampsia and warrants immediate intervention to prevent complications. Stopping oxytocin is part of the management of severe preeclampsia to avoid exacerbating the condition.

Choice B rationale

Frequency of contractions every 3 minutes is within the normal range during labor induction and does not warrant stopping the infusion unless there are other concerns.

Choice C rationale

A fetal heart rate of 155 bpm with early decelerations may require close monitoring but does not necessarily warrant stopping the oxytocin infusion. Early decelerations are typically a normal physiological response.

Choice D rationale

Frequency of contractions every 3 minutes is expected during active labor and is generally not a cause to stop the oxytocin infusion. The nurse should continue to monitor the labor progression closely.

A. The patient who is 37 years of age, obese, and experiencing pregnancy-induced hypertension. B. The patient with preexisting hypertension who is currently pregnant with twins. C. The patient who is 16 years of age just diagnosed with gestational diabetes. D. The patient who is 28 years old and delivered a premature neonate 3 years prior.

Correct Answer is A

Explanation

Choice A rationale

A 37-year-old patient with obesity and pregnancy-induced hypertension presents multiple risk factors. Advanced maternal age, obesity, and hypertension collectively increase the likelihood of complications such as preeclampsia, gestational diabetes, and cesarean delivery, necessitating close monitoring and management.

Choice B rationale

A patient with preexisting hypertension and twins is indeed high-risk due to the combined strain on the cardiovascular system and potential for preterm labor or other complications associated with multiple gestations. However, the presence of pregnancy-induced hypertension and obesity in the first patient poses a slightly higher cumulative risk.

Choice C rationale

A 16-year-old patient with newly diagnosed gestational diabetes is at increased risk, particularly because of age and the potential for poorly managed diabetes leading to complications. However, this scenario presents fewer immediate cumulative risks compared to older age and existing hypertension.

Choice D rationale

A 28-year-old patient who had a premature birth three years prior must be monitored for signs of recurrent preterm labor. Yet, this history alone does not present as high a cumulative risk as older maternal age, obesity, and pregnancy-induced hypertension. .

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During a vaginal delivery, the obstetrician declares that a shoulder dystocia has occurred.Which of the following actions by the nurse is appropriate at this time?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with pre-eclampsia with severe features at 38 weeks' gestation is being induced with IV oxytocin.Which of the following would warrant the nurse to stop the infusion?

Correct Answer is A

Explanation

The nurse in a prenatal clinic is reviewing the files of four patients scheduled for visits.Which patient does the nurse identify as having the highest-risk pregnancy?

Correct Answer is A

Explanation

An 18-hour-old baby with an elevated bilirubin level is placed under the bili lights.Which of the following is an expected nursing action in these circumstances?

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