Following a normal spontaneous vaginal delivery (NSVD), a 28 year old G3 now P3 mother develops sudden onset shortness of breath, hypoxia and cyanosis. The delivery room nurse quickly recognizes these symptoms as possible:
Select one:
Manifestations of uteroplacental insufficiency.
Manifestations of prolapsed cord.
Manifestations of anaphylactoid syndrome of pregnancy.
Manifestations of an acute asthmatic episode.
The Correct Answer is C
Choice A Reason: Manifestations of uteroplacental insufficiency. This is an incorrect answer that describes a different condition that affects the fetus, not the mother. Uteroplacental insufficiency is a condition where the placenta fails to deliver adequate oxygen and nutrients to the fetus, which can result in fetal growth restriction, distress, or demise. Uteroplacental insufficiency does not cause shortness of breath, hypoxia, or cyanosis in the mother.
Choice B Reason: Manifestations of prolapsed cord. This is an incorrect answer that refers to another condition that affects the fetus, not the mother. Prolapsed cord is a condition where the umbilical cord slips through the cervix before the baby and becomes compressed by the fetal head, which can reduce oxygen flow to the fetus. Prolapsed cord does not cause shortness of breath, hypoxia, or cyanosis in the mother.
Choice C Reason: Manifestations of anaphylactoid syndrome of pregnancy. This is because anaphylactoid syndrome of pregnancy, also known as amniotic fluid embolism, is a rare and fatal condition where amniotic fluid enters into the maternal bloodstream and causes an allergic reaction, which can lead to respiratory failure, cardiac arrest, coagulopathy, and coma. Anaphylactoid syndrome of pregnancy can occur during or after labor and delivery, especially in cases of NSVD, multiparity, advanced maternal age, or placental abruption.
Choice D Reason: Manifestations of an acute asthmatic episode. This is an incorrect answer that assumes that the mother has a history of asthma or an allergic trigger. Asthma is a chronic inflammatory disorder of the airways that causes wheezing, coughing, chest tightness, and dyspnea. Asthma can be exacerbated by pregnancy or labor, but it is not a common cause of sudden onset respiratory distress in the postpartum period.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason: Episodes of hypoglycemia and hyperglycemia. This is because episodes of hypoglycemia and hyperglycemia are common complications of diabetes during pregnancy, which can affect both the mother and the fetus. Hypoglycemia is a condition where the blood glucose level drops below the normal range, which can cause symptoms such as sweating, trembling, hunger, confusion, or loss of consciousness. Hyperglycemia is a condition where the blood glucose level rises above the normal range, which can cause symptoms such as thirst, polyuria, fatigue, blurred vision, or ketoacidosis. Diabetes during pregnancy requires careful monitoring and management of blood glucose levels to prevent adverse outcomes such as fetal macrosomia, congenital anomalies, stillbirth, or neonatal hypoglycemia.
Choice B Reason: Postpartum hemorrhage. This is an incorrect answer that refers to a different complication that may occur after delivery, not during pregnancy. Postpartum hemorrhage is excessive bleeding from the uterus or genital tract after delivery, which can cause hypovolemic shock, anemia, or death. Postpartum hemorrhage can be caused by uterine atony, retained placenta, lacerations, or coagulation disorders.
Choice C Reason: Cerebrovascular accident (CVA). This is an incorrect answer that indicates a rare and severe complication that may occur during or after pregnancy, not specifically related to diabetes. CVA is also known as stroke, which is an interruption of blood flow to the brain due to ischemia or hemorrhage, which can cause neurological deficits or death. CVA can be caused by hypertension, preeclampsia-eclampsia, thrombophilia, or vascular malformations.
Choice D Reason: Acute vasospasm. This is an incorrect answer that suggests a different condition that may occur during pregnancy, not associated with diabetes. Acute vasospasm is also known as Raynaud's phenomenon, which is a disorder of blood vessels that causes them to narrow and reduce blood flow to the extremities in response to cold or stress, which can cause pain, numbness, or color changes. Acute vasospasm can be triggered by smoking, medications, or autoimmune diseases.
Correct Answer is A
Explanation
Choice A Reason: Docusate sodium (Colace). This is because docusate sodium is a stool softener that can prevent constipation and straining during defecation, which can aggravate or impair the healing of a perineal laceration. A fourth-degree perineal laceration is a severe tear that extends through the skin, muscles, perineal body, and anal sphincter into the rectal mucosa. It can occur during vaginal delivery due to factors such as fetal macrosomia, forceps use, or episiotomy.
Choice B Reason: Bromocriptine (Parlodel). This is an inappropriate medication for a postpartum client with a fourth- degree perineal laceration, as it has no effect on wound healing or pain relief. Bromocriptine is a dopamine agonist that can suppress lactation by inhibiting prolactin secretion. It is used for women who do not wish to breastfeed or who have medical contraindications to breastfeeding.
Choice C Reason: Ferrous sulfate (Feosol). This is an unnecessary medication for a postpartum client with a fourth- degree perineal laceration, unless she has iron deficiency anemia. Ferrous sulfate is an iron supplement that can treat or prevent anemia by increasing hemoglobin production and oxygen-carrying capacity. Anemia can occur in the postpartum period due to blood loss during delivery or poor nutritional intake during pregnancy.
Choice D Reason: Methylergonovine (Methergine). This is an irrelevant medication for a postpartum client with a fourth-degree perineal laceration, as it does not affect wound healing or pain relief. Methylergonovine is an ergot alkaloid that can stimulate uterine contractions and reduce postpartum bleeding. It is used for women who have uterine atony or hemorrhage.
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