nursing 223 maternity case 3 amelia sung exams questions and answers 20222023 verified answers
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NURSING 223
NURSING 223
NURSING 223
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Maternity Case Amelia Sung
1. Which of the following pregnancy-related conditions increase the risk
for shoulder dystocia?: Uncontrolled maternal gestational diabetes
Rationale: Uncontrolled gestational diabetes leads to fetal
macrosomia, fat pads at the fetal neck, and increased maternal weight
gain, all factors that increase the incidence of shoulder dystocia.
Preeclampsia and IUGR both result in smaller infants and thus do not
increase the risk of shoulder dystocia. Hyperemesis, while it can
continue throughout the pregnancy, is generally a problem of the first
trimester and not related to the delivery.
2. The nurse documents the following events: crowning at 0749, fetal head
emerged at 0800, McRobert's maneuver performed at 0802, suprapubic
pres- sure applied at 0806, and fetal body delivered at 0808. What is the
signifi- cance of documenting these events?: Provides an indicator of the
potential for fetal compromise
Rationale: Documenting this sequence of events provides an indicator
of the potential for fetal compromise related to decreased
1/
,oxygenation. The time of birth is when the entire body is born. The
focus is on the well-being of the mother
and fetus/baby, not the team's response. The Apgar score is assigned
using the standard criteria.
3. The nurse has assessed that the patient in labor is at risk of shoulder
dystocia. After delivery of the fetal head, the nurse states in a clear, loud
voice, "Fetal heart rate 90 beats per minute with minimal variability." Why
is it important for the nurse to communicate this information?: To inform
the provider about the fetal status
Rationale: A call-out is a clear and concise statement of data or an
event that everyone on the health care team needs to know to care for
the patient effectively. Changes in the FHR are not routinely
announced in the delivery room, but in this situation the call-out by the
nurse is important to give data to the provider so the provider can
evaluate the fetal status and determine the next course of action. The
patient is focused on pushing out the fetus, so the information is not
for her benefit. The nurse's interpretation of routine fetal activity is
documented in the patient's chart, not verbally.
2/
, 4. What is the first action by the nurse to assist with the delivery of the fetal
shoulders and body when there is shoulder dystocia?: Flex the mother's
thighs toward her abdomen
3/
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