A primigravida woman at 42 weeks' gestation received Prepidil ...

[asd123]

A primigravida woman at 42 weeks' gestation received Prepidil (dinoprostone) for induction 12 hours ago. The Bishop score is now 3. Which of the following actions by the nurse is appropriate?
 
  a. Perform Nitrazine analysis of the amniotic fluid.
  b. Report the lack of progress to the obstetrician.
  c. Place the woman on her left side.
  d. Ask the doctor for an order for oxytocin.

Question 2

Your patient is a 28-year-old gravida 2 para 1 in active labor. She has been in labor for 12 hours. Upon further assessment, the nurse determines that she is experiencing a hypotonic labor pattern.
 
  Possible maternal and fetal implications from hypotonic labor patterns are:
  a. Intrauterine infection and maternal exhaustion with fetal distress usually occurring early in labor.
  b. Intrauterine infection and maternal exhaustion with fetal distress usually occurring late in labor.
  c. Intrauterine infection and postpartum hemorrhage with fetal distress early in labor.
  d. Intrauterine infection and ruptured uterus and fetal death.

[mmpiza]

Answer to Question 1

ANS: b
Feedback
a. There is nothing in the scenario that implies that the membranes may have ruptured.
b. Little progress has taken place. The Bishop score of a primigravida will need to be 9 or higher before oxytocin will be effective.
c. There is nothing in the scenario that implies that the patient needs to be placed on her side.
d. The Bishop score of a primigravida will need to be 9 or higher before oxytocin will be effective.

Answer to Question 2

ANS: b
Feedback
a. The risk of hypotonic labor occurs later in labor.
b. Hypotonic labor patterns increase risk for infection and maternal exhaustion, with fetal distress occurring late in labor as hypotonic patterns prolong labor.
c. There is not an increased risk of postpartum hemorrhage or fetal distress in early labor.
d. Hypotonic patterns do not result in rupture of the uterus.