The patient has delivered a 4,200g fetus. The physician performed ...

[joesmith1212]

The patient has delivered a 4,200g fetus. The physician performed a midline episiotomy, which extended into a third-degree laceration. The patient asks the nurse where she tore. Which response is best? The episiotomy extended and tore:
 
  1. Through your rectal mucosa.
  2. Up near your urethra.
  3. Into the muscle layer.
  4. Through your rectal sphincter.

Question 2

The nurse is caring for a laboring patient with known cephalopelvic disproportion (CPD). The woman develops tachysystolic labor patterns. Which possible course of treatment should the nurse anticipate?
 
  1. Oxytocin administration
  2. Cesarean section
  3. Nipple stimulation
  4. Amniotomy

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Answer to Question 1

Correct Answer: 4
Rationale 1: A fourth-degree laceration is through the rectal mucosa.
Rationale 2: A periurethral laceration is near the urethra.
Rationale 3: A first-degree laceration involves only the skin. A second-degree laceration involves skin and muscle.
Rationale 4: A third-degree laceration includes the rectal sphincter.

Answer to Question 2

Correct Answer: 2
Rationale: Cesarean section is the most likely course of action. Oxytocin, amniotomy, and nipple stimulation are all indicated for induction of labor. With cephalopelvic disproportion (CPD), a cesarean birth is indicated, as vaginal delivery cannot be performed.