Major perineal trauma (extension to or through the anal ...

[cmoore54]

Major perineal trauma (extension to or through the anal sphincter) is more likely to occur if what type of episiotomy is performed?
 
  1. Mediolateral
  2. Episiorrhaphy
  3. Midline
  4. Medical

Question 2

Two hours ago, a patient at 39 weeks' gestation was 3 cm dilated, 40 effaced, and +1 station. Frequency of contractions was every 5 minutes with duration 40 seconds and intensity 50 mmHg.
 
  The current assessment is 4 cm dilated, 40 effaced, and +1 station. Frequency of contractions is now every 3 minutes with 4050 seconds' duration and intensity of 40 mmHg. The priority intervention would be: 1. Beginning oxytocin after assessing for CPD.
  2. Giving terbutaline to stop the preterm labor.
  3. Starting oxygen at 8 L/min.
  4. Having the anesthesiologist give the patient an epidural.

[fatboyy09]

Answer to Question 1

3
Explanation: 3. Major perineal trauma is more likely to occur if a midline episiotomy is performed. The major disadvantage is that a tear of the midline incision may extend through the anal sphincter and rectum.

Answer to Question 2

1
Rationale 1: The patient is having hypertonic contractions. The presence of CPD can prolong labor, so it is important to rule this out. Oxytocin (Pitocin) can create a more productive labor pattern by strengthening the contractions.
Rationale 2: Terbutaline would not be recommended. The contraction pattern is incoordinate, but the contractions need to be enhanced, not stopped.
Rationale 3: Oxygen will not hurt, but it is not the priority.
Rationale 4: An epidural will not change the incoordinate contraction pattern.

[cmoore54]

Correct answers!

[fatboyy09]

Great! Please up vote