When reviewing the prenatal record of a client at 42 weeks' ...

[vHAUNG6011]

When reviewing the prenatal record of a client at 42 weeks' gestation, the nurse recognizes that induction of labor is indicated based on the finding of:
 
  a. reduced amniotic fluid volume.
  b. cervix 2 cm at last prenatal visit.
  c. fundal height measured at the xyphoid process.
  d. 1-pound weight gain at each of the last two weekly visits.

Question 2

Which assessment finding indicates a complication in the client attempting a vaginal birth after cesarean (VBAC)?
 
  a. Complaint of pain between the scapulae
  b. Change in fetal baseline from 128 to 132 bpm
  c. Contractions every 3 minutes lasting 70 seconds
  d. Pain level of 6 on scale of 0 to 10 during acme of contraction

[katheyjon]

Answer to Question 1

ANS: A
Reduced amniotic fluid volume (oligohydramnios) often accompanies placental insufficiency and can result in fetal hypoxia. Lack of adequate amniotic fluid can result in umbilical cord compression; cervix 2 cm at last prenatal visit, fundal height measured at the xyphoid process, and 1-pound weight gain at each of the last two weekly visits are normal prenatal findings for a 42-week gestation.

Answer to Question 2

ANS: A
A client attempting a VBAC is at greater risk for uterine rupture. As blood leaks into the abdomen, pain occurs between the scapulae or in the chest because of irritation from blood below the diaphragm; a change in the fetal baseline from 128 to 132 bpm, contractions every 3 minutes lasting 70 seconds, and a pain level of 6 on a scale of 0 to 10 during the acme of contraction would be normal findings during labor.