The nurse in the birthing unit is aware that according to the ...

[mynx]

The nurse in the birthing unit is aware that according to the Emergency Medical Treatment and Active Labor Act (EMTALA), pregnant women should receive care for problems such as which of the following? (Select all that apply.)
 
  A.
  A history of recent trauma
  B.
  Contractions that occur 20 minutes apart
  C.
  Decreased fetal movement
  D.
  Rupture of the membranes
  E.
  Sexually transmitted infections

Question 2

A nurse is caring for a new mother during the fourth stage of labor and assesses the following: patient has soaked two peri-pads in 45 minutes, pulse is 118 beats/minute, and blood pressure is 90/62 mm Hg. Which action by the nurse is most important?
 
  A.
  Assess the firmness of the patient's uterus.
  B.
  Document the findings and reassess in 15 minutes.
  C.
  Encourage the woman to attempt breastfeeding.
  D.
  Escort the woman to the bathroom to void.

[joechoochoy]

Answer to Question 1

ANS: A, C, D
The federal regulation known as the Emergency Medical Treatment and Active Labor Act (EMTALA) was created to ensure that all women receive emergency treatment or active labor care whenever such treatment is sought. The nurse who is working in a birthing unit must be familiar with the full range of responsibilities included in the EMTALA regulations: (1) provide services to pregnant women when an urgent pregnancy problem such as labor, rupture of the membranes, decreased fetal movement, or recent trauma is experienced; and (2) fully document all relevant information to include assessment findings, interventions implemented, and the patient's response to the care provided. Treatment would not be required for women whose contractions are 20 minutes apart or who may have sexually transmitted infections.

Answer to Question 2

ANS: A
Hypotension, tachycardia, excessive bleeding (more than one peri-pad in the first hour), and a boggy, noncontracting uterus are all danger signs of postpartum hemorrhage. Based on this woman's signs and symptoms, the nurse should assess her uterus and, if necessary, begin uterine massage. Documentation needs to be thorough, but further action is needed. Breastfeeding does stimulate the uterus, but this action is not the priority in a possible emergent situation. A hypotensive woman should not be ambulated.