Author Question: A diabetic patient goes into labor at 36 weeks' gestation. Provided that tests for fetal lung ... (Read 65 times)

soccerdreamer_17 · **on:** Jun 27, 2018

A diabetic patient goes into labor at 36 weeks' gestation. Provided that tests for fetal lung maturity are successful, the nurse will anticipate: Note: Credit will be given only if all correct and no incorrect choices are selected.

Select all that apply. 1. Administration of tocolytic therapy.
2. Beta-sympathomimetic administration.
3. Allowance of labor to progress.
4. Hourly blood glucose monitoring.
5. Cesarean birth if the HgbA1c is 7.

Question 2

The patient requires vacuum extraction assistance. To provide easier access to the fetal head, the physician cuts a mediolateral episiotomy. After delivery, the patient asks the nurse to describe the episiotomy.

The nurse responds, The episiotomy: 1. Goes straight back toward your rectum.
2. Is from your vagina toward the urethra.
3. Is cut diagonally away from your vagina.
4. Extends from your vagina into your rectum.

kingfahad97 · **Reply #1 on:** Jun 27, 2018

Answer to Question 1

3,4
Rationale 1: Tocolytic therapy will not be used, as it can increase the maternal blood glucose.
Rationale 2: B-sympathomimetics will not be administered, as they can increase the maternal blood glucose.
Rationale 3: There will be no attempt to stop the labor, as this can compromise the mother and fetus.
Rationale 4: A euglycemic state is desirable to avoid fetal hypoglycemia.
Rationale 5: A cesarean birth would be considered if the HgbA1c were increasing, as this would indicate sustained hyperglycemia.

Answer to Question 2

3
Rationale 1: A midline episiotomy is straight back from the vagina toward the rectum.
Rationale 2: Episiotomies are not cut anteriorly toward the urethra unless the patient has had a female circumcision.
Rationale 3: A mediolateral episiotomy is angled from the vaginal opening toward the buttock.
Rationale 4: Extension into the rectum is a fourth-degree laceration.