The nurse is discussing with a couple their concerns about ...

[Diane]

The nurse is discussing with a couple their concerns about delivering vaginally after having a cesarean birth. Parents planning on a vaginal birth after a cesarean birth (VBAC) should prepare:
 
  1. Exclusively for a vaginal delivery.
  2. Two birth plans: one for vaginal and one for cesarean.
  3. For a long labor.
  4. For a short labor.

Question 2

The nurse is admitting a patient to the labor and delivery unit. Which aspect of the patient's history requires notifying the physician?
 
  1. Blood pressure 120/88
  2. Father a carrier of sickle-cell trait
  3. Dark red vaginal bleeding
  4. History of domestic abuse

[macagnavarro]

Answer to Question 1

2
Rationale 1: Preparing exclusively for a vaginal delivery will decrease a parent's sense of control over the birth experience if a cesarean needs to be performed.
Rationale 2: In the care of vaginal birth after cesarean birth (VBAC), two birth plans should be prepared: one for vaginal delivery and one for cesarean birth.
Rationale 3: The length of labor (short or long) cannot be determined for a VBAC delivery.
Rationale 4: The length of labor (short or long) cannot be determined for a VBAC delivery.

Answer to Question 2

3
Rationale 1: Although the diastolic reading is slightly elevated, this blood pressure reading is not the top priority.
Rationale 2: The infant also might have sickle-cell trait, but it is not life-threatening at this time.
Rationale 3: Third-trimester bleeding is caused by either placenta previa or abruptio placentae. Dark red bleeding usually indicates abruptio placentae, which is life-threatening to both mother and fetus.
Rationale 4: This patient is at risk for harm after delivery but is not in a life-threatening situation at this time. This is not the highest priority for the patient.

[Diane]

Thank you

[macagnavarro]

No problemo