A client is consulting a certified nursemidwife because she is ...

[chandani]

A client is consulting a certified nursemidwife because she is hoping for a vaginal birth after cesarean (VBAC) for this pregnancy. Which statement indicates that the client requires more in-formation about VBAC?
 
  1. I can try a vaginal birth because my uterine incision is a low segment transverse incision.
  2. The vertical scar on my skin doesn't mean that the scar on my uterus goes in the same direc-tion.
  3. There is about a 90 chance of giving birth vaginally after a cesarean.
  4. Because my hospital has a surgery staff on call 24 hours a day, I can try a VBAC there.

Question 2

The clinic nurse is compiling informational data for a yearly report. Which of the following clients would be classified as a primigravida?
 
  1. A client at 18 weeks' gestation who had a spontaneous loss at 12 weeks
  2. A client at 13 weeks' gestation who had an ectopic pregnancy at 8 weeks
  3. A client at 14 weeks' gestation who has a 3-year-old daughter at home
  4. A client at 15 weeks' gestation who has never been pregnant before

[Melissahxx]

Answer to Question 1

3
Rationale:
1. Only low segment transverse uterine incisions are recommended for attempting a VBAC.
2. Abdominal skin incisions and uterine incisions are not always the same.
3. Recent media reports identifying risks of VBAC have reintroduced the debate regarding its safety.
4. VBAC should only be attempted in facilities that have 24-hour coverage of operating room staff and anesthesia.

Answer to Question 2

4
Rationale: Primigravida can be broken down into the Latin roots: primi (prime, or first) and gravida (pregnancy). A pregnant woman who has had a pregnancy end before 20 weeks is considered a primipara. A pregnant woman who has been pregnant before is called a multigravida.
1. Primigravida can be broken down into the Latin roots: primi (prime, or first) and gravida (pregnancy). A pregnant woman who has had a pregnancy end before 20 weeks is considered a primipara. A pregnant woman who has been pregnant before is called a multigravida.
2. Primigravida can be broken down into the Latin roots: primi (prime, or first) and gravida (pregnancy). A pregnant woman who has had a pregnancy end before 20 weeks is considered a primipara. A pregnant woman who has been pregnant before is called a multigravida.
3. Primigravida can be broken down into the Latin roots: primi (prime, or first) and gravida (pregnancy). A pregnant woman who has had a pregnancy end before 20 weeks is considered a primipara. A pregnant woman who has been pregnant before is called a multigravida
4. Primigravida can be broken down into the Latin roots: primi (prime, or first) and gravida (pregnancy). A pregnant woman who has had a pregnancy end before 20 weeks is considered a primipara. A pregnant woman who has been pregnant before is called a multigravida