A woman at 39 weeks of gestation with a history of preeclampsia ...

[lak]

A woman at 39 weeks of gestation with a history of preeclampsia is admitted to the labor and birth unit.
 
  She suddenly experiences increased contraction frequency of every 1 to 2 minutes; dark red vaginal bleeding; and a tense, painful abdomen. The nurse suspects the onset of:
  a. Eclamptic seizure. c. Placenta previa.
  b. Rupture of the uterus. d. Placental abruption.

Question 2

Your patient is being induced because of her worsening preeclampsia. She is also receiving magnesium sulfate. It appears that her labor has not become active despite several hours of oxytocin administration.
 
  She asks the nurse, Why is it taking so long? The most appropriate response by the nurse would be:
  a. The magnesium is relaxing your uterus and competing with the oxytocin. It may increase the duration of your labor.
  b. I don't know why it is taking so long.
  c. The length of labor varies for different women.
  d. Your baby is just being stubborn.

[jharrington11]

Answer to Question 1

ANS: D
Uterine tenderness in the presence of increasing tone may be the earliest finding of premature separation of the placenta (abruptio placentae or placental abruption). Women with hypertension are at increased risk for an abruption. Eclamptic seizures are evidenced by the presence of generalized tonic-clonic convulsions. Uterine rupture manifests as hypotonic uterine activity, signs of hypovolemia, and in many cases the absence of pain. Placenta previa manifests with bright red, painless vaginal bleeding.

Answer to Question 2

ANS: A
Because magnesium sulfate is a tocolytic agent, its use may increase the duration of labor. The amount of oxytocin needed to stimulate labor may be more than that needed for the woman who is not receiving magnesium sulfate. I don't know why it is taking so long is not an appropriate statement for the nurse to make. Although the length of labor does vary in different women, the most likely reason this woman's labor is protracted is the tocolytic effect of magnesium sulfate. The behavior of the fetus has no bearing on the length of labor.

[lak]

Thank you

[jharrington11]

Happy to help you