Which presentation is most likely to occur with a hypertonic ...

[HCHenry]

Which presentation is most likely to occur with a hypertonic labor pattern? (Select all that apply.)
 
  a. Increased risk for placenta previa
  b. Painful uterine contractions
  c. Increased resting tone
  d. Uterine vasodilation
  e. Increased uterine pressure
  f. Effective uterine contraction

Question 2

Emergency measures used in the treatment of a prolapsed cord include which of the following? (Select all that apply.)
 
  a. Administration of oxygen via face mask at 8 to 10 L/min
  b. Maternal change of position to knee-chest
  c. Administration of tocolytic agent
  d. Administration of oxytocin (Pitocin)
  e. Vaginal elevation
  f. Insertion of cord back into vaginal area

[Dunkey]

Answer to Question 1

ANS: B, C, E
Hypertonic labor patterns indicate increased uterine pressure and resting tone. Uterine ischemia occurs, leading to vasoconstriction and constant cramplike abdominal pain. Thus, there is an increased risk for placental abruption as compared with placenta previa, which is based on malpresentation of the placental attachment. The contractions are painful but not effective for progression of labor.

Answer to Question 2

ANS: A, B, C, E
Prolapsed cord is a medical emergency. Oxygen should be administered to the mother to increase perfusion from mother to fetus. The maternal position change to knee-chest or Trendelenburg to offset pressure on the presenting cord should be done. A tocolytic drug such as terbutaline inhibits contractions, increasing placental blood flow and reducing intermittent pressure of the fetus against the pelvis and cord. Vaginal elevation should be done to offset pressure on the presenting cord. Pitocin and manipulation of the cord by reinsertion are contraindicated.

[HCHenry]

TYSM

[scottmt]

Thanks for the timely response, appreciate it