A patient who is pregnant expresses a desire to attempt a vaginal delivery after a cesarean birth 2 years before.
The primary care provider (PCP) initiates trial of labor after cesarean (TOLAC) and vaginal birth after cesarean (VBAC) screening.
The nurse is aware that which patient information will likely disqualify the patient for VBAC?
A low transverse uterine scar.
Patient asks multiple Questions.
First labor needed to be induced.
Cesarean due to pelvic abnormalities.
The Correct Answer is D
Choice A rationale
A low transverse uterine scar is considered the safest type of uterine incision for a VBAC because it is less likely to rupture compared to other types of scars. Therefore, a low transverse uterine scar would not disqualify the patient for VBAC.
Choice B rationale
Patient asking multiple questions does not disqualify her for VBAC. Patient education and ensuring the patient’s understanding and agreement with the procedure is an essential part of the process.
Choice C rationale
Induction of labor in the first pregnancy does not automatically disqualify a patient from attempting VBAC. The success of VBAC depends on multiple factors including the reason for the initial cesarean section.
Choice D rationale
A cesarean due to pelvic abnormalities would disqualify the patient for VBAC because the underlying pelvic condition that necessitated the initial cesarean section is likely still present and would increase the risk of complications during vaginal birth.
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View Related questions
Correct Answer is D
Explanation
Choice A rationale
Precipitous labor and birth are not directly associated with postpartum endometritis. The primary risk factors are related to infections during labor.
Choice B rationale
Postpartum endometritis is typically treated with a combination of antibiotics for 7-10 days, not a single dose of ampicillin or cephalosporin. A single dose would be insufficient for
treating the infection.
Choice C rationale
Postpartum endometritis is more common following cesarean birth due to increased risk of infection despite the use of sterile techniques during surgery.
Choice D rationale
Postpartum endometritis is associated with internal monitoring, amnioinfusion, prolonged labor, and prolonged rupture of membranes. These factors increase the risk of infection,
which can lead to endometritis.
Correct Answer is ["A","B","C","D","E"]
Explanation
Choice A rationale
Hypertensive disorders, such as preeclampsia, increase the risk of placental abruption. They can cause changes in the blood vessels of the placenta, reducing blood flow and increasing the likelihood of separation.
Choice B rationale
Uterine fibroids, which are noncancerous growths in the uterus, can interfere with the proper attachment of the placenta, raising the risk of placental abruption.
Choice C rationale
Cigarette smoking contributes to placental abruption by reducing oxygen supply to the placenta, causing placental insufficiency and increasing the risk of premature separation.
Choice D rationale
Abdominal trauma, such as from a fall or car accident, can cause mechanical disruption of the placenta, leading to abruption.
Choice E rationale
Methamphetamine use can cause vasoconstriction and hypertension, which compromise placental blood flow and increase the risk of abruption.