Mia is a G7P6 who is 39 weeks and 2 days. She has come to obstetrics (OB) triage complaining of contraction pain every 3 to 5 minutes, has a large amount of bloody show, and tells you her last two deliveries took about 2 hours.
What would you expect her diagnosis to be and what would be your next step?
She is experiencing labor dystocia. The provider will be called to assess the need for an immediate cesarean section, and you would begin to prepare the patient for surgery.
She is at risk for a precipitous labor. The provider will be called to the bedside immediately while you remain at Mia's side providing support and preparing her for delivery.
She is at risk for cephalopelvic disproportion. The provider will be called to assess the need for a forceps delivery, and you will call the blood bank in order to have blood on standby.
She is experiencing false labor. The provider will be called to reassess and you will monitor her closely.
The Correct Answer is B
Choice A rationale
Labor dystocia involves prolonged labor. Her fast delivery history suggests the opposite, indicating rapid labor progress.
Choice B rationale
Rapid labor progression, frequent contractions, and previous short labors suggest she is at risk for precipitous labor, requiring immediate preparation for delivery.
Choice C rationale
Cephalopelvic disproportion indicates size mismatch between baby and pelvis, not rapid labor. Her history of quick deliveries does not align with this condition.
Choice D rationale
False labor typically involves irregular, less intense contractions. Her regular, intense contractions and labor history suggest active labor, not false labor.
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View Related questions
Correct Answer is B
Explanation
Choice A rationale
Swaddling provides warmth but doesn't address jitteriness, which may be due to hypoglycemia.
Choice B rationale
Jitteriness in a newborn can indicate hypoglycemia. Prompt glucose assessment is crucial for early detection and management.
Choice C rationale
Feeding could help with glucose levels, but without knowing the glucose status, it might not be the immediate priority.
Choice D rationale
Routine medications are important but not as urgent as addressing possible hypoglycemia in a jittery baby.
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.