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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?

A.

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.

B.

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.

C.

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.

D.

She is experiencing false labor. The provider will be called to reassess and you will monitor her closely.

Answer and Explanation

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 C

Explanation

Choice A rationale

Dexamethasone does not directly stop labor contractions; instead, it is used to enhance fetal lung maturity.

Choice B rationale

Dexamethasone is not for infection prevention; antibiotics are used for that purpose in cases of premature rupture of membranes.

Choice C rationale

Dexamethasone is administered to enhance fetal lung maturity, reducing the risk of respiratory distress syndrome in preterm infants.

Choice D rationale

Dexamethasone is not used for pain relief in preterm labor; other medications are prescribed for pain management.

Correct Answer is A

Explanation

Choice A rationale

A 37-year-old patient with obesity and pregnancy-induced hypertension presents multiple risk factors. Advanced maternal age, obesity, and hypertension collectively increase the

likelihood of complications such as preeclampsia, gestational diabetes, and cesarean delivery, necessitating close monitoring and management.

Choice B rationale

A patient with preexisting hypertension and twins is indeed high-risk due to the combined strain on the cardiovascular system and potential for preterm labor or other complications

associated with multiple gestations. However, the presence of pregnancy-induced hypertension and obesity in the first patient poses a slightly higher cumulative risk.

Choice C rationale

A 16-year-old patient with newly diagnosed gestational diabetes is at increased risk, particularly because of age and the potential for poorly managed diabetes leading to

complications. However, this scenario presents fewer immediate cumulative risks compared to older age and existing hypertension.

Choice D rationale

A 28-year-old patient who had a premature birth three years prior must be monitored for signs of recurrent preterm labor. Yet, this history alone does not present as high a cumulative

risk as older maternal age, obesity, and pregnancy-induced hypertension. .

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