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The nurse is providing care for a patient in the second phase of labor. After more than 4 hours of pushing, the nurse suspects fetal dystocia.
Which is the greatest risk related to the nurse's suspected complication?

A.

Greater risk for maternal lacerations.

B.

Fetal injury confirmed by the presence of bruising.

C.

Neonatal asphyxia related to prolonged labor.

D.

Increased consideration for a cesarean delivery

Answer and Explanation

The Correct Answer is C

Choice A rationale

While maternal lacerations are a risk during childbirth, they are not the greatest risk in cases of fetal dystocia. The focus is primarily on fetal wellbeing.

 

Choice B rationale

Fetal injury such as bruising can occur with dystocia, but the primary concern is the potential for severe, life-threatening complications.

 

Choice C rationale

Neonatal asphyxia related to prolonged labor is the greatest risk with fetal dystocia. Prolonged labor can lead to decreased oxygen supply to the fetus, causing asphyxia and

potential brain injury.

 

Choice D rationale

Increased consideration for a cesarean delivery is a possible outcome of fetal dystocia, but it is a management decision rather than a direct risk to the baby’s immediate health.


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View Related questions

Correct Answer is C

Explanation

Choice A rationale

Decreased pain level can be an effect of addressing the cause of pain, but it doesn't indicate improved uterine tone or resolution of atony.

Choice B rationale

Stable blood pressure is important, but it is not the direct outcome of improved uterine tone or the resolution of uterine atony.

Choice C rationale

A firm fundus at or below the umbilicus indicates successful contraction of the uterus, resolving uterine atony and reducing bleeding.

Choice D rationale

Reduced lochial flow can indicate decreased bleeding, but it does not directly indicate improved uterine tone or resolution of uterine atony.

Correct Answer is D

Explanation

Choice A rationale

A respiratory rate of 18 breaths/min is normal and does not indicate magnesium toxicity or the need for calcium gluconate.

Choice B rationale

Urinary output of 30 mL/hr is within the acceptable range and does not suggest magnesium toxicity. This indicates adequate renal function.

Choice C rationale

Patellar reflexes rated at one indicate mild hyporeflexia, which can be a side effect of magnesium sulfate but does not necessitate immediate intervention.

Choice D rationale

Serum magnesium level of 10 mg/dL is significantly elevated, indicating magnesium toxicity. Calcium gluconate is the antidote for magnesium toxicity and should be administered

promptly to prevent severe complications.

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