The primary healthcare provider for a client at 38 1/7 weeks' gestation calls the labor and delivery suite to schedule an induction for the next day. The client is having no medical or pregnancy complications.
Which of the following responses by the nurse would be appropriate?
At what time would you like to begin the induction?
What is the client's Bishop score?
I am sorry but the client will not be able to be induced tomorrow.
I will have the prostaglandin induction medication prepared.
The Correct Answer is B
Choice A rationale
Induction timing is secondary to assessing readiness. The Bishop score determines cervical favorability for induction success.
Choice B rationale
The Bishop score assesses cervical readiness for labor induction, which is vital in planning an effective induction.
Choice C rationale
Refusal to induce without considering clinical data is inappropriate. The Bishop score evaluation determines readiness.
Choice D rationale
Prostaglandin preparation follows Bishop score assessment to ensure induction safety and efficacy.
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Correct Answer is D
Explanation
Choice A rationale
Placental abruption involves the detachment of the placenta from the uterine wall before delivery, causing bleeding, abdominal pain, and uterine tenderness. It does not typically cause dyspnea, hypotension, frothy sputum, or loss of consciousness.
Choice B rationale
Uterine rupture is a tear in the uterine wall, often in a scarred uterus. Symptoms include severe abdominal pain, abnormal fetal heart rate, and vaginal bleeding. It can cause shock, but not frothy sputum or sudden dyspnea.
Choice C rationale
Uterine inversion occurs when the uterus turns inside out, often during placental delivery. It leads to pain, hemorrhage, and shock. Like uterine rupture, it does not cause frothy sputum or sudden dyspnea.
Choice D rationale
Anaphylactoid syndrome (amniotic fluid embolism) occurs when amniotic fluid enters the maternal circulation, causing an anaphylactic reaction. Symptoms include sudden dyspnea, hypotension, frothy sputum, and loss of consciousness, fitting the scenario described.
Correct Answer is D
Explanation
Choice A rationale
Oxytocin is used to induce or augment labor, not typically used before an external version, which is a procedure to turn a breech baby to a head-down position.
Choice B rationale
Methylergonovine is used to prevent or control postpartum hemorrhage by inducing strong uterine contractions, not indicated before an external version.
Choice C rationale
Betamethasone is a corticosteroid used to accelerate fetal lung maturity in preterm labor, not required for an external version.
Choice D rationale
Terbutaline is a tocolytic agent used to relax the uterus, making it easier to manipulate the fetus during the external version procedure.