MIDTERM: Shoulder Dystocia Flashcards
Which maternal factor increases the risk of shoulder dystocia?
a) Low maternal weight
b) Advanced maternal age
c) Preeclampsia
d) Prolonged second stage of labor
d) Prolonged second stage of labor
Rationale: A prolonged second stage of labor can increase the risk of shoulder dystocia by creating conditions for fetal impaction.
What is the hallmark sign of shoulder dystocia during delivery?
a) Cephalopelvic disproportion
b) The fetal head retracting against the perineum
c) Rapid descent during the second stage of labor
d) The presence of asynclitism
b) The fetal head retracting against the perineum
Rationale: Turtle sign occurs when the fetal head delivers but then retracts back against the perineum due to shoulder impaction.
What should be the nurse’s first action when shoulder dystocia is identified?
a) Stop maternal pushing and call for help
b) Perform the McRoberts Maneuver immediately
c) Administer uterotonics
d) Apply fundal pressure
a) Stop maternal pushing and call for help
Rationale: Preventing further impaction by stopping maternal pushing and calling for assistance are immediate priorities when shoulder dystocia is identified.
Which maneuver involves flexing the maternal thighs tightly against the abdomen to widen the pelvic outlet?
a) McRoberts Maneuver
b) Gaskin Maneuver
c) Zavanelli Maneuver
d) Wood’s Screw Maneuver
a) McRoberts Maneuver
Rationale: The McRoberts Maneuver helps open the pelvic outlet by flexing the maternal thighs tightly against the abdomen, facilitating the release of the shoulder.
Which of the following should NOT be performed during shoulder dystocia management?
a) Apply suprapubic pressure
b) Assign a timekeeper to document interventions
c) Rotate the fetus using the Wood’s Screw Maneuver
d) Encourage maternal pushing
d) Encourage maternal pushing
Rationale: Maternal pushing should be stopped during shoulder dystocia to avoid worsening the impaction.
What is the purpose of suprapubic pressure during shoulder dystocia?
a) To push the fetal head back into the birth canal
b) To compress the umbilical cord and reduce fetal heart rate
c) To dislodge the anterior shoulder from under the pubic bone
d) To assist in delivering the posterior arm
c) To dislodge the anterior shoulder from under the pubic bone
Rationale: Suprapubic pressure helps dislodge the impacted anterior shoulder, facilitating delivery.
Which advanced maneuver for shoulder dystocia involves repositioning the mother onto her hands and knees?
a) Gaskin Maneuver
b) Zavanelli Maneuver
c) McRoberts Maneuver
d) Wood’s Screw Maneuver
a) Gaskin Maneuver
Rationale: The Gaskin Maneuver positions the mother on her hands and knees to widen the pelvis and assist in delivery
What is the primary goal of the Zavanelli Maneuver
a) To rotate the fetus and reduce the shoulder diameter
b) To deliver the posterior arm
c) To reinsert the fetal head into the birth canal for cesarean delivery
d) To apply downward pressure on the fundus
c) To reinsert the fetal head into the birth canal for cesarean delivery
Rationale: The Zavanelli Maneuver is a last-resort technique where the fetal head is reinserted into the birth canal to allow cesarean delivery
Which fetal complication is most likely with shoulder dystocia?
a) Neonatal hypoglycemia
b) Brachial plexus injury
c) Placental abruption
d) Hyperbilirubinemia
b) Brachial plexus injury
Rationale: Shoulder dystocia increases the risk of brachial plexus injuries due to excessive traction on the baby’s shoulder during delivery.
What role should the nurse assign during shoulder dystocia management?
a) Monitor fetal heart rate every 15 minutes
b) Administer uterotonics to control bleeding
c) Apply fundal pressure to assist delivery
d) Record time and interventions during the emergency
d) Record time and interventions during the emergency
Rationale: Assigning a recorder to document time and interventions ensures accurate tracking and legal documentation during the emergency.
What is the risk of prolonged shoulder dystocia (>5 minutes)?
a) Neonatal asphyxia
b) Maternal eclampsia
c) Uterine rupture
d) Neonatal hypoglycemia
a) Neonatal asphyxia
Rationale: Prolonged shoulder dystocia can lead to neonatal asphyxia due to impaired oxygenation during the delayed delivery.
What is the significance of the “Turtle Sign” during labor?
a) It indicates macrosomia.
b) It suggests impending uterine rupture.
c) It confirms shoulder dystocia.
d) It indicates umbilical cord prolapse.
c) It confirms shoulder dystocia.
Rationale: The “Turtle Sign” is a classic indicator of shoulder dystocia, where the fetal head retracts against the perineum after delivery.
Which risk factor for shoulder dystocia is fetal in origin?
a) Prolonged second stage of labor
b) Macrosomia
c) Operative vaginal delivery
d) Maternal diabetes
b) Macrosomia
Rationale: Macrosomia (fetal weight >4500g) is a major fetal risk factor for shoulder dystocia due to the increased likelihood of impaction.
Which maneuver involves intentional fracture of the fetal clavicle to reduce shoulder diameter?
a) McRoberts Maneuver
b) Wood’s Screw Maneuver
c) Clavicular Fracture
d) Zavanelli Maneuver
c) Clavicular Fracture
Rationale: Clavicular fracture is a last-resort maneuver to reduce the fetal shoulder diameter and facilitate delivery.
Which of the following is considered a last-resort surgical intervention for shoulder dystocia?
a) Gaskin Maneuver
b) Delivery of the Posterior Arm
c) McRoberts Maneuver
d) Abdominal Rescue
c) Abdominal Rescue
Rationale: Abdominal rescue, or hysterotomy, is a last-resort surgical intervention used when all other maneuvers fail to resolve shoulder dystocia.
