North American Registry of Midwives (NARM) Practice Exam

Ketonuria in labor indicates the need for which medical intervention?

1. Monitoring of vital signs

2. Oral glucose administration

3. IV fluids

4. Increased oxygen flow

The correct answer is: IV fluids

Ketonuria in labor is an important sign that suggests the mother may be experiencing inadequate carbohydrate intake or significant stress on her body, which can lead to ketosis. When ketones are present in the urine, it indicates that the body is breaking down fat for energy instead of carbohydrates. This metabolic state can pose risks for both the mother and the fetus, including potential fetal distress and complications related to dehydration or electrolyte imbalances. The administration of IV fluids is crucial in this scenario as it helps to rehydrate the mother and can also provide necessary electrolytes. This intervention aids in restoring the fluid balance and can help in transitioning the mother’s metabolism towards a more stable state, improving overall comfort and health during labor. Additionally, adequate hydration can also promote better uterine contractions and fetal monitoring outcomes. Oral glucose administration may seem like a relevant choice since it could also address the low carbohydrate levels, but it may not be effective or safe if the mother is in labor and may not address dehydration adequately. Monitoring vital signs and increasing oxygen flow are important, but they do not directly impact the ketonuria situation in the same way IV fluids do.