mod 4 mother baby Chapter 13
A primigravida client at 38 weeks' gestation calls the clinic and reports, "My baby is lower and it is more difficult to walk." Which response should the nurse prioritize?
"The baby has dropped into the pelvis; your body and baby are getting ready for labor in the next few weeks."
A nurse sees a pregnant client at the clinic. The client is close to her due date. During the visit the nurse would emphasize that the client get evaluated quickly should her membranes rupture spontaneously based on the understanding of which possibility?
increased risk of infection
A client in labor is agitated and nervous about the birth of her child. The nurse explains to the client that fear and anxiety cause the release of certain compounds that can prolong labor. The nurse is referring to which compounds?
catecholamines
gynecoid pelvis
categorized as a typical female pelvis (although only about half of all women have this type of pelvis); the rounded shape of the gynecoid inlet allows the fetus room to negotiate the dimensions of the bony passageway
signs of premonitory signs of labor
cervical changes lightening increased energy level blood show braxton hicks contractions spontaneous rupture of membranes
A nurse is teaching a group of pregnant women about the signs that labor is approaching. When describing these signs, which sign would the nurse explain as being essential for effacement and dilation (dilatation) to occur?
cervical ripening and softening
There are four essential components of labor. The first is the passageway. It is composed of the bony pelvis and soft tissues. What is one component of the passageway?
cervix
When explaining to a class of pregnant women why labor begins, the nurse will include the fact that there are several theories that have been proposed to explain why labor begins, although none have been proven scientifically. Which idea is one of those theories?
change in estrogen to progesterone ratio
The nurse is determining how often contractions occur measuring from the beginning of the one contraction to the beginning of the next contraction. The nurse documents this finding as:
frequency
patience in labor
the birthing process takes time. If more time were allowed for women to labor naturally without intervention, the cesarean birth rate would most likely be reduced.
What assessment finding would suggest to the care team that the pregnant client has completed the first stage of labor?
the client's cervix is fully dilated
The nurse is caring for a client at 39 weeks' gestation who is noted to be at 0 station. The nurse is correct to document which?
the fetus in in the true pelvis and engaged
first stage of labor
the initial stage of childbirth in which regular contractions begin and the cervix dilates
A client calls the prenatal clinic and tells the nurse, "I think I am in labor." The nurse determines that the client is in true labor based on which client statement?
"I feel pressure in my vagina when I have the contraction."
A student observes during an initial prenatal visit. The student states, "I heard the primary care provider say that the client has a gynecoid pelvis. What does that mean?" The best response by the nurse is:
"It is rounded in shape and allows ample room for the neonate to fit through the passageway."
The nurse determines a client is 7 cm dilated. What is the best response when asked by the client's partner how long will she be in labor?
"She is in active labor; she is progressing at this point and we will keep you posted."
A nurse is performing an assessment on a client in early labor who is discouraged about the seemingly slow progress of her labor. Which response should the nurse prioritize for this client after noting the effacement is progressing even though the cervix is still only 2 cm for the past 2 hours?
"You are still 2 cm dilated, but the cervix is thinning out nicely."
A client in her third trimester comes to the clinic for an evaluation. Assessment reveals that the cervix is thinning. The client says, "I know my cervix needs to dilate, but why does it get thinner?" Which response by the nurse would be appropriate?
"You need the cervix to thin so it can stretch more easily."
attitude
(degree of body flexion); fetal lie (relationship of body parts); fetal presentation (first body part); fetal position (relationship to maternal pelvis); fetal station; and fetal engagement are all important factors that have an impact on the ultimate outcome in the birthing process.
The client is being rushed into the labor and delivery unit. At which station would the nurse document the fetus immediately prior to birth?
+4
Single footling breech
-Lie: Longitudinal or vertical -Presentation :Breech (incomplete) -Presenting part: sacrum -Attitude: flexion except for one leg extended at hip and knee C
Pitocin (oxytocin)
-Stimulate uterine smooth muscle; induce labor, control post-partum bleeding. -S/E: seizure, hypotension, increased uterine motility, painful contractions, decreased uterine blood flow, hyponatremia. ↑BP -Titrate 1 to 2 mU in 3 ml of fluids uterine rupture, severe hypoxia, Tachysystolie raise every 20-30 goal contraction 2-3 min.
cervical canal. 2cm in length would be described as
0% effaced
The nurse is providing care to a client in labor. On examination, the nurse determines the fetus is at -1 station. The nurse interprets this as indicating that the fetus is:
1 cm above the ischial spines
fully dilated cervix
10 cm
cervical canal 0cm in length would be described as
100% effaced
dilation goes from
1cm to 10cm
stages of labor
1st: dilating stage 3 phases: Latent (0-3cm) Active (4-7cm) Traditional (8-10cm w/ urge to push) 2nd stage: delivery 3rd: placental delivery 4th: recovery- primary goal to prevent hemorrhage from uterine atony, 1st void within 1 hour and then q2-3 hrs, Rhogam
A pregnant client arrives to the clinic for a prenatal visit appearing uncomfortable. During the assessment, the nurse determines the client is experiencing fairly strong contractions at 12:05 p.m., 12:10 p.m., 12:15 p.m., and 12:20 p.m. What can the nurse conclude from these findings?
The frequency of the contractions is every 5 minutes.
cervical canal 1 cm in length would be described as
50% effaced
placental separation
After the infant is born, the uterus continues to contract strongly and can now retract, decreasing markedly in size. These contractions cause the placenta to pull away from the uterine wall. The following signs of separation indicate that the placenta is ready to deliver: The uterus rises upward. The umbilical cord lengthens. A sudden trickle of blood is released from the vaginal opening. The uterus changes its shape to globular.
A primigravida client at 39 weeks' gestation calls the OB unit questioning the nurse about being in labor. Which response should the nurse prioritize?
Ask the woman to describe why she believes that she is in labor.
During which time is the nurse correct to document the end of the third stage of labor?
At the time of placental delivery
The nurse is teaching a class to a group of pregnant women in their second trimester. Which information about the effects of maternal position on labor will the nurse include?
Being upright promotes a sense of control for the mother.
Fetal molding
Can occur when pressure is applied to the jaw in vitro, causing a distortion
A primigravida has an office appointment at 39 weeks' gestation. Which assessment data is most definitive of the onset of labor?
Cervical ripening is noted on examination.
Which assessment would indicate that a woman is in true labor?
Cervix is 4 cm dilated, 90% effaced. True labor is characterized by contractions occurring at regular intervals that increase in frequency, duration, and intensity. These contractions bring about progressive cervical dilation and effacement. Thus, a cervix dilated to 4 cm and 90% effaced indicates true labor. Rupture of membranes may occur before the onset of labor, at the onset of labor, or at any time during labor and thus is not indicative of true labor. Engagement occurs when the presenting part reaches 0 station; it typically occurs 2 weeks before term in primigravidas and several weeks before the onset of labor or at the beginning of labor for multiparas. Contractions of true labor typically last 30 to 60 seconds and occur approximately every 4 to 6 minutes.
The nurse is documenting the length of time in the second stage of labor. Which data will the nurse use to complete the documentation?
Complete cervical dilation (dilatation) and time of fetal birth
The nurse cares for a pregnant client in labor and determines the fetus is in the right occiput anterior (ROA) position. Which action by the nurse is best?
Continue to monitor the progress of labor.
enfacement of the cervix
Effacement means that the cervix stretches and gets thinner. Dilatation means that the cervix opens. As labor nears, the cervix may start to thin or stretch (efface) and open (dilate). This prepares the cervix for the baby to pass through the birth canal (vagina).
Pitocin side effects
Contractions closer than 2 minutes, intensity >90 mm Hg (Mercury), duration >90 seconds, resting tone >20 mm Hg, either felt by palpation or intrauterine catheter. Fetal tachycardia, bradycardia, late decels, altered variability
engagement
Engagement occurs when the greatest transverse diameter of the head in vertex (biparietal diameter) passes through the pelvic inlet (usually 0 station). The head usually enters the pelvis with the sagittal suture aligned in the transverse diameter.
false labor
False labor, prodromal labor, and Braxton Hicks contractions are all names for contractions that do not contribute in a measurable way toward the goal of birth. Distinguishing between true and false labor is an essential nursing assessment skill and one that develops with experience.
Fetal Engagement (Passenger)
Fetal engagement signifies the entrance of the largest diameter of the fetal presenting part (usually the fetal head) into the smallest diameter of the maternal pelvis
Which consideration is a priority when caring for a mother with strong contractions 1 minute apart?
Fetal heart rate in relation to contractions
second stage of labor
Full dilation Intense contractions BIRTH!!
Which nursing action is a priority when the fetus is at the +4 station?
Have a blue bulb suction and an infant warmer ready.
Pain during labor is a nearly universal experience for childbearing women
Having a strong sense of self and meaningful support from others can often help women manage labor well and reduce the sensation of pain.
maternal responses to labor
Heart rate increases by 10 to 20 bpm. Cardiac output increases by 12% to 31% during the first stage of labor and by 50% during the second stage of labor. Blood pressure increases by up to 35 mm Hg during uterine contractions in all labor stages. The white blood cell count increases to 25,000 to 30,000 cells/mm3 perhaps as a result of tissue trauma. Respiratory rate increases and more oxygen is consumed related to the increase in metabolism. Gastric motility and food absorption decrease, which may increase the risk of nausea and vomiting during the transition stage of labor. Gastric emptying and gastric pH decrease, increasing the risk of vomiting with aspiration. Temperature rises slightly, possibly due to an increase in muscle activity. Muscular aches and cramps occur as a result of stress on the musculoskeletal system. Basal metabolic rate increases and blood glucose levels decrease because of the stress of labor
A pregnant client is admitted to a maternity clinic for birth. Which assessment finding indicates that the client's fetus is in the transverse lie position?
Long axis of fetus is perpendicular to that of client.
The nurse is caring for a client whose fetus is noted to be in the position shown. For which fetal lie would the nurse provide client teaching?
Longitudinal
When caring for a client in the third stage of labor, the nurse notices that the expulsion of the placenta has not occurred within 5 minutes after birth of the infant. What should the nurse do?
Nothing. Normal time for stage three is 5 to 30 minutes.
Fetal response to labor
Periodic fetal heart rate accelerations and slight decelerations related to fetal movement, fundal pressure, and uterine contractions Decrease in circulation and perfusion to the fetus secondary to uterine contractions (a healthy fetus is able to compensate for this drop) Increase in arterial carbon dioxide pressure (PCO2) Decrease in fetal breathing movements throughout labor Decrease in fetal oxygen pressure with a decrease in the partial pressure of oxygen (PO2) (Decherney et al., 2019)
As the nurse is explaining the difference between true versus false labor to her childbirth class, she states that the major difference between them is
Progressive cervical changes occur in true labor.
A nurse is coaching a woman during the second stage of labor. Which action should the nurse encourage the client to do at this time?
Push with contractions and rest between them.
A pregnant woman comes to the emergency department stating she thinks she is in labor. Which assessment finding concerning the pain will the nurse interpret as confirmation that this client is in true labor?
Radiates from the back to the front
fetal attitude
Refers to the posturing (flexion or extension) of the joints and the relationship of fetal parts to one another. the most common fetal attitude when labor begins is with all joints flexed.
fetal response to birth
Respiratory changes during labor help prepare the fetus for extrauterine respiration immediately after birth.
When determining the frequency of contractions, the nurse would measure which period of time?
Start of one contraction to the start of the next contraction
Cephalohematoma is?
Swelling caused by bleeding between the osteum and periosteum of the skull. This swelling does not cross suture lines.
A pregnant client wants to know why the labor of a primigravida usually lasts longer than that of a woman who has already given birth once and is pregnant a second time. What explanation should the nurse offer the client?
The cervix takes around 12 to 16 hours to dilate during first pregnancy.
Fetal presentation and position
The fetal presenting part acts as a wedge to efface and dilate the cervix as each contraction pushes it downward.
cardinal movements of labor
The fetus goes through many positional changes as it travels through the passageway. These positional changes are known as the cardinal movements of labor. They are deliberate, specific, and precise movements that allow the smallest diameter of the fetal head to pass through a corresponding diameter of the mother's pelvic structure. Although cardinal movements are conceptualized as separate and sequential, the movements are typically concurrent
The nurse is caring for a client at 39 weeks' gestation who is noted to be at 0 station. The nurse is correct to document which?
The fetus is in the true pelvis and engaged.
Which observation would suggest that placental separation is occurring?
Uterine shape changes to globular. After the placenta separates from the uterine wall, the shape of the uterus changes from discoid to globular. The uterus continues to contract throughout the placental separation process and the umbilical cord continues to pulsate for several minutes after placental separation occurs. Maternal blood pressure is not affected by placental separation because the maternal blood volume has increased dramatically during pregnancy to compensate for blood loss during birth.
partners
Women desire support and attentive care during labor and birth. Caregivers can convey emotional support by offering their continued presence and words of encouragement. Throughout the world, few women are left to labor totally alone; emotional, physical, and/or spiritual support during labor is the norm for most cultures
A nurse is assisting a client who is in the first stage of labor. Which principle should the nurse keep in mind to help make this client's labor and birth as natural as possible?
Women should be able to move about freely throughout labor.
The nurse is noting a collection of blood under the scalp on a newborn being discharged to home. The nurse is correct to prepare teaching instructions of which topic?
a cephalohematoma
False labor is
a condition seen during the latter weeks of some pregnancies in which irregular uterine contractions are felt, but the cervix is not affected.
fetal station
a measure of the degree of descent of the presenting part of the fetus through the birth canal An easy way to understand this concept is to think in terms of meeting the goal, which is birth. If the fetus is descending downward (past the ischial spines) and moving toward meeting the goal of birth, then the station is positive and the centimeter numbers grow bigger from +1 to +4. If the fetus is not descending past the ischial spines, then the station is negative and the centimeter numbers grow from −1 to −4. The farther away the presenting part from the outside, the larger the negative number (−4 cm). The closer the presenting part of the fetus is to the outside, the larger the positive number (+4 cm). Figure 13.10 shows stations of the presenting part.
Cindy, a 20-year-old primipara, calls the birthing center where you work as a nurse and reports that she thinks she is in labor because she feels labor pains. Her due date is this week. The midwives have been giving her prenatal care throughout this pregnancy.
ask about the frequency and duration of her contractions. ask about how long she has experienced labor pains. ask about any other signs she may have experienced such as bloody show, lightening, backache, ruptured membranes, and so forth. ask if walking tends to increase or decrease the intensity of contractions. ask her when she last felt fetal movement. ask her how far away she is from the birthing center. ask her if she has a support person in the home with her.
The most intense time during labor is during the
active
A nurse is conducting an in-service program for staff nurses working in the labor and birth unit. The nurse is discussing ways to promote a positive birth outcome for the woman in labor. The nurse determines that additional teaching is necessary when the group identifies which measure? promoting the woman's feelings of control providing clear information about procedures allowing the woman time to be alone encouraging the woman to use relaxation techniques
allowing the woman time to be alone
complete breech presentation
buttocks and feet present, fetal hips and knees are flexed, lower legs crossed. B
During which time is the nurse correct to document the end of the third stage of labor?
at the time of placental delivery
During a prenatal visit a pregnant client asks the nurse how to tell whether the contractions she is having are true contractions or Braxton Hicks contractions. Which description should the nurse mention as characteristic of true contractions? Select all that apply.
begin irregularly but become regular and predictable felt first in lower back and sweep around to the abdomen in a wave. increase in duration, frequency, and intensity
During a prenatal visit a pregnant client asks the nurse how to tell whether the contractions she is having are true contractions or Braxton Hicks contractions. Which description should the nurse mention as characteristic of true contractions? Select all that apply.
beginin irregularly but become regular and predictable felt first in lower back and sweep around to the abdomen in a wave increase in duration, frequency and intensity
Which feature would alert the nurse that the client is in the transition phase of labor?
beginning urge to bear down
Double footling breech
both feet dangling D
psychological response to childbearing
clear information about procedures support; not being alone sense of mastery, self confidence trust in staff caring for her positive reaction to the pregnancy personal control over breathing preparation for the childbirth experience
Evidence-based practice applied to the clinical setting improves
client care and overall better outcomes.
The nurse is assisting a client in labor and delivery and notes the placenta is now delivered. What will the nurse document?
completion of the third stage of labor
pregnancy pathway
consists of the maternal pelvis and soft tissue
true labor
contractions bring about progressive cervical dilation and effacement. contraction timing is regular and becoming closer together. usually 4-6 minutes apart, lasting 30-60 seconds contraction strength becomes stronger with time, vaginal pressure is usually felt contraction discomfort starts in the back and radiates around toward the front of the abdomen.
A new dad is alarmed at the shape of his newborn's head. When responding to the dad, the nurse reminds him this is due to:
cranial bones overlapping at the suture lines.
Which cardinal movement of delivery is the nurse correct to document by station
decent
Which cardinal movement of delivery is the nurse correct to document by station?
descent
The student nurse is learning about normal labor. The teacher reviews the cardinal movements of labor and determines the instruction has been effective when the student correctly states the order of the cardinal movements as follows:
descent, flexion, internal rotation, extension, external rotation, expulsion
A nurse is caring for a pregnant client in labor in a health care facility. The nurse knows that which sign marks the termination of the first stage of labor in the client?
dilation of cervix to diameter of 10 cm
The nurse is caring for a client who is experiencing a noneventful labor process. Which assessment findings may occur as the client progresses through the stages of labor? Select all that apply.
dry mucous membranes nausea increased white blood cell count increased urine specific gravity hyperventilation
Mentally preparing for childbirth is important for women to
enable them to work with the natural forces of labor and not against them.
When the presenting part of the fetus reaches 0 station, __________ has occurred.
engagement
An anthropoid pelvis is most favorable for a vaginal birth. true or false
false
Effacement occurs when the fetal presenting part begins to descend into the maternal pelvis. true or false
false
The ratio of estrogen to progesterone remains constant throughout pregnancy into labor. true or false
false
A pregnant client in labor has to undergo a sonogram to confirm the fetal position of a shoulder presentation. For which condition associated with shoulder presentation during a vaginal birth should the nurse assess?
fetal anomalies
A nurse performs an initial assessment of a laboring woman and reports the following findings to the primary care provider: fetal heart rate is 152 bpm, cervix is 100% effaced and 5 cm dilated, membranes are intact, and presenting part is well applied to the cervix and at -1 station. The nurse recognizes that the client is in which stage of labor?
first active
Maternal Positions in Labor
has only recently been the subject of well-controlled research. Scientific evidence has shown that nonmoving, back-lying positions during labor are not healthy (Dekker, 2019). In an upright position, gravity can help in bringing the fetus down, and there is less risk of compressing the maternal aorta which supplies oxygen to the fetus. However, despite this evidence to the contrary, many women continue to lie flat on their backs during labor. Some of the reasons why this practice continues include the beliefs that: laboring women need to conserve their energy and not tire themselves. nurses cannot keep track of the whereabouts of ambulating women. it is the preference of the health care provider. the fetus can be monitored better in this position. the supine position facilitates vaginal examinations and external belt adjustment. a bed is "where one is supposed to be" in a hospital setting. the position is more convenient for the delivering health care provider. laboring women are connected to medical equipment that impedes movement
To give birth to her infant, a woman is asked to push with contractions. Which pushing technique is the most effective and safest?
head elevated, grasping knees, breathing out think of knee chest...
Which is the most important nursing assessment of the mother during the fourth stage of labor?
hemorrhage
frank breech
hips flexed, knees extended image A
Catecholamines
hormones secreted by the adrenal medulla that affect the sympathetic nervous system in stress response
duration
how long the contraction lasts
intensity
how strong the contractions. are
"shiny" schultz mechanism
if placenta separates from the inside to the outer margins, it is expelled with the fetal (shiny) side presenting
A nurse is caring for a pregnant client who is in labor. Which maternal physiologic responses should the nurse monitor for in the client as the client progresses through birth? Select all that apply.
increase in HR increase in Blood Pressure increase in Respiratory rate
A nurse is caring for a pregnant client who is in labor. Which maternal physiologic responses should the nurse monitor for in the client as the client progresses through birth? Select all that apply.
increase in heart rate increase in blood pressure increase in resp rate.
The nurse is reviewing the laboratory test results of a client in labor. Which finding would the nurse consider normal?
increased white blood cell count
Uterine contractions are assessed according to frequency, duration, and ____________.
intensity
False labor signs
irregular contractions that vary in length and intensity; noticeable fundus; contractions stop with relaxation; no cervical changes
doula
is a greek word meaning woman servant or caregiver. it now commonly refers to a woman who offers emotional and practical support to a mother or couple before, during, and after childbirth. a doula believes in mothering the mother and clinical supports remains the job of the midwife or medical staff.
A pregnant client is admitted to a maternity clinic for birth. The client wishes to adopt the kneeling position during labor. The nurse knows that which of the following is an advantage of adopting a kneeling position during labor?
it helps to rotate the fetus in a posterior position
The nurse is monitoring a client who is in labor and notes the client is happy, cheerful, and "ready to see the baby." The nurse interprets this to mean the client is in which stage or phase of labor?
latent phase.
Place the following stages of labor in order from what occurs first to last. All options must be used.
latent stage active stage transition stage second stage third stage
Physiologic preparation for labor would be demonstrated by
lightening, when the fetus drops into true pelvis. the fetus gets into position by descending into the maternal true pelvis in preparation for birth. The woman will experience heaviness in her lower pelvis and urinary frequency when this occurs.
Which fetal lie is most conducive to a spontaneous vaginal birth?
longitudinal A longitudinal lie places the fetus in a vertical position, which would be the most conducive for a spontaneous vaginal birth. A transverse lie does not allow for a vaginal birth because the fetus is lying perpendicular to the maternal spine. A perpendicular lie describes the transverse lie, which would not be conducive for a spontaneous birth. An oblique lie would not allow for a spontaneous vaginal birth because the fetus would not fit through the maternal pelvis in this side-lying position.
A nurse is caring for a client who is in the first stage of labor. The client is experiencing extreme pain due to the labor. The nurse understands that which factors are causing the extreme pain in the client? Select all that apply.
lower uterine segment distention stretching and tearing of structures dilation of the cervix
dirty duncan mechanism
maternal side the red raw side presenting first.
The skull is the most important factor in relation to the labor and birth processes. The fetal skull must be small enough to travel through the bony pelvis. What feature of the fetal skull helps to make this passage possible?
molding
Labor is a complex
multifaceted interaction between the mother and fetus. Thus, it is difficult to determine exactly why labor begins and what initiates it.
false labor also
no fetal engagement.
As the woman experiences and progresses through childbirth
numerous physiologic responses occur that assist her adaptation to the laboring process.
The fetal head is the largest and least compressible fetal structure.
occipital
Assessment reveals that the fetus of a client in labor is in the vertex presentation. The nurse determines that which part is presenting?
occiput
Before the onset of labor, a pregnant woman's body undergoes several changes in preparation for the birth of the newborn
often leading to characteristic signs and symptoms that suggest labor is near. These changes include cervical changes, lightening, increased energy level, bloody show, Braxton Hicks contractions, and spontaneous rupture of membranes.
Which interventions are underutilized in promoting a normal birth? Select all that apply. Oral nutrition and fluids in labor Open-glottis pushing in the second stage of labor Skin-to-skin contact after birth for infant bonding Routine artificial rupture of membranes (amniotomy) Labor induction with intravenous Pitocin Routine episiotomy to shorten labor length
oral nutrition and fluids in labor open glottis pushing in the second stage of labor skin to skin contact after birth for infant bonding.
The nurse is instructing on maternal hormones which may impact the onset of labor. Which hormones are included in the discussion? Select all that apply.
oxytocin progesterone prostaglandins
The critical factors in labor and birth are designated as the 10 Ps
passageway (birth canal), passenger (fetus and placenta), powers (contractions), position (maternal), psychological response, philosophy (low-tech, high-touch), partners (support caregivers), patience (natural timing), patient (client) preparation (childbirth knowledge base), and pain management (comfort measures).
The passageway consists of the maternal ________ and soft tissues.
pelvis
The nurse has been asked to present information to a group of civic leaders concerning women's health issues. In preparing the information, the nurse includes what goal from Healthy People 2030 related to women in labor?
reduce the rate of cesarean births among low risk women
Frequency
refers to how often the contractions occur and is measured from the beginning of one contraction to the beginning of the next contraction.
intensity
refers to the strength of the contraction determined by manual palpation or measured by an internal intrauterine pressure catheter. The catheter is positioned in the uterine cavity through the cervix after the membranes have ruptured. It reports intensity by measuring the pressure of the amniotic fluid inside the uterus in millimeters of mercury. It is not recommended for routine use in low-risk laboring women due to the potential risk of infection and injury to the placenta or fetus. In a recent study using noninvasive technology, it was found that using a multichannel electromyogram that acquires a uterine signal and maternal and fetal electrocardiograms was more accurate than that of an external Doppler and fetal scalp electrode monitor
true labor
regular contractions, discomfort radiates from the back, intensity increases with walking, cervix effaced and dilated is true or false labor
fetal lie
relationship of the long axis of the fetus to the long axis of the mother
A nurse is explaining to a pregnant client about the changes occurring in the body in preparation for labor. Which hormone would the nurse include in the explanation as being responsible for causing the pelvic connective tissue to become more relaxed and elastic?
relaxin
A pregnant client is admitted to a maternity clinic after experiencing contractions. The assigned nurse observes that the client experiences pauses between contractions. The nurse knows that which event marks the importance of the pauses between contractions during labor?
restoration of blood flow to uterus and placenta
When teaching a group of nursing students about the different types of pelvis, the nurse describes which features of a gynecoid pelvis? Select all that apply.
round shaped inlet dull ischial spines wide pubic arch
The labor process is comprised of a series of rhythmic, involuntary, usually quite uncomfortable uterine muscle contractions that bring about
shortening (effacement) and opening (dilation) of the cervix, and a bursting of the fetal membranes. Important parameters of uterine contractions are frequency, duration, and intensity.
Assessment of a woman in labor reveals that the scapula of the fetus is the presenting part. The nurse interprets this finding as indicating which fetal presentation?
shoulder
A nurse has been assisting a client who has been in labor. The nurse determines the client is moving into the transition phase based on which assessment findings? Select all that apply.
strong desire to push irritability with restlessness
A nurse is monitoring a woman in labor. Which assessment finding is most concerning to the nurse? Client begins vomiting. Blood pressure is 128/82 mm Hg. Respiratory rate is 22 breaths/minute. Temperature is 101.6°F (38.7°C).
temperature is 101.6 f
Dilation
the opening or enlargement of the external cervical os.
fetal position
the relationship of the occiput, sacrum, chin, or scapula of the fetus to the front, back, or sides of the mother's pelvis describes the relationship of a given point on the presenting part of the fetus to a designated point of the maternal pelvis
third stage of labor
the stage during which the afterbirth is expelled placental expulsion.
A client experiencing contractions presents at a health care facility. Assessment conducted by the nurse reveals that the client has been experiencing Braxton Hicks contractions. The nurse has to educate the client on the usefulness of Braxton Hicks contractions. Which role do Braxton Hicks contractions play in aiding labor?
these contractions help in softening and ripening the cervix
A client has just given birth to a healthy baby boy, but the placenta has not yet delivered. What stage of labor does this scenario represent?
third
The two primary types of fetal lie are longitudinal and _________.
transverse
Braxton Hicks contractions diminish with walking or changing position. true or false
true
During the second stage of labor, a woman is generally:
turning inward to concentrate on body sensations.
The diameters of the fetal skull vary considerably
with some diameters shortening and others lengthening as the head is molded during the labor and birth process.
Fetal Station (Passenger)
• refers to the relationship of the presenting part to the level of the maternal pelvic ischial spines. • measured in centimeters and is referred to as a minus or plus, depending on its location above or below the ischial spines. • Zero (0) station is designated when the presenting part is at the level of the maternal ischial spines • The farther away the presenting part from the outside, the larger the negative number (-4 cm). • The closer the presenting part of the fetus is to the out-side, the larger the positive number (+4 cm).