OB 2

transition

the end of the first stage of labor, just before the woman experiences pushing sensations

cardinal movements of labor

position changes to keep the smallest diameter of the fetal head (in cephalic presentations) always presenting to the smallest diameter of the birth canal (descent, flexion, internal rotation, extension, external rotation, and expulsion)

When assessing fetal heart rate patterns, which finding would alert the nurse to a possible problem?

prolonged decelerations

effacement

thinning of the cervix in 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

The nurse is assessing a pregnant client at 37 weeks' gestation and notes the fetus is at zero station. When questioned by the client as to what has happened, the nurse should point out which event has occurred?

Engagement

Which consideration is a priority when caring for a mother with strong contractions 1 minute apart?

Fetal heart rate in relation to contractions

A nurse is providing care to a pregnant client in labor. Assessment of a fetus identifies the buttocks as the presenting part, with the legs extended upward. The nurse identifies this as which type of breech presentation?

Frank

The nurse is caring for a client in active labor. Which assessment finding requires health care provider notification?

Gross proteinuria

Which nursing action is a priority when the fetus is at the +4 station?

Have a blue bulb suction and an infant warmer ready

A client is in active labor. Checking the EFM tracing, the nurse notes variables that are abnormal. What would be the nurse's first nursing intervention?

Help the woman change positions.

A 32-year-old woman presents to the labor and birth suite in active labor. She is multigravida, relaxed, and talking with her husband. When examined by the nurse, the fetus is found to be in a cephalic presentation. His occiput is facing toward the front and slightly to the right of the mother's pelvis, and he is exhibiting a flexed attitude. How does the nurse document the position of the fetus?

ROA

Phases of contraction

The acme is the peak intensity of a contraction. The increment refers to the building up of the contraction. The decrement refers to the letting down of the contraction. Diastole refers to the relaxation phase of a contraction.

The client may spend the latent phase of the first stage of labor at home unless which occurs?

The client experiences a rupture of membranes

Stages of labor

The primary change occurring during the first stage of labor is progressive cervical dilation. Contractions occur during the first and second stages of labor. Fetal movement through the birth canal is the major change during the second stage of labor. Placental separation occurs during the third stage of labor.

When teaching a group of soon-to-be parents about the structures of the fetal skull, the nurse describes the anterior fontanelle. Which description would the nurse include?

approximately 2 to 3 cm in size

Which action is a priority when caring for a woman during the fourth stage of labor?

assessing the uterine fundus

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

Assessment reveals that the fetus of a client in labor is in the vertex presentation. The nurse determines that which part is presenting?

occiput

Which finding would the nurse expect in a neonate who is born with the assistance of a vacuum extractor?

scalp edema