Chapter 14 (includes some PrepU questions)

abdominal muscle contractions

abdominal muscle contractions may help strengthen abdominal muscles during pregnancy, help prevent constipation, and help restore abdominal tone after pregnancy

Dick-Read Method..

based on the premise that fear leads to tension and, later, pain; If fear is combated, tension and thus pain is avoided.

Bradley Method..

based on the premise that pregnancy and childbirth are joyful, natural processes and that a woman's PARTNER should play an active role during pregnancy, labor, and the early newborn period

cleansing breath

breathes in deeply and then exhales deeply; prevents hyperventilation and hypoventilation

perineal and abdominal exercises

exercises to strengthen pelvic and abdominal muscles to make these muscles stronger and more supple for labor; allows for stretching during birth, reduces discomfort, and helps perineal muscles function more efficiently after childbirth

gating control theory of pain perception

gate control mechanisms in the substantia gelatinosa that are capable of halting an impulse at the level of the spinal cord so the impulse is never perceived at the brain level as pain—a process similar to closing a gate

A newly pregnant patient explains to the nurse that she is interested in midwifery care but would like to deliver in the hospital. What is the best response from the nurse?

"That's no problem because most midwives deliver in the hospital setting."

Leboyer method

A method of childbirth where delivery occurs in a quiet, dimly lit room and the infant's head is not pulled, minimizing the trauma for the newborn and allowing for immediate bonding between mother and child

A pregnant client is discussing the possibility of using the services of an alternative birthing center (ABC). She states to the nurse, "I will be able to have an epidural if I choose too, right?" What information should the nurse provide to the client?

Although there are many benefits to having the birth in an ABC, epidurals are administered in the hospital setting.

A nurse is working to increase participation in childbirth education classes for pregnant women who are receiving care at the clinic. To achieve this goal, which area would the nurse need to focus on as a common reason why some women shy away from attending these classses?

fear that participation means commitment to a medication-free birth

A nurse is conducting an informal teaching session for a group of pregnant women about childbirth education classes. Which information would the nurse most likely include as an outcome associated of these types of classes? Select all that apply.

Increased satisfaction Reduction in amount of reported pain Increased feelings of control

You are at a sports event when a woman begins to give birth. You volunteer to assist until further help arrives. The infant cries immediately and is not in obvious respiratory distress. Which would be the best action following delivery of the placenta?

Encourage the infant to breastfeed. Breastfeeding causes the release of natural oxytocin, helping to contract the uterus and minimize bleeding.

effleurage

French for "light addominal massage"; distraction technique and decreases sensory stimuli transmission from the abdominal wall, helping limit local discomfort

psychoprophylactic

Lamaze; theory that through stimulus-response conditioning, women can learn to use controlled breathing to reduce pain during labor; focuses on preventing pain in labor (prophylaxis) by use of the mind (psyche)

doula

a woman experienced in childbirth who provides continuous emotional and physical support;

birthing bed

a bed specifically prepared for birth

alternative birthing centers (ABCs)

a setting for birth separate from a hospital

birthing chair

comfortable reclining chair; furnishes perineal exposure so a birth attendant can assist with the birth; has the advantage of maintaining a woman in a semi-Fowler's position, a position that acts with gravity and so may speed the second stage of labor.

Focusing/Imagery

concentrating on a picture, image, scenery as a form of distraction

Commonly used nonpharmacologic techniques for pain relief in labor are..

conscious relaxation, consciously controlled breathing, effleurage, focusing, imagery, and hydrotherapy.

A pregnant client informs the nurse that she is considering a "water birth" for the labor and delivery of her child. What does the nurse anticipate as potential complications for this type of birth? (Select all that apply.)

contamination of the bath water with feces as the mother pushes during labor and uterine infection

A woman in labor arrives at the hospital. When she reaches the labor-and-delivery floor, she asks the nurse to place a special knife she has brought from home under the mattress of her bed. This is an example of which of the following?

cultural belief

A nursing student learning about childbirth preparation in a maternity course correctly identifies which of the following to be a major determinant of the plans women make for childbirth?

culture

conscious relaxation

deliberately relaxing one set of muscles, then another, and another until the body is completely relaxed; support person concentrates on noticing symptoms of tension such as a wrinkled brow, clenched fists, or a stiffly held arm

prenatal yoga

helps a woman stay overall fit by their focus on gentle stretching and deep breathing; breathing techniques are also useful in labor to help both relaxation and pain management

squatting

helps to stretch the muscles of the pelvic floor; useful position for second-stage labor

Second-Stage Breathing

holding the breath for a prolonged time impairs blood return from the vena cava (a Valsalva maneuver); not encouraged

Common sites for childbirth include..

hospitals, ABCs, and home settings.

Psychosexual Method (Kitzinger)..

includes a program of conscious relaxation and levels of progressive breathing that encourage a woman to "flow with" rather than struggle against contractions

A nurse observes a woman in labor and her spouse as they practice breathing exercises to manage the client's pain. Before each contraction, she takes a deep, cleansing breath and then breathes at a controlled pace. During each contraction, she gradually shifts from slow, deep breaths to shallow, rapid ones and then back to slow, deep ones. Her spouse coaches her and performs effleurage on her abdomen. The nurse recognizes that this couple is using which method of pain management?

lamaze

pelvic floor contractions (Kegal excercises)

muscle-strengthening exercises helpful in the postpartum period to reduce pain and promote perineal healing; helps prevent stress incontinence

A client expresses a concern to the nurse about maintaining sexual responsiveness and preventing incontinence after giving birth. Which of the following exercises should the nurse most strongly recommend for these purposes?

pelvic floor contractions

A pregnant woman is taught many different types of exercises during pregnancy to help relieve pain, prevent complications, and facilitate an easier delivery. Which of the following exercises is taught to relieve backache during pregnancy?

pelvic rocking

A client in the third trimester comes to the clinic for a follow up visit complaining of a backache. Which activity would the nurse include when teaching the client how to relieve her backache?

pelvic rocking exercises

A nurse is providing care to a couple who is planning to get pregnant within a short time and who need proactive nutritional strategies prior to conceiving. The nurse would most likely recommend which type of care?

preconception visits

Classes for expectant parents provide information on..

pregnancy, birth, and child care.

consciously controlled breathing

provides distraction as well as prevents the diaphragm from descending fully and putting pressure on the expanding uterus

conditioned reflex

reflex that automatically occur in response to a stimulus

A nurse is caring for a client in the first trimester of her second pregnancy. Which of the following education classes would be most appropriate for the nurse to suggest?

refresher course

tailor sitting

stretches perineal muscles without occluding blood supply to the lower legs; one leg in front of the other, not put one ankle on top of the other to avoid interfering with leg circulation

Common exercises taught in pregnancy to strengthen perineal muscles are..

tailor sitting, squatting, and Kegel exercises.

Types of childbirth preparations include..

the Bradley (partner coached), Kitzinger (psychosexual), Dick-Read, and Lamaze methods. Lamaze is the most common method used in the United States.

Abdominal muscle contraction and pelvic rocking exercises both strengthen..

the abdominal muscles and help relieve backache.

A nurse is teaching a preconception class and discussing the importance of nutrition modifications during the preconception phase. The nurse stresses an increase in folic acid and protein. Which foods are high in protein? (Select all that apply.)

tofo, beans, and red meat