Chapter 8: Nursing Care of Women W/ Complications During Labor and Birth Practice Questions

A woman is preparing for administration of a cervical ripening agent. What nursing actions will the nurse anticipate implementing? (Select all that apply.) a. Insert IV. b. Record a baseline fetal heart rate. c. Explain procedure to patient. d. Instruct patient to ambulate immediately afterward. e. Ensure a tocolytic is available.

- a, b, c - IV with saline or heparin is administered in case uterine tachysystole occurs so IV tocolytics can be used - Why not e if IV tocolytics are on stand-by to be used, maybe it refers to PO tocolytics which are not used, but IV tocolytics are needed instead?

A client is admitted in labor with spontaneous rupture of membranes 24 hours earlier. The fluid is clear and the fetal heart rate is 124 with moderate variability. Which assessment is most important for the nurse to make at this time? 1. Contraction frequency and duration. 2. Maternal temperature. 3. Cervical dilation and effacement. 4. Maternal pulse rate.

1. Contraction frequency and duration. - The biggest priority during ROM is infection which is indicated by mom's temp, especially if its been 24 hrs or longer after membranes are ruptured

A primigravida's membranes rupture spontaneously. Which action should the nurse take first? 1. Determine the fetal heart rate. 2. Prepare for immediate delivery. 3. Monitor the contraction pattern. 4. Note the amount, color, and odor of the amniotic fluid.

1. Determine the fetal heart rate. - Consider safety, yes 4. noting the characteristics of the amniotic fluid is important, however, determining FHR takes priority bc of primarily safety of the baby, knowing the FHR helps know risks like uterine cord prolapse or cord compression, which reflects on the FHR (variable decels)

During a vaginal delivery, the obstetrician declares that a shoulder dystocia has occurred. Which of the following actions by the nurse is appropriate at this time? 1. Administer oxytocin intravenously per doctor's orders. 2. Flex the woman's thighs sharply toward her abdomen. 3. Apply oxygen using a tight-fitting face mask. 4. Apply downward pressure on the woman's fundus.

2. Flex the woman's thighs sharply toward her abdomen. - This action is called the McRoberts' maneuver, which is done during a shoulder dystocia to help open and increase the pelvic outlet somewhat to give more space for the baby to be delivered - Don't confuse the fundus with the suprapubic area, putting pressure on the fundus can make the baby more stuck, but suprapubic pressure is a typical nursing action for shoulder dystocia and help get the baby out

The nurse can anticipate that which of the following patients may be scheduled for induction of labor? A woman who is: 1. 38 weeks' gestation with fetus in transverse lie. 2. 40 weeks' gestation with fetal macrosomia. 3. 40 weeks' gestation with gestational hypertension. 4. 40 weeks' gestation with a fetal prolapsed cord.

3. 40 weeks' gestation with gestational hypertension. - The pregnancy can't be continued in the case of gestation hypertension, so mom has to be induced for labor - Induction puts baby at risk for other options

A woman has been in the second stage of labor for 2 1/2 hours. The fetal head is at +4 station and the fetal heart is showing mild late decelerations. The obstetrician advises the woman that the baby will be delivered with forceps. Which of the following actions should the nurse take at this time? 1. Obtain a consent for the use of forceps. 2. Encourage the woman to push between contractions. 3. Assess the fetal heart rate after each contraction. 4. Advise the woman to refuse the use of forceps.

3. Assess the fetal heart rate after each contraction. - Note that consent for forceps isn't needed, vaginal delivery consent covers the use of forceps - FHR is always assessed after each contraction

A woman with severe preeclampsia, 38 weeks' gestation, is being induced with IV oxytocin (Pitocin). Which of the following would warrant the nurse to stop the infusion? 1. Blood pressure 160/110. 2. Frequency of contractions every 3 minutes. 3. Duration of contractions of 130 seconds. 4. Fetal heart rate 156 with early decelerations.

3. Duration of contractions of 130 seconds. - The primary concern is the long length of the contractions, 130 seconds is too long for a woman who's on oxytocin which puts baby at risk - Mom's BP is not an issue and is expected for mom's diagnosis of preeclampsia

A pregnant woman, G3 P2002, had her two other children by cesarean section. Which of the following situations would mandate that this delivery also be by cesarean? 1. The woman refuses to have a regional anesthesia. 2. The woman is postdates with intact membranes. 3. The baby is in the occiput posterior position. 4. The previous uterine incisions were vertical.

3. The baby is in the occiput posterior position. - Occiput posterior, where baby's back of the head faces the back of the pelvis is not an indication for c-section, bet a previous c-section definitely is - A previous c-section is at risk of uterine rupture during a regular vaginal birth, so another c-section is done instead

A woman is scheduled to have an external version for a breech presentation. The nurse carefully assesses the client's chart knowing that which of the following is a contraindication to this procedure? 1. Station -2. 2. 38 weeks' gestation. 3. Reactive NST. 4. Previous cesarean section.

4. Previous cesarean section. - A previous c-section is a major contraindication for version bc version can rupture the incision - Station isn't a risk for version

A client is scheduled for an external version. The nurse would expect to prepare which of the following medications to be administered prior to the procedure? 1. Oxytocin (Pitocin). 2. Ergonovine (Methergine). 3. Betamethasone (Celestone). 4. Terbutaline (Brethine).

4. Terbutaline (Brethine). - Terbutaline is a muscle relaxant, so its administered before the version so the uterine muscle doesn't prevent the maneuver - Betamethasone, used for fetal lung maturity isn't used - Methergine is used to contract the uterus, usually for postpartum bleeding, it can actually make the version maneuver more difficult

A woman is having a difficult labor because the fetus is presenting in the right occipital position (ROP). What position will the nurse promote to encourage fetal rotation and pain relief? a. Prone with legs supported and give her a back massage b. Supine with legs bent at the knee c. Standing with support d. Sitting up and leaning forward on the over-bed table

d. Sitting up and leaning forward on the over-bed table - This position, similar to orthopneic helps rotate the baby in the correct position (sitting, kneeling, standing & leaning forward) - Hands-knees position, side-lying, squatting, and lunging on chair are other positions that can help rotate the baby and give pain relief

A nurse is assisting with the care of a client in active labor. The nurse observes clear fluid and a loop of pulsating umbilical cord outside the client's vagina. Which of the following actions should the nurse perform first? a. Place the client in the Trendelenburg position. b. Apply finger pressure to the presenting part. c. Administer oxygen at 10 L/min via a nonrebreather mask. d. Call for assistance.

d. Call for assistance. - Safety first, the other 3 actions should be performed, but calling for help is priority, bc the provider or RN can manually move and relieve pressure off the cord

A new mother is distressed and tearful about the elevated dome over her infants posterior fontanelle. The nurse responds, This condition will resolve itself in a few days. What is the cause? a. Prolonged pressure against the partially dilated cervix b. Small leak of fluid through the posterior fontanelle c. Pressure of the forceps during delivery d. The effect of the vacuum extractor

d. The effect of the vacuum extractor - Provide education and reassure the mom that the dome can happen bc of the vacuum extractor, the bump is completely benign and goes away after a few days

The nurse in the obstetrician's office is caring for four 25-week-gestation prenatal clients who are carrying singleton pregnancies. With which of the following clients should the nurse carefully review the signs and symptoms of preterm labor (PTL)? Select all that apply. 1. 38-year-old in an abusive relationship. 2. 34-year-old whose first child was born at 32 weeks' gestation. 3. 30-year-old whose baby has a two-vessel cord. 4. 26-year-old with a history of long menstrual periods. 5. 22-year-old who smokes 2 packs of cigarettes every day.

1, 2, 5 - A mom thats over 35 is usually at risk for preterm labor along with domestic violence - A 2 vessel cord doesn't but the mom at risk for preterm labor - Cigarette smoking along with drug use puts mom at risk of preterm labor

A client just spontaneously ruptured membranes. Which of the following factors makes her especially at high risk for having a prolapsed cord? Select all that apply. 1. Breech presentation. 2. Station -3. 3. Oligohydramnios. 4. Dilation 2 cm. 5. Transverse lie.

1, 2, 5 - Risks for prolapse cord is a breech presentation, low station, and transverse lie - Risks factors are abnormal presentation like breech, bc the cord can slip past the baby in these positions and become the presenting part - Similar situation for a negative fetal station, the baby is not yet engaged and so high up, there's space for the cord to slip and become the presenting part - Hydramnios too little amniotic fluid is actually a risk factor for a prolapsed cord no oligohydramnios - Transverse is another malpresentation that lead to prolapsed cord - Dilation should not cause prolapse cord, dilation is a regular part of labor

A client is on terbutaline (Brethine) via subcutaneous pump for preterm labor. The nurse auscultates the fetal heart rate at 100 beats per minute via Doppler. Which of the following actions should the nurse perform next? 1. Assess the maternal pulse while listening to the fetal heart rate. 2. Notify the health care provider. 3. Stop the terbutaline infusion. 4. Administer oxygen to the mother via face mask.

1. Assess the maternal pulse while listening to the fetal heart rate. - Terbutaline increases both mom and baby's HRs, so its possible for the doppler to pick up the mom's HR instead of baby. - If mom and baby's HR are at the same rate from mom's radial pulse and FHR, then it confirms that its mom's HR that's being picked up

The nurse is assigned to assist with caring for a client who has been admitted to the labor unit. The client is 9 cm dilated and is experiencing precipitous labor. Which is the priority nursing action? 1. Prepare for an oxytocin infusion. 2. Keep the client in a side-lying position. 3. Prepare the client for epidural anesthesia. 4. Encourage the client to start pushing with the contractions.

2. Keep the client in a side-lying position. - The priority for precipitous labor is fetal oxygenation, caused by the frequent contractions and short rests for this type of labor - The best action from these choices 1st, is to keep mom in a side-lying position to allow more blood and O2 to baby by preventing vena cava and aorta compression - Pushing would make the issue worse, since the frequent contractions does not allow synched pushing and may further cause issues with oxygenation

The nurse is monitoring a woman, G2 P1001, 41 weeks' gestation, in labor. A 12 p.m. assessment revealed: cervix, 4 cm; 80% effaced; -3 station; and FH 124 with moderate variability. A 5 p.m. assessment: cervix, 6 cm; 90% effaced; -3 station; and FH 120 with moderate variability. A 10 p.m. assessment: cervix, 8 cm; 100% effaced; -3 station; and FH 124 with moderate variability. Based on the assessments, which of the following should the nurse conclude? 1. Labor is progressing well. 2. The woman is likely carrying a macrosomic fetus. 3. The baby is in fetal distress. 4. The woman will be in second stage in about five hours.

2. The woman is likely carrying a macrosomic fetus. - Make note and read carefully, all other factors of pregnancy is progressing EXCEPT station, which stays at -3 throughout monitoring, the baby isn't descending out of the uterus at all - This is an indicator that the baby is too big to move down, and mom is probably carrying a macrosomal baby

Four women request to labor in the hospital bathtub. In which of the following situations is the procedure contraindicated? Select all that apply. 1. Woman during transition. 2. Woman during second stage of labor. 3. Woman receiving oxytocin for induction. 4. Woman with meconium-stained fluid. 5. Woman with fetus in the occiput posterior position.

3, 4 - Hydrotherapy, done by giving labor in a bathtub, can be therapeutic, however, induction and continuous fetal heart monitoring can't be performed, so if mom is in bathtub, oxytocin can't be used for induction and baby who could be in fetal distress won't be able to be monitored - There's no contraindication if baby's in the occiput posterior position

A nurse is caring for a gravid client who is G1 P0000, 35 weeks' gestation. Which of the following would warrant the nurse to notify the woman's health care practitioner that the client is in preterm labor? Select all that apply. 1. Contraction frequency every 15 minutes. 2. Effacement 10%. 3. Dilation 3 cm. 4. Cervical length of 2 cm. 5. Contraction duration of 30 seconds.

3, 4 - Indicators that mom is in preterm labor are: effacement more than 80%, dilation more than 1cm, and cervical length less than 2.5cm, contractions would be 3 or more within 30 mins.

Which of the following situations in a fully dilated client is incompatible with a forceps delivery? Select all that apply. 1. Maternal history of asthma. 2. Right occiput posterior position at +4 station. 3. Transverse fetal lie. 4. Fetal heart rate of 60 beats per minute at -1 station. 5. Maternal history of cerebral palsy

3, 4 - Baby is not malpresenting, and baby is in the verge of being delivered, so forceps can be used -3 and 4 are correct, baby is malpresenting and its unsafe to use forceps esp. since baby is bradycardic and too high, you can't tell if there's space to use forceps and using them can cause a fractured skull or subdural hematoma

The nurse is assessing the Bishop score on a postdates client. Which of the following measurements will the nurse assess? Select all that apply. 1. Gestational age. 2. Rupture of membranes. 3. Cervical dilation. 4. Fetal station. 5. Cervical position.

3, 4, 5 - ROM is not part of Bishop score - ROM and gestational age is not an indicator on the status of the cervix

A woman being induced with oxytocin (Pitocin) is contracting every 3 min × 30 seconds. Suddenly the woman becomes dyspneic and cyanotic, and begins to cough up bloody sputum. Which of the following nursing interventions is of highest priority? 1. Check blood pressure. 2. Assess fetal heart rate. 3. Administer oxygen. 4. Stop oxytocin infusion.

3. Administer oxygen. - ABCs. Yeah, mom is contracting very frequently, but she also has difficulty breathing and turning blue, the priority action is her airway and breathing, then oxytocin bc mom is dying - The signs mom is showing are classic signs of amniotic fluid embolism, so nurse should give mom O2 and call code

A 28-week-gestation client with intact membranes is admitted with the following findings: Contractions every 5 min × 60 sec, 3 cm dilated, 80% effaced. Which of the following medications will the obstetrician likely order? 1. Oxytocin (Pitocin). 2. Ergonovine (Methergine). 3. Magnesium sulfate. 4. Morphine sulfate.

3. Magnesium sulfate. - Note that magnesium sulfate is used for both preeclampsia and as a tocolytic to stop labor - Methergine is primarily used for postpartum hemorrhage after the placenta's been delivered

The health care practitioner performed an amniotomy 5 minutes ago on a client, G3 P1011, 40 weeks' gestation, -4 station, and ROP position. The fetal heart rate is 140 with variable decelerations. The fluid is green tinged and smells musty. The nurse concludes that which of the following situations is present at this time? 1. The fetus is post-term. 2. The presentation is breech. 3. The cord is prolapsed. 4. The amniotic fluid is infected.

3. The cord is prolapsed. - Its not 4 bc infection is indicated by a bad odor, not musty, even tho there should be no color, but the green color is an indicator of meconium stain not infection, if it was infected it would be yellow and cloudy - variable decels. are indicator of prolapse cord

A client telephones the labor and delivery suite and states, "My bag of waters just broke and it smells funny." Which of the following responses would be appropriate for the nurse make at this time? 1. "Have you notified your doctor of the smell?" 2. "The bag of waters always has an unusual odor." 3. "Your labor should start very soon." 4. "Have you felt the baby move since the membranes broke?"

4. "Have you felt the baby move since the membranes broke?" - Assessing and collecting information from mom is priority, so asking if she notified the doctor is wrong - Because mom's membranes broke and it has a smell, the biggest risks are prolapse cord from the cord slipping when membranes broke & infection, so asking if the baby's has moved helps confirm if the baby's alive and that the cord isn't prolapsed

A woman, G3 P2002, is 6 cm dilated. The fetal monitor tracing shows recurring deep late decelerations. The woman's doctor informs her that the baby must be delivered by cesarean section. The woman refuses to sign the informed consent. Which of the following actions by the nurse is appropriate? 1. Strongly encourage the woman to sign the informed consent. 2. Prepare the woman for the cesarean section. 3. Inform the woman that the baby will likely die without the surgery. 4. Provide the woman with ongoing labor support.

4. Provide the woman with ongoing labor support. - Even in potentially life threatening situations, and you and provider agree that c-section is needed to save baby's life, 3 is scaring the patient into submission not informing - Mom's decision must be prioritized and respected, even if it's life threatening to baby (you are putting your license at risk if you don't respect mom's consent)

A nurse is assisting with the care for a client who reports manifestations of preterm labor. Which of the following findings are risk factors of this condition? (SATA). a) Urinary tract infection b) Multifetal pregnancy c) Hydramnios d) Diabetes mellitus e) uterine abnormalities

a, b, c, d, e - UTI, polyhydramnios, are big risk factors for preterm labor, polyhydramnios bc the excess fluids causes an irritable uterus and risk preterm labor

The nurse is caring for a patient who is threatening preterm labor and has been given glucocorticoids. What is the purpose of glucocorticoid administration? a. Prevent infection. b. Increase fetal lung maturity. c. Increase blood flow from placenta. d. Relax the cervix

b. Increase fetal lung maturity. - Note that glucocorticoids are a type of corticosteroids, so don't get thrown off by the wording, but glucocorticoids like betamethasone help mature baby's lungs if they're preterm

The nurse is caring for four women who are in labor. The nurse is aware that he or she will likely prepare which of the women for cesarean delivery? Select all that apply. 1. Fetus is in the left sacral posterior position. 2. Placenta is attached to the posterior portion of the uterine wall. 3. Fetus has been diagnosed with meningomyelocele. 4. Client is hepatitis B surface antigen positive. 5. The lecithin/sphingomyelin ratio in the amniotic fluid is 1.5:1.

1, 3 - 1 and 3 are correct, fetal anomalies and baby malpresenting are indicated for c-section - However, just like hep B doesn't put baby in risk for breastfeeding, it also doesn't put baby at risk during c-section, the only 2 viral disease that would need c-section for baby is HIV and Herpes Simplex 2

Immediately after a woman spontaneously ruptures her membranes, the nurse notes a loop of the umbilical cord protruding from the woman's vagina. Which of the following actions should the nurse perform first? 1. Put the client in the knee-chest position. 2. Assess the fetal heart rate. 3. Administer oxygen by tight face mask. 4. Telephone the obstetrician with the findings.

1. Put the client in the knee-chest position. - Priority action and safety - Nurse must perform the first action that can help save baby, don't get stuck in actions of assessing first, if its an emergency situation - Here the first action is position change because it can help move the umbilical cord and stop compression, then you can assess to check if the action worked - all other actions are performed, but by putting mom in knee-chest position it can save the baby

After a precipitous delivery, the nurse notes that the new mother is passive and only touches her newborn briefly with her fingertips. The nurse should do which to help the woman process what has happened? 1. Support the mother in her reaction to the newborn. 2. Encourage the mother to breastfeed soon after birth. 3. Tell the mother that it is important to hold the newborn. 4. Document a complete account of the mother's reaction in the birth record.

1. Support the mother in her reaction to the newborn. - Therapeutic communication, acknowledge the mom's feelings and reaction to the fast delivery - Other options, including 3. telling her that its important to hold the baby, dismisses and forces her to do other actions, without acknowledgement of how she may feel

During a strenuous labor, the woman asks for some pain remedy for the sudden pain between her scapulae that seems to occur with every breath she takes. What is the best nursing action? a. Give the pain remedy. b. Notify the charge nurse immediately. c. Turn the patient to her back and flex her knees. d. Suggest that the coach give her a back rub.

b. Notify the charge nurse immediately. - The charge nurse is notified immediately, bc pain between shoulder blades are a sign of uterine rupture

A student nurse questions the instructor regarding what alteration should be made for the assessment of the fundus of a new postoperative cesarean section patient. What is the best response? a. The fundus is not assessed until the second postoperative day. b. The fundus is assessed by walking fingers from the side of the uterus to the midline. c. The fundus is assessed only if large clots appear in lochia. d. The fundus is assessed only once every shift.

b. The fundus is assessed by walking fingers from the side of the uterus to the midline. - Fundal assessment should be performed even if uncomfortable for mom unfortunately to assess for possible hemorrhage - The fundal assessment can be adjusted to be more gentle, so walking fingers from side to midline can prevent any injury to surgical site

What are the rationales for labor induction? (Select all that apply.) a. Placenta previa b. Prolapse of cord c. High station of fetus d. Maternal diabetes e. Placental insufficiency

c, e - Diabetes in mom and definitely placental insufficiency are indications that the mom should be induct to get the baby out ASAP - Mom's diabetic symptoms and conditions can worsen as the pregnancy progresses - If there's not enough blood getting to the baby and its not being resolved, then it may be better to induce and try to get the baby out - a, b, c are actually contraindications for labor induction, a c-section may be needed instead

What nursing assessment should be reported immediately after an amniotomy? a. Fetal heart rate is regular at 154 beats/min. b. Amniotic fluid is clear with flecks of vernix. c. Amniotic fluid is watery and pale green. d. Maternal temperature is 37.8 C.

c. Amniotic fluid is watery and pale green. - Pale green amniotic fluid is a major red flag! This is a sign of meconium stain, so baby is at risk of meconium aspiration and distress - Commit to memory that mom's temp should be less than 38 C (100.4 F), otherwise sign of infection and fever, mom's temp is normal here.

What complications of overstimulation of uterine contractions may occur? (Select all that apply.) a. Water intoxication b. Impaired placental exchange of oxygen and nutrients c. Increased blood pressure d. Convulsions e. Uterine rupture

a, b, e - If mom is being overstimulated, esp. when administered oxytocin, water intoxication can happen bc oxytocin prevents urination and promotes fluid retention - excessive contractions (tachysystole) can cause the placenta to get compressed and prevent O2 and nutrients from getting to the baby - uterine rupture can happen from the force of too many contractions

A woman who is 33 weeks pregnant is admitted to the obstetric unit because her membranes ruptured spontaneously. What complication should the nurse closely assess for with this patient? a. Chorioamnionitis b. Hemorrhage c. Hypotension d. Amniotic fluid embolism

a. Chorioamnionitis - Remember, the biggest risk after ROM is infection, there's no sac to provide protection to baby, and the risk grows after 24hrs so its expected that after ROM that the baby should be delivered soon after - Chorioamnionitis is infection of the amniotic sac

The nurse is administering terbutaline (Brethine) to a pregnant woman to prevent preterm labor. The nurse would assess for which adverse effect? a. Maternal tachycardia b. Maternal hypertension c. Fetal bradycardia d. Fetal hypokalemia

a. Maternal tachycardia - Tachycardia in mom is a common side effect of terbutaline, with the antidote for SEs being propranolol

A labor dysfunction due to decreased uterine muscle tone occurs in a patient who is dilated to 5 cm with membranes intact. What action by the physician will the nurse anticipate? a. Perform an amniotomy. b. Initiate tocolytic drugs. c. Order a sedative for the patient. d. Plan to do an emergency cesarean section.

a. Perform an amniotomy. - We want to induce labor in the mom, help move along dilation, and her membranes are still intact, so an amniotomy will cause ROM - Tocolytics are not used bc it will stop contractions, no sedative is needed, and c-section is done as a last resort if nothing else is helping with the labor or if indicated

How might the nurse instruct the patient to stimulate her nipples in an attempt to increase the quality of uterine contractions? (Select all that apply.) a. Place a warm, moist washcloth over the breast. b. Brush the nipples with a dry washcloth. c. Gently pull on the nipples. d. Apply suction to the nipples with a breast pump. e. Press the palms of her hands down on her breasts.

b, c, d - Along with other methods, brushing nipples with a dry washcloth, pulling on the nipples, and using a breast pump are effective methods of nipple stimulation

A woman is 37 weeks pregnant and questioning the nurse about possible induction of labor at term. What conditions would contraindicate labor induction? (Select all that apply.) a. Maternal gynecoid pelvis b. Placenta previa c. Horizontal cesarean incision d. Prolapsed cord e. Gestational diabetes

b, d - Placenta previa and prolapse cord are contraindications for labor induction, since placenta previa covers vaginal os, amniotomy can damage the placenta and prolapse cord similarly can be damaged in an amniotomy, so a c-sections is performed instead - don't confuse gestational diabetes with hypertension, where induction is actually used for that case - Diabetes is actually indicated for c-section

Which statement indicates a woman understands activity limitations for the management of preterm labor? a. After my shower in the morning, I do the laundry and straighten up the house; then I rest. b. I pack a picnic basket and put it next to the sofa so I do not have to get up for food during the day. c. I have a 2-year-old to care for, but I try to rest as much as I can. d. I get really bored at home, so I go to the shopping mall for just a little while.

b. I pack a picnic basket and put it next to the sofa so I do not have to get up for food during the day. - Mom to prevent preterm labor, can pre-prep to prevent too much activity during the day - c is wrong bc it prevents mom from performing her responsibilities and does not acknowledge how to organize her necessary activities while also resting - Note that walking and activity can cause contractions and labor

A pulsating structure is felt during a vaginal examination of a woman in labor. How would the nurse position the woman to prevent compression of a prolapsed cord? a. On her right side with knees flexed b. On her left side with a pillow placed between her legs c. On her back with her head lower than the rest of her body d. Supine with her legs elevated and bent at the knee

c. On her back with her head lower than the rest of her body - For prolapse cord, one of the positions to help compression is Trendelenburg, along with knee-chest (mom on all fours basically), and side-lying with hips elevated on pillows, not knees flexed or pillows btwn legs - For Trendelenburg, this makes sense bc gravity of the position can help lift the baby off the cord in the vaginal canal

The initial vaginal examination of a woman admitted to the labor unit reveals that the cervix is dilated 9 cm. The panicked woman begs the nurse, Please give me something. What is the most appropriate pain relief intervention for a woman in precipitate labor? a. Get an order for an intravenous narcotic. b. Notify the anesthesiologist for an epidural block. c. Stay and breathe with her during contractions. d. Tell her to bear with it because she is close to delivery.

c. Stay and breathe with her during contractions. - The mom in this case is experiencing a precipitous delivery (fast labor), bc of this delivery is soon expected and the nurse should provide support to mom and keep her calm with breathing, which can help with the pain and coping with contractions - b is wrong, bc of the precipitous delivery, there may not be time to administer an epidural block

A woman who is 24 weeks pregnant is placed on an intravenous infusion of magnesium sulfate. What side effect should the nurse inform the patient that she might experience? a. Nausea and vomiting b. Headache c. Warm flush d. Urinary frequency

c. Warm flush - Magnesium sulfate is a drug that helps stop contractions, pt should warn the pt that they might feel a sudden warm sensation after administration

The nurse is caring for a patient diagnosed with hypotonic labor dysfunction. What will the nurse expect when caring for this patient? a. Elevated uterine resting tone b. Painful and poorly coordinated contractions c. Implementation of fluid restriction d. Use of frequent position changes

d. Use of frequent position changes - Frequent position changes are used to treat discomfort and progress the labor, normally the upright or lateral position helps - IV fluids are increased not decreased