Chapter 13 - Labor and Birth Processes

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 which to be causes of the extreme pain in the client? Select all that apply. a. lower uterine segment distention b. fetus moving along the birth canal c. stretching and tearing of structures d. spontaneous placental expulsion e. dilation of the cervix

a, c, e

2nd phase of labor

active phase

External Rotation

allows the shoulders to rotate internally to fit the maternal pelvis

A client in the third stage of labor has experienced placental separation and expulsion. Why is it necessary for a nurse to massage the woman's uterus briefly until it is firm? a. to reduce boggy nature of the uterus b. to remove pieces left attached to uterine c. to constrict uterine blood vessels d. to lessen the chances of conducting an episiotomy

c

Oxytocin aids in stimulating prostaglandin synthesis through receptors in the __________.

decidua

Descent

downward movement of the fetal head until it is with the pelvic inlet. a maneuver that occurs throughout the laboring process

The thinning out process of the cervix during labor is termed __________?

effacement

Vaginal birth is most favorable with _________ type of pelvis because the inlet is round and the outlet is roomy.

gynecoid

What are the reasons that cause women to adopt back-lying positions during labor?

helps conserve energy; facilitates vaginal examinations

What are the maternal physiologic responses that occur as a woman progresses through childbirth?

increase HR of 10 to 20 bpm; incense BP up to 35 mm Hg; increased RR; slight increase in temp.; muscular aches/cramps

1st phase of labor

latent phase

_________ occurs when the fetal presenting part begins to descend into the maternal pelvis.

lightening

Flexion

occurs as the vertex meets resistance from the cervix, walls of the pelvis, or the pelvic floor

In which clients are breech presentations normally observed?

prematurity, placenta previa, multiparity, uterine abnormalities, some congenital anomalies

The __________ suture is located between the parietal bones and divides the skull into the right and left halves.

sagittal

An increase in prostaglandins leads to myometrial _________ and to a reduction in cervical resistance.

sensitization

Extension

the head emerges through extension under the symphysis pubis, along with the shoulders

3rd phase of labor

transition phase

What are the signs of separation that indicate the placenta is ready to deliver?

uterus rises upward; umbilical cord lengthens; blood trickles suddenly from the vaginal opening; uterus changes its shape to globular

__________ station is designated when the presenting part is at the level of the maternal ischial spines.

zero

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? a. long axis of fetus is at 60 degrees to that of client b. long axis of fetus is parallel to that of client c. long axis of fetus is perpendicular to that of client d. long axis of fetus is at 45 degrees to that of client

c

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? a. uterine abnormalities b. fetal anomalies c. congenital anomalies d. prematurity

b

Engagement

occurs when the greatest transverse diameter of the head in vertex passes through the pelvic inlet

The birth __________ is the route through which the fetus must travel to be birthed vaginally.

passageway

Why should the nurse encourage the pregnant client experiencing contractions to adopt the upright or lateral position?

reduces the duration of the second stage of labor; reduces perineal tears; enhances a sense of control; alters the shape and size of the pelvis; assist gravity to move the fetus downward

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 play in aiding labor? a. these contractions help in softening and ripening of the cervix b. these contractions increase the release of prostaglandins c. these contractions increase oxytocin sensitivity d. these contractions make maternal breathing easier

a

A nurse is assigned the task of educating a pregnant client about birth. Which nursing interventions should the nurse perform as a part of prenatal education for the client to ensure a positive birth experience? Select all that apply. a. provide the client clear information on procedures involved b. encourage the client to have a sense of mastery and self-control c. encourage the client to have a positive reaction to pregnancy d. instruct the client to spend some time alone each day e. instruct the client to begin changing the home environment

a, b, c

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. a. increase in heart rate b. increase in blood pressure c. increase in respiratory rate d. slight decrease in body temperature e. increase in gastric emptying and pH

a, b, c

The assessment of a pregnant client, who is toward the end of her third trimester, reveals that she has increased prostaglandin levels. For which factors should the nurse assess the client? Select all that apply. a. reduction in cervical resistance b. myometrial contractions c. boggy appearance of the uterus d. softening and thinning of the cervix e. hypotonic character of the bladder

a, b, d

A nurse is caring for a pregnant client during labor. Which methods should the nurse use to provide comfort to the pregnant client? Select all that apply. a. hand holding b. chewing gum c. massaging d. acupressure e. prescribed pain killers

a, c, d

A client in her third trimester of pregnancy arrives at a health care facility with a report of cramping and low back pain; she also notes that she is urinating more frequently and that her breathing has become easier the past few days. Physical examination conducted by the nurse indicates that the client has edema of the lower extremities, along with an increase in vaginal discharge. What should the nurse do next? a. notify the health care provider b. continue to monitor the client c. assess the client's blood pressure d. prepare the client for birth

b

A pregnant client wants to know why the labor of a first-time-pregnant woman usually lasts longer than that of a woman who has already delivered once and is pregnant a second time. What explanation should the nurse offer the client? a. Braxton Hicks contractions are not strong enough during first pregnancy b. Contractions are stronger during the first pregnancy than the second c. the cervix takes around 12 to 16 hours to dilate during first pregnancy d. spontaneous rupture of membranes occurs during first pregnancy

c

What are the factors that ensure a positive birth experience for the pregnant client?

clear information on procedures; positive support; sense of mastery, self-confidence; positive reaction to the pregnancy; preparation for the childbirth

A nurse is caring for a client in labor who is delivering. For which fetal response should the nurse monitor? a. decrease in arterial carbon dioxide pressure b. increase in fetal breathing movements c. increase in fetal oxygen pressure d. decrease in circulation and perfusion to the fetus

d

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? a. diffuse abdominal cramping b. rupturing of fetal membranes c. start of regular contractions d. dilation of cervix diameter of 10 cm

d

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? a. effacement and dilation of the cervix b. shortening of the upper uterine segment c. reduction in length of the cervical canal d. restoration of blood flow to uterus and placenta

d

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 to be an advantage of adopting a kneeling position during labor? a. it helps the woman in labor to save energy b. it facilitates vaginal examinations c. it facilitates external belt adjustment d. it helps to rotate fetus in a posterior position

d

The elongated shape of the fetal skull at birth as a result of overlapping of the cranial bones is known as _________.

molding

A sudden increase in energy on the part of the expectant woman 24 to 48 hours before the onset of labor is sometimes referred as _________.

nesting

4th phase of labor

pelvic phase

5th phase of labor

perineal phase

7th phase of labor

placental expulsion

6th phase of labor

placental separation

What are the factors influencing the ability of a woman to cope with labor stress?

previous birthing experiences; involvement of support system; expectations of birthing experience; anxiety and fear of labor; fatigue and weariness