OB EXAM 2 CH. 13 PREP U
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? Encourage women with previous cesareans to always have a cesarean. Ensure care during labor includes immunizations. Reduce the rate of cesarean births among low-risk women. Ensure all couples receive preconception genetic counseling.
Reduce the rate of cesarean births among low-risk women.
woman in labor reveals that the scapula of the fetus is the presenting part. finding as indicating which fetal presentation?
shoulder
Which consideration is a priority when caring for a mother with strong contractions 1 minute apart? Maternal request for pain medication Fetal heart rate in relation to contractions The station in which the fetus is located Maternal heart rate and blood pressure
Fetal heart rate in relation to contractions
What term is used to describe the position of the fetal long axis in relation to the long axis of the mother? Fetal attitude Fetal lie Fetal position Fetal presentation
Fetal lie
True labor contractions
felt in the lower back, in contrast to Braxton Hicks contractions that typically last about 30 seconds and occur primarily in the abdomen and groin and are relieved by walking, voiding, eating, increasing fluid intake, or changing positions. come if occurring every 5 min
Assessment reveals that the fetus of a client in labor is in the vertex presentation. The nurse determines that which part is presenting? occiput buttocks shoulders brow
occiput
The community health nurse is conducting a presentation on labor and delivery. When illustrating the birth process, the nurse should point out "0 station" refers to which sign? "This means +1 and the baby is entering the true pelvis." "This indicates that you start labor within the next 24 hours." "This is just a way of determining your progress in labor." "The presenting part is at the true pelvis and is engaged."
"The presenting part is at the true pelvis and is engaged."
Which nursing action is a priority when the fetus is at the +4 station? Have a blue bulb suction and an infant warmer ready. Prepare for an immediate cesarean birth. Have a tocometer and a client gown ready. Provide lubricating jelly and an internal monitor.
Have a blue bulb suction and an infant warmer ready.
How is oxytocin administered?
administered piggybacked into the primary intravenous line with an infusion pump titrated to uterine activity.
When teaching a group of nursing students about the stages of labor, the nurse explains that softening, thinning, and shortening of the cervical canal occur during the first stage of labor. Which term is the nurse referring to in the explanation? dilation (dilatation) molding effacement crowning
effacement
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? transition phase latent phase stage two stage three
latent phase
the nurse assesses a client in labor and finds that the fetal long axis is longitudinal to the maternal long axis. How should the nurse document this finding? attitude presentation lie position
lie
A pregnant woman at 37 weeks' gestation calls the clinic to say she thinks that she is in labor. The nurse instructs the woman to go to the health care facility based on the client's report of contractions that are: occurring about every 5 minutes. relieved by walking. lasting about 30 seconds. occurring in the abdomen and groin.
occurring about every 5 minutes.
The five "Ps" of labor are: passageway, passenger, position, powers, psych. passenger, position, presentation, pushing, psych. passenger, position, powers, presentation, psych. passenger, posture, position, presentation, psych.
passageway, passenger, position, powers, psych.
The five "Ps" of labor are: passenger, position, powers, presentation, psych. passenger, position, presentation, pushing, psych. passageway, passenger, position, powers, psych. passenger, posture, position, presentation, psych.
passageway, passenger, position, powers, psych.
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 moved down into the pelvis; this means you will be in labor within 24 hours, so wait for contractions then come to the hospital." "That is something we expect with a second or third baby, but because it is your first, you need to be checked." "This is not normal unless you are in active labor; come to the hospital and be checked." "The baby has dropped into the pelvis; your body and baby are getting ready for labor in the next few weeks."
"The baby has dropped into the pelvis; your body and baby are getting ready for labor in the next few weeks."
At which point along the birth canal must the fetal head extend for successful passage? At the level of the iliac crest At the level of the ischial spines At the level of the pelvic inlet At the level of the symphysis pubis
At the level of the symphysis pubis
During which time is the nurse correct to document the end of the third stage of labor? At the time of placental delivery When the mother is moved to the postpartum unit When pushing begins Following fetal birth
At the time of placental delivery
Braxton Hicks contractions are termed "practice contractions" and occur throughout pregnancy. When the woman's body is getting ready to go into labor, it begins to show anticipatory signs of impending labor. Among these signs are Braxton Hicks contractions that are more frequent and stronger in intensity. What differentiates Braxton Hicks contractions from true labor? Braxton Hicks contractions usually decrease in intensity with walking. Braxton Hicks contractions do not last long enough to be true labor. Braxton Hicks contractions get closer together with activity. Braxton Hicks contractions cause "ripening" of the cervix.
Braxton Hicks contractions usually decrease in intensity with walking.
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? Do a vaginal exam to see if the placenta is stuck in the birth canal. Nothing. Normal time for stage three is 5 to 30 minutes. Notify the primary care provider of the problem. Increase the IV tocolytic to help in expulsion of the placenta.
Nothing. Normal time for stage three is 5 to 30 minutes.
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? Lasts about 20 to 25 seconds Occurs in an irregular pattern Radiates from the back to the front Slows when the woman changes position
Radiates from the back to the front
What is oxytocin used for?
Stimulates labor, uterine contractions, milk let-down; controls uterine hemorrhage
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. Spontaneous rupture of membranes occurs during first pregnancy. Braxton Hicks contractions are not strong enough during first pregnancy. Contractions are stronger during the first pregnancy than the second.
The cervix takes around 12 to 16 hours to dilate during first pregnancy.
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 client is fully effaced. The fetus has descended down the birth canal. The fetus is floating high in the pelvis. The fetus is in the true pelvis and engaged.
The fetus is in the true pelvis and engaged.
When teaching a group of soon-to-be parents about the structures of the fetal skull, the nurse describes the anterior fontanel (fontanelle). Which description would the nurse include? approximately 2 to 3 cm in size located at the back of the fetal head triangular shape closes 8 to 12 weeks after birth
approximately 2 to 3 cm in size
A nurse is providing care to a woman in labor. When reviewing the woman's medical record, the nurse notes that fetal position is documented as LSA. The nurse interprets this to mean that which part of the fetus is presenting?
buttocks
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 False pelvis Perineum Uterus
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? decrease in the level of estrogen change in estrogen-to-progesterone ratio decrease in number of oxytocin receptors decrease in prostaglandins, leading to myometrium contractions
change in estrogen-to-progesterone ratio
The nurse is measuring a contraction from the beginning of the increment to the end of the decrement for the same contraction. The nurse would document this as which finding? peak duration frequency intensity
duration
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? third first, latent second first, active
first, active SUBMIT ANSWER
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 lying supine with legs in lithotomy stirrups squatting while holding her breath lying on side, arms grasped on abdomen
head elevated, grasping knees, breathing out
The nurse is teaching a prenatal class on the difference between true and false labor contractions. The nurse determines the session is successful when the class correctly chooses which factor as an indication of true labor contraction? cause discomfort over the top of uterus remain irregular with the same intensity subside when walking around and use the lateral position increase even if relaxing and taking a shower
increase even if relaxing and taking a shower
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. slight decrease in body temperature increase in gastric emptying and pH increase in respiratory rate increase in heart rate increase in blood pressure
increase in heart rate increase in blood pressure increase in respiratory rate
While discussing labor with a client and her partner, the nurse is asked what the best position is for giving birth to the baby. The nurse provides them with information that indicates research has shown which position as the best? position of comfort for the mother squatting lying on her back with feet in stirrups semi-Fowler position
position of comfort for 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 oxytocin prolactin progesterone
relaxin
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 -5 0 +1
+4
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 lying supine with legs in lithotomy stirrups lying on side, arms grasped on abdomen squatting while holding her breath
head elevated, grasping knees, breathing out
which client outcome during active and transitional labor is best? The client will walk in the hall for 15 minutes every 2 hours. The client will state a pain level of 7 and under during contractions. The client will practice breathing techniques during contractions. The client will tolerate 8 oz (240 ml) of clear liquids during labor process.
The client will practice breathing techniques during contractions.
fetus parallel to the maternal spine
longitude
he 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." "She is still in early latent labor and has much too long to go to tell when she will give birth." "She is in the transition phase of labor, and it will be within 2 to 3 hours, though it might be sooner." "She is doing well and is in the second stage; it could be anytime now."
"She is in active labor; she is progressing at this point and we will keep you posted."
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? ROP LOA ROA LOP
ROA
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 (38.7°C).
The nursing instructor is teaching a session on how labor starts. The instructor determines the session is successful when the class correctly chooses which causative factor that initiates labor? Progesterone levels rise at term to initiate contractions. Oxytocin blood levels increase with contractions. The ovary releases additional estrogen at term. Prostaglandins may be the causative factor of labor.
Prostaglandins may be the causative factor of labor.