Review questions (test 2)

A nurse explains the purpose of effleurage to a client in early labor. The nurse tells the client that effleurage is:

Light stroking of the abdomen to facilitate relaxation during labor and provide tactile stimulation to the fetus

Should change moms position every

30 min

A fetal scalp pH below ____ indicates acidosis and fetal hypoxia.

7.25

A client arrives at a birthing center in active labor. Her membranes are still intact, and the nurse-midwife prepares to perform an amniotomy. A nurse who is assisting the nurse-midwife explains to the client that after this procedure, she will most likely have:

Amniotomy can be used to induce labor when the condition of the cervix is favorable (ripe) or to augment labor if the process begins to slow. Rupturing of membranes allows the fetal head to contact the cervix more directly and may increase the efficiency of contractions.

A pregnant client is admitted to the labor room. An assessment is performed, and the nurse notes that the client's hemoglobin and hematocrit levels are low, indicating anemia. What is she at risk for?

Anemic women have a greater likelihood of cardiac decompensation during labor, postpartum infection, and poor wound healing. Anemia does not specifically present a risk for hemorrhage

After doing Leopold's maneuvers, the nurse determines that the fetus is in the ROP position. To best auscultate the fetal heart tones, the Doppler is placed:

Below the umbilicus on the right side

A laboring client is in the first stage of labor and has progressed from 4 to 7 cm in cervical dilation. In which of the following phases of the first stage does cervical dilation occur most rapidly?

Cervical dilation occurs more rapidly during the active phase than any of the previous phases.

Does a primigravida efface first or dilate first?

Efface then dilate

What things can place a woman at risk for traumatic uterine rupture?

Excessive fundal pressure, forceps delivery, violent bearing down efforts, tumultuous labor, and shoulder dystocia

After epidural is given change positions every ___ and asses vs every ___.

Hour, 5-15 min

A nurse in the labor room is preparing to care for a client with hypertonic uterine dysfunction. The nurse is told that the client is experiencing uncoordinated contractions that are erratic in their frequency, duration, and intensity. The priority nursing intervention would be to:

Management of hypertonic labor depends on the cause. Relief of pain is the primary intervention to promote a normal labor pattern.

What opioid agonist analgesic do you not want to give to pt with cardiac problems?

Meperidine

A laboring client complains of low back pain. The nurse replies that this pain occurs most when the position of the fetus is:

Occiput posterior

A nurse is assigned to care for a client with hypotonic uterine dysfunction and signs of a slowing labor. The nurse is reviewing the physician's orders and would expect to note what prescribed treatments for this condition?

Oxytocin

The nurse is monitoring the fetal heart rate (FHR) of a client who is in labor at full term. What measure does the nurse take to obtain the most accurate baseline fetal heart rate?

The baseline fetal heart rate is the average rate during a 10-minute segment, and that is why the nurse must obtain a 10-minute segment of tracing to determine the baseline FHR. In order to determine a baseline heart rate, the 10-minute segment must not include periods of marked variability or periodic or episodic changes. The nurse must ensure there are at least 2 minutes of interpretable baseline data in a 10-minute segment of tracing.

During the period of induction of labor, a client should be observed carefully for signs of:

Uterine tetany could result from the use of oxytocin to induce labor. Because oxytocin promotes powerful uterine contractions, uterine tetany may occur. The oxytocin infusion must be stopped to prevent uterine rupture and fetal compromise.

What fetal position is most favorable for birth?

Vertex presentation

A laboring client is to have a pudendal block. The nurse plans to tell the client that once the block is working she:

Will not feel the episiotomy

The goal of management in abruptio placentae is to

control the hemorrhage and deliver the fetus as soon as possible. Delivery is the treatment of choice if the fetus is at term gestation or if the bleeding is moderate to severe and the mother or fetus is in jeopardy.

Variable decelerations usually are seen as a result of

cord compression; a change of position will relieve pressure on the cord.

While monitoring the fetal heart rate (FHR) of a client, the nurse notes tachycardia. What is a probable cause for this condition?

early signs of fetal distress

Signs of placental separation include

lengthening of the umbilical cord, a sudden gush of dark blood from the introitus (vagina), a firmly contracted uterus, and the uterus changing from a discoid (like a disk) to a globular (like a globe) shape. The client may experience vaginal fullness, but not severe uterine cramping.

The five essential factors (5 P's) are

passenger (fetus), passageway (pelvis), powers (contractions), placental position and function, and psyche (psychological response of the mother).

A nurse is caring for a client in labor. The nurse determines that the client is beginning in the 2nd stage of labor when...

the cervix is dilated completely.

The nurse instructs a pregnant client to breathe through the mouth and keep it open while pushing during labor. What is the rationale for this nursing intervention?

to increase both maternal and fetal oxygenation.

A nurse is monitoring a client in labor. The nurse suspects umbilical cord compression if which of the following is noted on the external monitor tracing during a contraction?

variable decelerations