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active phase

Transitioning breaths from "slow, deep breaths to quicker short breaths" at the contraction peak. a. transition phase b. second stage c. active phase d. latent phase

a. The cervix has changes of effacement and dilation (dilatation).

True labor is only indicated when. a. The cervix has changes of effacement and dilation (dilatation). b. The client has a history of giving birth to two infants. c. The contractions increase in duration and intensity. d. The client's membranes ruptured spontaneously.

latent phase

Begin rhythmic "short, quick breaths then blow out through pursed lips." a. transition phase b. second stage c. active phase d. latent phase

a. conscious relation b. distraction c. pain relief without special tools

Patterned breathing techniques used in labor provide which benefits? Select all that apply. a. conscious relaxation b. distraction c. pain relief without special tools d. spirituality

Feel for the fetal buttocks or head while palpating the abdomen The first maneuver involves feeling for the buttocks and head at the uterine fundus. Next, the nurse palpates on the side the fetal back is located. The third maneuver determines presentation and involves palpating the area just above the symphysis pubis. The final maneuver determines attitude and involves applying downward pressure in the direction of the symphysis pubis.

The nurse is performing Leopold maneuvers as part of the initial assessment. Which action would the nurse do first? Feel for the fetal buttocks or head while palpating the abdomen. Feel for the fetal back and limbs as the hands move laterally on the abdomen. Palpate for the presenting part in the area just above the symphysis pubis. Determine flexion by pressing downward toward the symphysis pubis.

b. Provide supplemental oxygen. The nurse should provide supplemental oxygen if a client who has been administered combined spinal-epidural analgesia exhibits signs of hypotension and associated FHR changes. The client should be assisted to a semi-Fowler's position; the client should not be kept in a supine position or be turned on her left side. Discontinuing IV fluid will cause dehydration.

A client administered combined spinal-epidural analgesia is showing signs of hypotension and associated fetal heart rate (FHR) changes. What intervention should the nurse perform to manage the changes? a. Assist the client to a supine position. b. Provide supplemental oxygen. c. Discontinue intravenous (IV) fluid. d. Turn the client to her right side.

a. decreased alertness Morphine is a commonly used opioid for the management of pain during labor. It is associated with newborn respiratory depression, decreased alertness, inhibited sucking, and a delay in effective feeding.

A woman received morphine during labor to help with pain control. Which finding would the nurse need to monitor the newborn for after birth? a. decreased alertness b. increased agitation c. low Apgar d. increased crying

d. "You have no trouble walking around and using the bathroom after you receive the epidural." Epidural anesthesia impairs mobility; most clients are placed on bed rest after epidural anesthesia is given. Urinary catheterization is frequently required.

When a client is counseled about the advantages of epidural anesthesia, which statement made by the counselor would indicate the need for further teaching? a. "Epidural anesthesia is more effective than opioid analgesia in providing pain relief." b. "You can continuously receive epidural anesthesia until you have the baby, and even afterward if you need it." c. "If you end up having a cesarean, the epidural can be used for anesthesia during surgery." d. "You have no trouble walking around and using the bathroom after you receive the epidural."

Fetal heart rate acceleration occurs The fetus is stimulated via an acoustic vibrator. From the stimulation, the fetal heart rate accelerates. If the acceleration occurs, fetal acidosis is not present. Fetal movement is limited in the birth canal. Decelerations do not indicate well-being. Acoustic vibrations do not descend the fetus into the birth canal.

When stimulating the fetus via an acoustic vibrator, which action indicates fetal well-being? An increase in fetal movements Fetal heart rate acceleration occurs. Fetal heart rate deceleration occurs. The fetus descends further into the birth canal.

b. Have the client pant and blow through the contractions The essential nursing action does not allow the client to push. The action is to have the client pant at the beginning of the contraction and then have the client blow through the peak of the contraction. Pushing efforts before the cervix is fully dilated may result in cervical lacerations or cause edema of the cervix, slowing delivery of the fetus. No pushing should be accomplished at this time. It is difficult to divert energy but not push. Assuming a Fowler position places weight on the perineum.

Which nursing action is essential if the laboring client has the urge to push but she is not fully dilated? a. Have the client lightly push to meet the need. b. Have the client pant and blow through the contraction. c. Have the client divert the energy to squeezing a hand. d. Assist the client to a Fowler position.

b. maternal hypertension and fetal bradycardia Epidural anesthesia conveys the risk of hypotension, especially if the client has not received an adequate amount of fluid before the procedure is performed. A sudden drop in maternal blood pressure can cause uterine hypoperfusion, which may result in fetal bradycardia. The other choices are not an adverse effect of epidural anesthesia.

A client in labor has administered an epidural anesthesia. Which assessment findings should the nurse prioritize? a. maternal hypotension and fetal tachycardia b. maternal hypertension and fetal bradycardia c. maternal hypotension and fetal bradycardia d. maternal hypertension and fetal tachycardia

pudendal block The client is too far dilated to have any parenteral medication or an epidural block. The best option is a local block or a pudendal block that will numb the vaginal wall to block the pain sensation to the pudendal nerve. The paracervical block is only used in the first stage of labor, and this client is in the second stage.

A woman dilated to 10 cm and feeling the urge to "have a bowel movement" is refusing to push and is screaming, "It hurts down there too much to push." What option should the nurse suggest at this point for pain management to facilitate pushing? epidural anesthesia pudendal block paracervical block parenteral medication

During the early labor phase Effleurage, a form of touch therapy, is a technique that the client uses in early labor. Light touch stimulates the nerve pathways to the brain and keeps them busy, thereby blocking pain sensation. This technique does not determine true labor, is not helpful in the active stage of labor (as contractions are more intense), nor is it done when the client is ready to give birth.

At which time in a client's labor process would the nurse encourage effleurage? At home as the client is determining true labor During the early labor phase During the active labor phase Immediately prior to birth

a. help the woman change positions Changing to a different position is a first intervention to determine if this will improve the oxygen to the fetus. It may not necessarily mean to elevate the left hip with a pillow. The client could try sitting up and dangling her feet.

The nurse is monitoring the EFM and notes the following: variable V-shaped decelerations in the FHR lasting about 30 seconds, accelerations of about 5 bpm before and after each deceleration, no overshoot, and baseline FHR within normal limits. Which response should the nurse prioritize? a. Help the woman change positions. b. Discontinue supplemental oxygen. c. Position the woman on her side with a pillow under her left hip. d. Start an oxytocic infusion and decrease the rate of IV fluids.

a. descent Descent is documented by station, which is the relationship of the fetal presenting part to the maternal ischial spines. Descent continues throughout labor until the fetus reaches the fetal station of +4. The other options represent fetal movements to accommodate the passage of the fetus.

Which cardinal movement of delivery is the nurse correct to document by station? a. Descent b. Flexion c. Extension d. Internal rotation

a. assess for labor progression Performing breathing exercises, ambulating, changing position, and emptying the bladder all can help the client experience a reduction in pain. However, the best first step is to assess the client for labor progress before assisting her otherwise. Bearing down can be a sign that the client is 10 cm dilated.

A client has been in labor for 10 hours and is 6 cm dilated. She has already expressed a desire to use nonpharmacologic pain management techniques. For the past hour, she has been lying in bed with her doula rubbing her back. Now, she has begun to moan loudly, grit her teeth, and bear down with each contraction. She rates her pain as 8 out of 10 with each contraction. What should the nurse do first? a. Assess for labor progression. b. Prepare the client for an epidural. c. Assist the client in ambulating to the bathroom. d. Instruct the client to do slow-paced breathing.


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