Chapter 13 Labor

"I would like the baby's father to cut the umbilical cord." "We will hire a doula for our labor support." "My 6-year old son will be in the birthing room, too." "I will remain in my bed for my labor and birth like last time."

"I will remain in my bed for my labor and birth like last time."

Assessment of a woman in labor reveals that the fetus is in a cephalic presentation and engagement has occurred. The nurse interprets this finding to indicate that the presenting part is at which station? -2 0 +1 -1

0

During the fourth stage of labor, which mother typically experiences the strongest afterpains? A primigravid whose breast milk has not come in The primigravid who delivers a 6 lb (2,688 g) newborn A multipara who is breast-feeding A multigravid with twins who decided to formula feed

A multipara who is breast-feeding

Which occurs as a result of contraction decrement? Select all that apply. The fetus is pushed down the birth canal. Blood flow to the fetus improves. The mother feels a gush of water in the perineal area. Fetal heart rate should return to baseline. The mother feels the contraction intensifying.

Blood flow to the fetus improves. Fetal heart rate should return to baseline.

A primigravida has an office appointment at 39 weeks' gestation. Which assessment data is most definitive of the onset of labor? The mother reports frequent urination. Expulsion of the mucus plug. The fetal head is engaged in the pelvis. Cervical ripening is noted on examination.

Cervical ripening is noted on examination.

The nurse cares for a pregnant client in labor and determines the fetus is in the right occiput anterior (ROA) position. Which action by the nurse is best? Continue to monitor the progress of labor. Educate the client this fetal position may result in a longer labor. Prepare the client for cesarean birth of the fetus. Auscultate fetal heart rate (FHR) in the left upper quadrant.

Continue to monitor the progress of labor.

The nurse is assessing a client for rupture of membranes. Which findings would confirm the presence of ruptured membranes? Select all that apply. The cervix is effaced. Ferning is present. Nitrazine paper turns blue. The client reports having wet pants. A pool of fluid is visible in the vagina.

Ferning is present. Nitrazine paper turns blue. A pool of fluid is visible in the vagina.

A 24-year-old primigravida client at 39 weeks' gestation presents to the OB unit concerned she is in labor. Which assessment findings will lead the nurse to determine the client is in true labor? The contraction pains have been present for 5 hours, and the patterns are regular. After walking for an hour, the contractions have not fully subsided. The client reports back pain, and the cervix is effacing and dilating. The contraction pains are 2 minutes apart and 1 minute in duration.

The client reports back pain, and the cervix is effacing and dilating.

A nurse is meeting with a group of pregnant clients who are in their last trimester to teach them the signs that may indicate they are going into labor. The nurse determines the session is successful after the clients correctly choose which signs as an indication of starting labor? Select all that apply. bloody show lightening constipation weight gain backache

bloody show lightening backache

A new dad is alarmed at the shape of his newborn's head. When responding to the dad, the nurse reminds him this is due to: a congenital defect. extreme pressure in the vaginal vault. cranial bones overlapping at the suture lines. prolonged labor.

cranial bones overlapping at the suture lines.

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? molding dilation (dilatation) effacement crowning

effacement

A nurse is providing care to a pregnant client in labor. Assessment of a fetus identifies the buttocks as the presenting part, with the legs extended upward. The nurse identifies this as which type of breech presentation? frank full complete footling

frank

Assessment reveals that the fetus of a client in labor is in the vertex presentation. The nurse determines that which part is presenting? occiput brow buttocks shoulders

occiput

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? effacement and dilation of the cervix restoration of blood flow to uterus and placenta reduction in length of the cervical canal shortening of the upper uterine segmen

restoration of blood flow to uterus and placenta

A nurse is describing how the fetus moves through the birth canal. Which component would the nurse identify as being most important in allowing the fetal head to move through the pelvis? frontal bones fontanelles sutures biparietal diameter

sutures

The five "P's" of labor are a) Passenger, Posture, Position, Presentation, Psych b) Passageway, Passenger, Position, Powers, Psych c) Passenger, Position, Powers, Presentation, Psych d) Passenger, Position, Presentation, Pushing, Psych

b) Passageway, Passenger, Position, Powers, Psych

A client has just given birth to a healthy baby boy, but the placenta has not yet delivered. What stage of labor does this scenario represent? First Second Third Fourth

Third

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 fetus is in the true pelvis and engaged. The fetus has descended down the birth canal. The client is fully effaced. The fetus is floating high in the pelvis.

The fetus is in the true pelvis and engaged.

Which consideration is a priority when caring for a mother with strong contractions 1 minute apart? Maternal request for pain medication The station in which the fetus is located Fetal heart rate in relation to contractions Maternal heart rate and blood pressure

Fetal heart rate in relation to contractions

A nurse sees a pregnant client at the clinic. The client is close to her due date. During the visit the nurse would emphasize that the client get evaluated quickly should her membranes rupture spontaneously based on the understanding of which possibility? potential rapid birth of fetus potential placenta previa increased risk of breech presentation increased risk of infection

increased risk of infection

The nurse is reviewing the laboratory test results of a client in labor. Which finding would the nurse consider normal? decreased plasma fibrinogen levels increased blood coagulation time increased blood glucose levels increased white blood cell count

increased white blood cell count

Which is the most important nursing assessment of the mother during the fourth stage of labor? Blood pressure Hemorrhage Heart rate The mother's psyche

Hemorrhage

The nurse is caring for a nullipara client at 40 weeks' gestation. After assessing the client, the health care provider states that the fetus is at a -4 station. Which statement by the client requires clarification by the nurse? "I hope that the end of my pregnancy will be uneventful." "The health care provider states my labor is imminent." "I will go home and pack my bag and await the labor process to begin." "The health care provider will reassess me next week, if I make it."

"The health care provider states my labor is imminent."

A nurse is teaching a woman in her third trimester about Braxton Hicks contractions. When describing these contractions, which information would the nurse likely include? Select all that apply. "They often spread downward before they go away." "They usually feel like a tightening across the top of your uterus." "They go away when you walk around or change position." "They usually happen in a regular pattern." "They typically last for about 3 minutes each time you have them."

"They often spread downward before they go away." "They usually feel like a tightening across the top of your uterus." "They go away when you walk around or change position."

The nurse is providing care to a client in labor. On examination, the nurse determines the fetus is at -1 station. The nurse interprets this as indicating that the fetus is: 1 cm below the ischial spines. 1 cm above the ischial spines. 1 cm above the pubic bone. 1 cm below the pubic bone.

1 cm above the ischial spines.

What assessment finding would suggest to the care team that the pregnant client has completed the first stage of labor? The client has contractions once every two minutes. The infant is born. The client experiences her first full contraction. The client's cervix is fully dilated.

The client's cervix is fully dilated.

The above nurse's note was documented in the client's record by the labor room nurse. In which position was the client born? With the brow facing the right anterior quadrant of the pelvis With the occiput facing the right anterior quadrant of the pelvis Rear facing with the occiput facing the posterior quadrant of the pelvis With the right side presenting, and the occiput facing the anterior quadrant

With the occiput facing the right anterior quadrant of the pelvis

The nurse is assessing a client who has given birth within the past hour. The nurse would expect to find the woman's fundus at which location? between the umbilicus and symphysis pubis 2 cm above the umbilicus at the level of the umbilicus one fingerbreadth below the umbilicus

at the level of the umbilicus

The nurse is reviewing the monitoring strip of a woman in labor who is experiencing a contraction. The nurse notes the time the contraction takes from its onset to reach its highest intensity. The nurse interprets this time as which phase? acme increment decrement peak

increment

A client in labor has been admitted to the labor and birth suite. The nurse assessing the woman notes that the fetus is in a cephalic presentation. Which description should the nurse identify by the term presentation? part of the fetal body entering the maternal pelvis first relation of the fetal presenting part to the maternal ischial spine relationship of the presenting part to the maternal pelvis relation of the different fetal body parts to one another

part of the fetal body entering the maternal pelvis first

A nurse is caring for a client in her third stage of labor. The nurse would predict the placenta is separating from the uterus based on which assessment findings? Select all that apply. falling downward of uterus in the abdomen umbilical cord descending lower down a relaxed and distended uterus fresh gushing of blood from the vagina a globular shaped uterus

umbilical cord descending lower down fresh gushing of blood from the vagina a globular shaped uterus