Chapter 13 labor and birth process

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 the number of assisted deliveries ( vacuum and forceps) -Reduces episiotomies and perineal tears -contributes to fewer abdominal fetal heart rate patterns -increases comfort and reduces requests for pain meds -enhances a sense of control reported by mothers

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

-clear information -positive support; not being alone - sense of mastery, self confidence - trust in staff - positive reaction of pregnancy -personal control of breathing -preparation for childbirth

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

hand holding massaging acupressure

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

-conserve energy -Nurses can keep track of clients more easily if they are not ambulating -The supine position facilitates vaginal exams and external belt adjustment - hospital setting - convenient for the doctor delivering - "connected to things" that make ambulating difficult

The thinning out process of the cervix during labor is termed ___

Effacement

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

Engagement

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

Gynecoid

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

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

-Increase heart rate (increases by 10-20 bpm) -Increase cardiac output (by 12%-31% during first stage of labor and 50% during second stage) -increase blood pressure (up to 35mm hg during uterine contractions in all labor stages) - Increase white blood cells (as result of tissue trauma) -Increase resp rate -decrease in gastric motility and food absorption which may increase nausea and vomitting during transition stage of labor - decrease in gastric emptying and gastric pH which increases vomiting and aspiration - slight temp elevation - muscular cramps -increased BMR and decreased blood glucose levels

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

-previous birth -current pregnancy experience -cultural considerations -support system -childbirth prep - expectations of birth -anxiety and fear -feelings of loss of control -fatigue and weariness

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

-provide the client with clear information on procedure involved -encourage the client to have a positive reaction to pregnancy -encourage the client to have a sense of mastery and self control

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

-reduction in cervical resistance -myometrial contractions -softening and thinning of the cervix

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

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

A pregnant client in labor has to undergo a sonogram to confirm the fetal position of a shoulder presentation. For which condition associated with should presentation during a vaginal birth should the nurse assess?

Fetal anomalies

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

Increase heart rate increase blood pressure increase resp rate

The client wishes to adopt a kneeling position during labor. The nurse knows that which to be an advantage of adopting a kneeling position during labor?

It helps to rotate fetus in a posterior position

__________ Occurs when the fetal presenting part begins to descend into the maternal pelvis

Lightening

A pregnant client is admitted to a maternity clinic for birth. Which assessment finding indicates that the clients fetus is in the transverse lie position?

Long axis of fetus is perpendicular to that of client

A pregnant client is admitted to a maternity clinic after experiencing contractions. the assigned nurse observes that the client experienced pauses between contractions. The nurse knows that which event marks the importance of the pauses between contractions during labor?

Restoration of blood flow to uterus and placenta

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. what explanation can the nurse offer?

The cervix takes around 12-16 hours to dilate during first pregnancy.

A client experiencing contractions presents at a healthcare facility. Assessment conducted by the nurse reveals that the client has been experiencing braxton hicks contractions. Which role do braxton hicks contractions play in aiding labor?

These contractions help in softening and ripening the cervix

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

Zero

Oxytocin aids in stimulating prostiglandin synthesis through receptors in the _____

decidua

A nurse is caring for a client in labor who is delivering. For which fetal response should the nurse monitor?

decrease in circulation and perfusion to the fetus

A nurse is caring for a pregnant client in labor in a health facility. The nurse knows that which sign marks the termination of the first stage of labor in the client?

dilation of cervix to 10 cm

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? select all that apply

lower uterine segment distention stretching and tearing of structures dilation of cervix

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 24-48 hours before the onset of labor is sometimes referred to as

nesting

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

passageway

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 wall c. To constrict the uterine blood vessels d. To lessen the chances of conducting an episiotomy

to constrict the uterine blood vessels