course point questions chapter 13,14,21

Third

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?

Long axis of fetus is perpendicular to that of client.

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

cord compression

A woman is admitted to the labor suite with contractions every 5 minutes lasting 1 minute. She is post-term and has oligohydramnios. What does this increase the risk of during birth? cord compression fetal hydrocephalus macrosomia shoulder dystocia

At the time of placental delivery

During which time is the nurse correct to document the end of the third stage of labor?

1 cm/hour for cervical dilation

The experienced labor and birth nurse knows to evaluate progress in active labor by using which simple rule? 2 cm/hour for cervical dilation 1/2 cm/hour for cervical dilation 1 cm/hour for cervical dilation 1/4 cm/hour for cervical dilation

Just before birth

The nurse is preparing to assist with a pudendal block. The nurse predicts the client is at which point in the labor process? Before dilation only Just after birth Just before birth Early stage labor

erratic

The nurse is monitoring the uterine contractions of a woman in labor. The nurse determines the woman is experiencing hypertonic uterine dysfunction based on which contraction finding? erratic. poor in quality. brief. well coordinated.

low socioeconomic status alcohol use high level of stress smoking

A nursing instructor teaching about risk factors associated with preterm labor should discuss which demographic and lifestyle issues? Select all that apply. low socioeconomic status infection alcohol use high level of stress hypertension smoking

to prevent supine hypotension syndrome

A nurse is preparing a patient for rhythm strip testing. She places the woman into a semi-Fowler's position. What is the appropriate rationale for this measure? To decrease the heart rate of the fetus To aid the woman as she pushes during labor To prevent the woman from falling out of bed To prevent supine hypotension syndrome

starting an IV and hanging IV fluids

What is a nursing intervention that helps prevent the most frequent side effect from epidural anesthesia in a pregnant client? starting an IV and hanging IV fluids maintaining the client in a supine position administrating IV ephedrine administrating IV naloxone

Counterpressure against the sacrum

The client is experiencing back labor and reporting intense pain in the lower back. The nurse should point out which intervention will be effective at this point? Effleurage of the abdomen during the contraction Counterpressure against the sacrum Conscious relaxation/guided imagery in low Fowler's Pant-blow (breaths and puffs breathing techniques)

lie

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?

Support the client's decision and call the obstetrician.

A client and her husband have prepared for a natural birth; however, as the client progresses to 8 cm dilation, she can no longer endure the pain and begs the nurse for an epidural. What is the nurse's best response? Gently remind the client of her goal of a natural birth and encourage and help her. Suggest a less extreme alternative such as a sedative. Support the client's decision and call the obstetrician. Ask the husband to gently remind her of their goal of natural birth and to encourage and help her.

Turn her or ask her to turn to her side.

f the monitor pattern of uteroplacental insufficiency were present, which action would the nurse do first? Administer oxygen at 3 to 4 L by nasal cannula. Help the woman to sit up in a semi-Fowler's position. Ask her to pant with the next contraction. Turn her or ask her to turn to her side.

increase in respiratory rate increase in heart rate increase in blood pressure

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 in gastric emptying and pH slight decrease in body temperature increase in respiratory rate increase in heart rate increase in blood pressure

maternal hypotension and fetal bradycardia

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

Assess fetal heart sounds.

A client's membranes have just ruptured. Her fetus is presenting breech. Which action should the nurse do immediately to rule out prolapse of the umbilical cord in this client? Administer amnioinfusion. Place the woman in Trendelenburg position. Administer oxygen at 10 L/min by face mask. Assess fetal heart sounds.

increasing birth weight.

A nursing instructor is teaching students about fetal presentations during birth. The mostcommon cause for increased incidence of shoulder dystocia is: increasing birth weight. increased number of overall pregnancies. longer lengths of labor. poor quality of prenatal care.

1,4,3,5,2 flexion, internal rotation, extension, external rotation, expulsion

A nurse is teaching a group of nursing students about the mechanism of labor when the fetus is in a cephalic presentation. The nurse determines the session is successful when the students correctly place the following events in which order? All options must be used. 1flexion 2expulsion 3extension 4internal rotation 5external rotation

increased risk of infection

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? increased risk of breech presentation potential placenta previa potential rapid birth of fetus increased risk of infection

every 15 minutes

The nurse is caring for a client who is considered low-risk and in active labor. During the second stage, the nurse would evaluate the client's FHR at which frequency? every 20 minutes every 10 minutes every 5 minutes every 15 minutes

Clear to straw-colored fluid

A gravida 1 client is admitted in the active phase of stage 1 labor with the fetus in the LOA position. The nurse anticipates noting which finding when the membranes rupture? Cloudy white fluid Bloody fluid Greenish fluid Clear to straw-colored fluid

transition phase

A multigravid client has been in labor for several hours and is becoming anxious and distressed with the intensity of her frequent contractions. The nurse observes moderate bloody show and performs a vaginal examination to assess the progress of labor. The cervix is 9 cm dilated. The nurse knows that the client is in which phase of labor? early phase active phase latent phase transition phase

administering oxytocin

A nurse assesses a client in labor and suspects hypotonic uterine dysfunction. Which intervention would the nurse expect to include in the plan of care for this client? encouraging the woman to assume a hands-and-knees position administering oxytocin preparing the woman for an amniotomy providing a comfortable environment with dim lighting

cyanosis pulmonary edema

A nurse is caring for a client who is experiencing acute onset of dyspnea and hypotension. The health care provider suspects the client has amniotic fluid embolism. What other signs or symptoms would alert the nurse to the presence of this condition in the client? Select all that apply. pulmonary edema hematuria hyperglycemia arrhythmia cyanosis

Assess fetal heart rate.

The nurse is reviewing the medication administration record (MAR) of a client at 39 weeks' gestation and notes that she is ordered an opioid for pain relief. Which is an assessment priority after administering? Assess for dry mouth. Assess for constipation. Assess maternal blood pressure. Assess fetal heart rate.

Continuous labor support

The nursing instructor is preparing a class discussing the role of the nurse during the labor and birthing process. Which intervention should the instructor point out has the greatest effect on relieving anxiety for the client? Continuous labor support Pharmacologic pain management Prenatal classes Massage therapy

The woman is prepared for labor and birth.

The pain of labor is influenced by many factors. What is one of these factors? The woman has lots of visitors during labor. The woman has a high tolerance for pain. The woman is prepared for labor and birth. The woman has a high threshold for pain.

Assess fetal heart rate for fetal safety.

occurs, what would the nurse do next? Elevate her hips to prevent cord prolapse. Ask her to bear down with the next contraction. Test a sample of amniotic fluid for protein. Assess fetal heart rate for fetal safety.

+4

The client is being rushed into the labor and delivery unit. At which station would the nurse document the fetus immediately prior to birth?

variable deceleration pattern

A woman in active labor has just had her membranes ruptured to speed up labor. The nurse is concerned the woman is experiencing a prolapse of the umbilical cord when the nurse notices which pattern on the fetal heart monitor? late deceleration with late recovery following contraction early deceleration with each contraction fetal heart rate (FHR) increase to 200 beats/min variable deceleration pattern

Maternal tachycardia and falling blood pressure

The nurse is monitoring a client who has given birth and is now bonding with her infant. Which finding should the nurse prioritize and report immediately for intervention? Placental separation 15 minutes after birth Maternal tachycardia and falling blood pressure Dark red lochia The mother is unable to void after 4 hours.

head elevated, grasping knees, breathing out

To give birth to her infant, a woman is asked to push with contractions. Which pushing technique is the most effective and safest? lying supine with legs in lithotomy stirrups head elevated, grasping knees, breathing out lying on side, arms grasped on abdomen squatting while holding her breath

complications of a postterm pregnancy

A pregnant woman comes to the birthing center, stating she is in labor and does not know far along her pregnancy is because she has not had prenatal care. A primary care provider performs an ultrasound that indicates oligohydramnios. When the client's membranes rupture, meconium is in the amniotic fluid. What does the nurse suspect may be occurring with this client? complications of a postterm pregnancy placental abruption complications of placenta previa complications of preterm labor

"The baby has dropped into the pelvis; your body and baby are getting ready for labor in the next few weeks."

A primigravidia 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 has dropped into the pelvis; your body and baby are getting ready for labor in the next few weeks." "This is not normal unless you are in active labor; come to the hospital and be checked." "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."

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

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? After walking for an hour, the contractions have not fully subsided. The contraction pains have been present for 5 hours, and the patterns are regular. The client reports back pain, and the cervix is effacing and dilating. The contraction pains are 2 minutes apart and 1 minute in duration.

These contractions help in softening and ripening the cervix.

A client experiencing contractions presents at a health care facility. Assessment conducted by the nurse reveals that the client has been experiencing Braxton Hicks contractions. The nurse has to educate the client on the usefulness of Braxton Hicks contractions. Which role do Braxton Hicks contractions play in aiding labor?

8 to 12 weeks

A client gave birth to a child 3 hours ago and noticed a triangular-shaped gap in the bones at the back of the head of her newborn. The attending nurse informs the client that it is the posterior fontanelle. The client is anxious to know when the posterior fontanelle will close. Which time span is the normal duration for the closure of the posterior fontanelle? 12 to 14 weeks 4 to 6 weeks 14 to 8 weeks 8 to 12 weeks

Assess for labor progression.

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? Assist the client in ambulating to the bathroom. Prepare the client for an epidural. Assess for labor progression. Instruct the client to do slow-paced breathing.

Pudendal block

A woman dilated to 10 centimeters 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 Paracervical block Pudendal block Parenteral medication

Assist the client to semi-Fowler's position, assess the fetal heart rate, start an IV bolus of 500 mL, and administer oxygen via face mask.

A client has just had an epidural placed. Before the procedure, her vital signs were as follows: BP 120/70, P90 bmp, R18 per min, and O2 sat 98%. Now, 3 minutes after the procedure, the client says she feels lightheaded and nauseous. Her vital signs are BP 80/40, P100 bmp, R20 per min, and O2 sat 96%. Which interventions should the nurse perform? Assist the client to Trendelenburg's, assess the fetal heart rate, and administer oxygen via face mask. Assist the client to the supine position, recheck the blood pressure, and administer an IV bolus of 1000 mL. Assist the client to a sitting position, assess the fetal heart rate, give naloxone, and administer oxygen via face mask. Assist the client to semi-Fowler's position, assess the fetal heart rate, start an IV bolus of 500 mL, and administer oxygen via face mask.

Assess vital signs.

A client has just received combined spinal epidural. Which nursing assessment should be performed first? Assess for spontaneous rupture of membranes. Assess vital signs. Assess pain level using a pain scale. Assess for fetal tachycardia. Assess for progress in labor.

Depressed deep tendon reflexes

A client in preterm labor is receiving magnesium sulfate IV and appears to be responding well. Which finding on assessment should the nurse prioritize? Depressed deep tendon reflexes Bradycardia Elevated blood glucose Tachypnea

external cephalic version

A client in week 38 of her pregnancy has an ultrasound performed at a routine office visit and learns that her fetus has not moved out of a breech position. Which intervention does the nurse anticipate for this client? forceps birth trial labor external cephalic version vacuum extraction

brachial plexus assessment

A client is experiencing shoulder dystocia during birth. The nurse would place priority on performing which assessment postbirth? extensive lacerations brachial plexus assessment monitor for a cardiac anomaly assess for cleft palate

"I may end up with a severe headache from the spinal anesthesia."

A client is scheduled for a cesarean section under spinal anesthesia. After instruction is given by the anesthesiologist, the nurse determines the client has understood the instructions when the client states: "I will need to lie on my right side to reduce vena cava compression." "I may end up with a severe headache from the spinal anesthesia." "I can continue sitting up after the spinal is given." "The anesthesia will numb both of my legs to a level above my breasts."

FHR

A client presents to the birthing center in labor. The client's membranes have just ruptured. Which assessment is the nurse's priority? fetal position maternal comfort level FHR signs of infection

10:30 a.m.

A low-risk client is in the active phase of labor. The nurse evaluates the fetal monitor strip at 10:00 a.m. and notes the following: moderate variability, FHR in the 130s, occasional accelerations, and no decelerations. At what time should the nurse reevaluate the FHR? 11:15 a.m. 10:05 a.m. 11:30 a.m. 10:30 a.m.

well-contracted uterus in the midline mild uterine cramping and shivering decreased intra-abdominal pressure

A nurse is caring for a client in her fourth stage of labor. Which assessments would indicate normal physiologic changes occurring during the fourth stage of labor? Select all that apply. well-contracted uterus in the midline mild uterine cramping and shivering increase in the blood pressure decrease in the pulse rate decreased intra-abdominal pressure

respiratory rate

A nurse is caring for a client who has been administered an epidural block. Which should the nurse assess next? respiratory rate pulse uterine contractions temperature

lightening bloody show backache

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 weight gain lightening constipation backache

Avoid any discussion of the situation with the couple.

A nurse is providing care to a couple who have experienced intrauterine fetal demise. Which action would be least effective in assisting a couple at this time? Give the parents a lock of the infant's hair. Assist the family in making arrangements for their stillborn infant. Allow the couple to spend as much time as they want with their stillborn infant. Avoid any discussion of the situation with the couple.

first, active

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 second first, latent first, active

administer oxygen by mask.

A woman experiences an amniotic fluid embolism as the placenta is delivered. The nurse's firstaction would be to: put firm pressure on the fundus of her uterus. increase her intravenous fluid infusion rate. administer oxygen by mask. tell the woman to take short, catchy breaths.

Begin CPR immediately. Apply oxygen mask and start oxygen at 10 L/min.

A woman in active labor suddenly sits up, clutches her chest, screams with pain, and then collapses back on the bed. The RN notes she is unconscious and a bluish-gray color. Which interventions are considered the priority for the nurse to implement? Select all that apply. Call lab and request 4 units of whole blood stat. Begin CPR immediately. Start oxytocin at 4 mu/min and titrate upward every 5 minutes. Place stethoscope on the abdomen to verify fetal heart rate. Apply oxygen mask and start oxygen at 10 L/min.

uterine rupture

A woman in active labor with a history of two previous cesarean births is being monitored frequently as she tries to have a vaginal birth. Suddenly, the woman grabs the nurse's hand and states, "Something inside me is tearing." The nurse notes her blood pressure is 80/50 mm Hg, pulse rate is 130 bpm and weak, the skin is cool and clammy, and the fetal monitor shows bradycardia. The nurse activates the code team because the nurse suspects the client may be experiencing which complication? compression on the inferior vena cava uterine rupture an amniotic embolism to the lungs an undiagnosed abdominal aorta aneurysm

applying counter pressure to the back

A woman whose fetus in in the occiput posterior position is experiencing increased back pain. Which is the best way for the nurse to help alleviate this back pain? performing acupuncture on the back applying ice to the back applying a heating pad to the back applying counter pressure to the back

"The injection is given in the space outside the spinal cord."

A woman's husband expresses concern about risk of paralysis from an epidural block being given to his wife. Which would be the most appropriate response by the nurse? "The injection is given at the third or fourth thoracic vertebrae so paralysis is not a problem." "I have never read or heard of this happening." "The injection is given in the space outside the spinal cord." "An injury is unlikely because of expert professional care given."

After rupture of membranes

At which time is it most important to monitor for umbilical cord prolapse? At the onset of labor After rupture of membranes During transitional labor When the fetus is crowning

lack of oxygen to the muscle fibers of the uterus due to compression of blood vessels

Early in labor, a pregnant client asks why contractions hurt so much. Which answer should the nurse provide? blocking of nerve transmission via mechanical irritation of nerve fibers distraction of the brain cortex by other stimuli release of endorphins in response to contractions lack of oxygen to the muscle fibers of the uterus due to compression of blood vessels

Neonatal depression is possible.

General anesthesia is not used frequently in obstetrics because of the risks involved. There are physiologic changes that occur during pregnancy that make the risks of general anesthesia higher than it is in the general population. What is one of those risks? The client is more sensitive to preanesthetic medications. The client is less sensitive to inhalation anesthetics. Neonatal depression is possible. Fetal hypersensitivity to anesthetic is possible.

Turn off the oxytocin.

Hypertonic labor is labor that is characterized by short, irregular contractions without complete relaxation of the uterine wall in between contractions. Hypertonic labor can be caused by an increased sensitivity to oxytocin. What would the nurse do for a client who is in hypertonic labor because of oxytocin augmentation? Turn off the methotrexate. Increase the methotrexate. Increase the oxytocin. Turn off the oxytocin.

fetal heart rate declining late with contractions and remaining depressed

If a fetus were not receiving enough oxygen during labor because of uteroplacental insufficiency, which pattern would the nurse anticipate seeing on the monitor? fetal heart rate declining late with contractions and remaining depressed variable decelerations, too unpredictable to count a shallow deceleration occurring with the beginning of contractions fetal baseline rate increasing at least 5 mm Hg with contractions

Placental abruption

The nurse is admitting a client at 23 weeks' gestation in preparation for induction and delivery after it was determined the fetus had died secondary to trauma. When asked by the client to explain what went wrong, the nurse can point out which potential cause for this loss? Premature rupture of membranes Placental abruption Genetic abnormality Preeclampsia

caput succedaneum

The nurse is assessing a woman who had a forceps-assisted birth for complications. Which condition would the nurse assess in the fetus? infection of episiotomy caput succedaneum perineal hematoma cervical lacerations

The completion of the third stage of labor

The nurse is assisting a client in labor and delivery and notes the placenta is now delivered. Which documentation should the nurse prioritize? The client's vital signs The completion of the third stage of labor The end of recovery The transition phase

Inability to push

The nurse is assisting a client through labor, monitoring her closely now that she has received an epidural. Which finding should the nurse prioritize to the anesthesiologist? Urinary retention Dry, cracked lips Inability to push Rapid progress of labor

Sudden shortness of breath

The nurse is caring for a client in active labor. Which assessment finding should the nurse prioritize and report to the team? Unrelieved pain Bradypnea Sudden shortness of breath Bradycardia

The urge to push occurs.

The nurse is caring for a client who has been in labor for the past 8 hours. The nurse determines that the client has transitioned into the second stage of labor based on which sign? Fetus is at -1 station. The urge to push occurs. Frequency of contractions are 5 to 6 minutes. Emotions are calm and happy.

McRoberts maneuver

Shoulder dystocia is a true medical emergency that can cause fetal demise because the baby cannot be born. Stuck in the birth canal, the infant cannot take its first breath. Which maneuver is first attempted to deliver an infant with shoulder dystocia? McGeorge maneuver McDonald maneuver McRoberts maneuver McRonald maneuver

Progesterone Prostaglandins Oxytocin

The nurse is instructing on maternal hormones which may impact the onset of labor. Which hormones are included in the discussion? Select all that apply. Progesterone Prostaglandins Insulin Oxytocin Testosterone Thyroxin

4,000 g or more.

The health care provider has determined that the source of dystocia for a woman is related to the fetus size. The nurse understands that macrosomia would indicate the fetus would weigh: 3,000 g or more. 4,000 g or more. 3,500 g or more. 4,500 g or more.

1 cm below the ischial spine.

The nurse assesses the client and tells her the baby is at +1 station. Which is the best response by the nurse when asked by the client what this means concerning the location of the baby? 1 cm below the ischial spine. 1 cm below the symphysis pubis. 1 cm above the ischial spine. 1 cm above the symphysis pubis.

administration of oxygen by mask

The nurse caring for a client in preterm labor observes abnormal fetal heart rate (FHR) patterns. Which nursing intervention should the nurse perform next? fetal scalp stimulation administration of oxygen by mask tactile stimulation application of vibroacoustic stimulation

determining the position of the fetus determining the lie of the fetus determining the presentation of the fetus

The nurse explains Leopold's maneuvers to a pregnant client. For which purposes are these maneuvers performed? Select all that apply. determining the position of the fetus determining the lie of the fetus determining the weight of the fetus determining the size of the fetus determining the presentation of the fetus

Encourage her through the contractions, explaining why she cannot receive any pain medication.

The nurse is monitoring a client who is in the second stage of labor, at +2 station, and anticipating birth within the hour. The client is now reporting the epidural has stopped working and is begging for something for pain. Which action should the nurse prioritize? Encourage her through the contractions, explaining why she cannot receive any pain medication. Call the anesthetist from the nurse's station to retry the epidural. Call the primary care provider, and obtain a reduced dose of meperidine. Give the meperidine because she needs pain relief now.

Discontinue the oxytocin infusion.

The nurse is monitoring a woman who is receiving oxytocin IV to assist with uterine irritability. Which action should the nurse prioritize if the woman's contractions are determined to be 80 seconds in length after 1 hour of administration of the oxytocin? Slow the infusion to under 10 gtts per minute. Increase the flow rate of the main line infusion. Discontinue the oxytocin infusion. Continue to monitor contraction duration every 2 hours.

Continuous support through the labor process helps decrease the need for pain medication.

The nurse is preparing a young couple for the upcoming birth of their child, and the mother expresses concern for needing pain medications and the effects on the fetus. When counseling the couple about pain relief, the nurse would incorporate which information in the teaching about measures to help to decrease the requests for pain medication? Continuous support through the labor process helps decrease the need for pain medication. Lying on an ice pack can help decrease the need for pain medication. A quick epidural can replace the need for pain medication. Sitting in a hot tub helps decrease the need for pain medication.

Pain originates from the cervix and lower uterine segment.

The nurse is preparing an educational event for pregnant women on the topic of labor pain and birth. The nurse understands the need to include the origin of labor pain for each stage of labor. What information will the nurse present for the first stage of labor? Diffuse abdominal pain signals a complication with progression of labor. It is reported as the worst pain a woman will ever feel. Pain originates from the cervix and lower uterine segment. Pain is focal in nature.

3,4,1,2

The nurse is working with a client approaching her due date. Arrange the sequence of typical labor pain that the client may experience from onset to birth of the fetus. Use all options. 1Intense contractions resulting in fetal movement 2Burning in the perineum 3Cramping in the lower abdomen 4Pain noted in the lower back, buttocks and thighs

Severe variable decelerations occur and are due to cord compression.

The nurse would prepare a client for amnioinfusion when which action occurs? Maternal pushing is compromised due to anesthesia. Fetal presenting part fails to rotate fully and descend in the pelvis. The fetus shows abnormal fetal heart rate patterns. Severe variable decelerations occur and are due to cord compression.

Facing the right anterior pelvic quadrant

The nursing instructor is illustrating the various positions the fetus may utilize during the passage through the vaginal canal at birth. The instructor determines the session is successful when the students correctly identify the ROA position, indicating which presentation by the fetus? Presenting with the face as the presenting part In a common breech birth position In a longitudinal lie facing the left posterior Facing the right anterior pelvic quadrant

effacement

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?

"I have no pain now."

Which client statement is anticipated after immediately receiving an intrathecal injection of pain medication? "I still have intense pain. The medication is not working." "I feel cramping but no sharp pain." "I feel a dull achiness around my abdomen." "I have no pain now."

Fetal heart rate in relation to contractions

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

Placing a wedge under the hips

Which nursing action prevents a complication associated with the lithotomy position for the birth of the fetus? Providing a paper bag Placing a wedge under the hips Massaging the client's lower back Rubbing the client's legs

Assess uterine tone to determine fundal firmness.

Which postoperative intervention should a nurse perform when caring for a client who has undergone a cesarean birth? Assess uterine tone to determine fundal firmness. Delay breastfeeding the newborn for a day. Ensure that the client does not cough or breathe deeply. Avoid early ambulation to prevent respiratory problems.

Difficulty breathing

Which primary symptom does the nurse identify as a potentially fatal complication of epidural or intrathecal anesthesia? Decreased level of consciousness Staggering gait Intense pain Difficulty breathing

Analgesia only reduces pain, but anesthesia partially or totally blocks all pain in a particular area.

Which statement is true regarding analgesia versus anesthesia? Decreased FHR variability is a common side effect when regional anesthesia is used. Regional anesthesia should be given with caution close to the time of birth because it crosses the placenta and can cause respiratory depression in the newborn. Hypotension is the most common side effect when systemic analgesia is used. Analgesia only reduces pain, but anesthesia partially or totally blocks all pain in a particular area.

45 ml urine output in 2 hours

he nurse is caring for a client after experiencing a placental abruption. Which finding is the priority to report to the health care provider? hematocrit of 36% 45 ml urine output in 2 hours hemoglobin of 13 g/dl platelet count of 150,000 mm3