Ladewig, Chapter 13
A primigravida is admitted to the labor unit with contractions every 7-8 minutes. She is 3 cm dilated, 70% effaced, and at 0 station. She is very anxious, is having difficulty coping with contractions, and states that she did not attend prenatal classes. What is the most effective nursing intervention? 1. Instruct the patient in abdominal breathing and progressive relaxation. 2. Instruct the patient in patterned, paced breathing and touch relaxation. 3. Instruct the patient in pelvic tilt and pelvic rock exercises. 4. Call the physician and request a sedative
Correct Answer: 1 Rationale 1: Abdominal breathing and progressive relaxation assist the patient in relaxing, and allow the uterine muscles to work more efficiently. Rationale 2: Patterned, paced breathing and touch relaxation are exercises that are taught in childbirth preparation classes and involve the use of a partner. Rationale 3: Pelvic tilt and rock exercises are body-conditioning exercises. Rationale 4: Providing sedatives would not allow the patient to participate actively in the process.
During a breastfeeding class, the nurse discusses ways to include the father in the breastfeeding process. The nurse knows further teaching is necessary when a prospective father states: 1. "I can feed the baby a bottle of formula." 2. "I can burp the baby between breasts." 3. "I can rock the baby to sleep after breastfeeding." 4. "When the baby wakes up, I can bring the baby to her mother."
Correct Answer: 1 Rationale 1: Feeding the baby a bottle is not an option. Breastfeeding has to be established. Rationale 2: Including the father in the breastfeeding process involves burping the baby between breasts and/or after feeding. Rationale 3: Including the father in the breastfeeding process involves rocking the baby back to sleep. Rationale 4: Including the father in the breastfeeding process involves bringing the baby to the mother for feedings.
The nurse is teaching a class to prenatal patients about the benefits of a doula. Which statement by a patient demonstrates the need for further teaching? 1. "The doula will deliver the baby." 2. "The doula will assist with the birth." 3. "The doula will provide guidance and encouragement." 4. "The doula will attend to my comfort needs."
Correct Answer: 1 Rationale 1: The doula is trained to assist with births, but she does not deliver the baby. Rationale 2: The doula is trained to assist with births, but she does not deliver the baby. Rationale 3: The doula offers guidance and encouragement, and attends to the many comfort needs of the laboring mother and her family. Rationale 4: The doula offers guidance and encouragement, and attends to the many comfort needs of the laboring mother and her family.
The nurse is discussing with a childbirth class the different techniques of breathing exercises available. Regardless of the method of childbirth preparation, most childbirth classes: 1. Present ways of alleviating fear. 2. Teach imagery for relaxation. 3. Use patterned, paced breathing techniques. 4. Present the benefits of epidural anesthesia
Correct Answer: 1 Rationale 1: The overall goal of prenatal classes is to decrease fear through increasing knowledge and teaching participants skills to help cope with labor. These skills include various relaxation methods and breathing techniques. Rationale 2: Not all classes teach imagery. Rationale 3: Not all classes use patterned, paced breathing. Rationale 4: Many couples will be able to avoid an epidural by using the techniques they learned in classes.
The nurse in the obstetrical clinic is setting appointments for patients seeking preconceptual care. Which patient should be seen first? 1. 36-year-old, has never been pregnant, takes medication for a seizure disorder. 2. 15-year-old, smokes one pack per day, had a miscarriage 4 months ago. 3. 22-year-old, runs long distances, has been on the pill for 6 years. 4. 29-year-old, has had two abortions, takes a multiple-vitamin supplement
Correct Answer: 1 Rationale 1: This patient is the top priority because she has multiple risk factors: She is over the age of 35 and therefore is at risk for trisomies; she takes medication, and some medications are teratogenic and contraindicated during pregnancy; and pregnancy is not recommended for women with some conditions. This patient needs to see the specialist who prescribes her antiseizure medication, as well as an obstetric provider, to discuss the risks her age presents to a possible pregnancy. Rationale 2: Although this patient has the risks of being young and a smoker, she is not the highest-priority patient. Rationale 3: The only risk factor this patient has is a need to increase folic acid intake due to being on the pill for six years. She is not the highest-priority patient. Rationale 4: This patient has no risk factors for pregnancy. A history of more than three abortions increases the risks of preterm labor and infertility, but this patient has only had two abortions. She is not the highest-priority patient.
The nurse is completing an assessment for a prenatal visit. Which statement indicates that further teaching is necessary? 1. "Because I'm in my third trimester, I should return to the clinic in a month." 2. "Now that I've felt fetal movement, I should feel movement regularly." 3. "Before I take any over-the-counter medications, I should contact my doctor." 4. "Alcohol is possibly harmful to my baby, even at the end of my pregnancy."
Correct Answer: 1 Rationale 1: This statement is incorrect because prenatal visits during the third trimester are every 2 weeks from 26 to 36 weeks, and every week from 36 weeks to delivery. Rationale 2: This is a true statement. Once fetal movement is perceived, it should be felt regularly. Initially, this might not be every day, but in the third trimester, fetal movement should be noticeable several times per day. Rationale 3: This is a true statement. Regardless of the gestational age, over-the-counter medications can have deleterious effects on mom or baby; thus it is important for a pregnant woman to consult her provider prior to taking any over-the-counter medications throughout the pregnancy. Rationale 4: This is a true statement. Alcohol should be avoided throughout pregnancy and lactation.
A nurse conducts a class on relaxation exercises. Which couple are demonstrating the appropriate technique for touch relaxation? 1. The expectant mother relaxes her muscles in response to her partner's touch. 2. The expectant mother relaxes one muscle group at a time as her partner observes. 3. The expectant mother and her partner perform light abdominal stroking. 4. The expectant mother relaxes the rest of her body while tensing a specific muscle under the direction of her partner.
Correct Answer: 1 Rationale 1: Touch relaxation increases cooperation and teamwork between the woman and her coach during labor. Rationale 2: Progressive relaxation relaxes one muscle group at a time. Rationale 3: Effleurage involves performing light abdominal stroking. Rationale 4: Disassociation relaxation involves relaxing the rest of the body while tensing a specific muscle group.
The OB-GYN nurse is evaluating patient satisfaction with her childbirth experience. The nurse looks at whether the nursing care included: Select all that apply. 1. Establishment of good rapport. 2. Involvement of the patient in decisions. 3. Provision of support to the patient. 4. Visitors' not being allowed in the labor room. 5. Keeping the patient bed-bound through labor.
Correct Answer: 1,2,3 Rationale 1: Establishing rapport with the patient and her support systems is important in providing a satisfying childbirth experience. Rationale 2: Involving the patient and her partner in the decision-making process is important in increasing satisfaction. Rationale 3: The patient requires support not only from the nurse, but also from family or a doula. Rationale 4: The patient needs to have family and/or friends with her during labor. The patient will limit visitors if needed. Rationale 5: The patient needs to be allowed to walk, use the rocking chair, sit in a hot tub, etc., if she desires.
The nurse is planning a prenatal class for adolescents. It is important that the class includes: Select all that apply. 1. Time to verbalize fears. 2. Only adolescent participants. 3. Provision of a support system. 4. Infant-stimulation concepts. 5. The Bradley philosophy of birthing.
Correct Answer: 1,2,3 Rationale 1: Prenatal education classes specifically designed for teens can provide a forum for verbalization of fears and concerns. Rationale 2: Many teenagers might feel that they might not receive privacy, respect, and acceptance in a standard adult-centered childbirth class. Rationale 3: Often, teenage mothers face pregnancy and childbirth without adequate support from a partner or parents. The teens-only class will provide this support. Rationale 4: Infant stimulation is not a goal of the prenatal education for teens. Rationale 5: All of the birthing methods should be presented to the adolescents during the prenatal education.
In counseling a pregnant patient about the main differences in birthing preparation methods, the nurse discusses: Select all that apply. 1. Theories as to why they work. 2. Relaxation techniques used. 3. Need for analgesia during labor. 4. Breathing patterns taught. 5. Importance of breastfeeding.
Correct Answer: 1,2,4 Rationale 1: One difference in the methods of birthing preparation lies in the theories of why they work. Rationale 2: One difference in the methods of birthing preparation lies in the relaxation techniques they teach. Rationale 3: The need for analgesia is not a difference between the different birthing preparation methods. Rationale 4: One difference in the methods of birthing preparation lies in the breathing patterns they teach.
The prenatal nurse is teaching a group of women about preconception health measures. Topics the nurse includes are: Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Smoking. 2. Caffeine. 3. Limiting folic acid. 4. Increasing dietary fat. 5. Use of prescription drugs.
Correct Answer: 1,2,5 Rationale 1: Not smoking-or at least limiting cigarette intake-is an important aspect of prenatal counseling. Rationale 2: As a precaution, women are advised to avoid caffeine or limit the intake. Rationale 3: Folic acid is a necessary prenatal vitamin to decrease the risk of a baby with a neural tube defect. Rationale 4: A balanced diet is needed before, during, and after a pregnancy. Increasing dietary fat is not recommended. Rationale 5: Some prescription drugs can cause damage to the developing fetus. This needs to be discussed with the healthcare provider.
During a prenatal class, the nurse teaches patients about breathing techniques. The nurse explains the goals of breathing are Select all that apply. 1. Increase physical and mental relaxation. 2. Decrease the efficient use of muscles. 3. Provide a sense of control during labor. 4. Provide a means of focusing atttention. 5. Control adequate breathing patterns
Correct Answer: 1,3,4 Rationale 1: A goal of breathing techniques is to increase physical and mental relaxation. Rationale 2: A goal of breathing techniques is to increase the efficient use of muscles, not decrease it. Rationale 3: A goal of breathing techniques is to provide a sense of control for the mother. Rationale 4: A goal of breathing techniques is to provide a means of focusing attention. Rationale 5: A goal of breathing techniques is to provide control for inadequate breathing patterns during labor.
A couple is allowing electronic monitoring to be applied during labor. After the nurse applies the equipment, risks for which the nurse should assess include: Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Supine postural hypotension. 2. Cord prolapse with ruptured membranes. 3. Monitoring the machine, not the patient. 4. Intrauterine perforation. 5. Slowing of contractions in active labor.
Correct Answer: 1,3,4 Rationale 1: Supine postural hypotension is a risk of electronic fetal monitoring. Rationale 2: Use of electronic fetal monitoring does not cause cord prolapse with ruptured membranes. Rationale 3: Use of electronic fetal monitoring decreases personal interaction with mother because of attention paid to the machine. Rationale 4: Intrauterine perforation is a risk of electronic fetal monitoring when an internal uterine pressure device is used. Rationale 5: Use of electronic fetal monitoring does not cause the slowing of contractions in active labor.
The nurse is discussing with a couple their concerns about delivering vaginally after having a cesarean birth. Parents planning on a vaginal birth after a cesarean birth (VBAC) should prepare: 1. Exclusively for a vaginal delivery. 2. Two birth plans: one for vaginal and one for cesarean. 3. For a long labor. 4. For a short labor.
Correct Answer: 2 Rationale 1: Preparing exclusively for a vaginal delivery will decrease a parent's sense of control over the birth experience if a cesarean needs to be performed. Rationale 2: In the care of vaginal birth after cesarean birth (VBAC), two birth plans should be prepared: one for vaginal delivery and one for cesarean birth. Rationale 3: The length of labor (short or long) cannot be determined for a VBAC delivery. Rationale 4: The length of labor (short or long) cannot be determined for a VBAC delivery.
A patient states that she is not interested in Lamaze classes because she is single and does not want to have natural childbirth. The nurse's best response would be: 1. "Lamaze classes promise painless childbirth. If you learn their methods, your pain is minimal." 2. "Lamaze classes can teach you relaxation methods and also the benefits and risks of pain-relief methods. This assists you in making the best decision for you." 3. "You are very nervous. I think these classes would be best for you." 4. "Lamaze classes are geared toward couples. You might want to find a different class."
Correct Answer: 2 Rationale 1: Stating that Lamaze classes promise painless childbirth is providing false information. Rationale 2: Lamaze teaches relaxation methods by utilizing patterned breathing. Those who are able to use the method require little if any anesthesia during delivery. Rationale 3: This is an inappropriate response. Rationale 4: This is an inappropriate response
A patient having her fourth child is admitted to the labor unit and is accompanied by a doula. The intrapartum nurse expects the doula to assist with: 1. Fetal monitoring and relaxation techniques. 2. Physical and emotional comfort techniques. 3. Breathing techniques and labor assessment. 4. Massage and vaginal exams
Correct Answer: 2 Rationale 1: The doula will not be involved with fetal monitoring. Rationale 2: A doula is a trained lay birth companion, and focuses on helping the mother to relax and increase her comfort. Rationale 3: The doula does not do labor assessments. Rationale 4: A doula does not do vaginal exams.
The nurse assesses her patient and finds her to have mild anxiety concerning the birth process. The patient states that she is not interested in attending classes because her husband does not want to participate. The nurse's best response would be: 1. "Your best choice is to be sedated and let the team do the work." 2. "Birthing classes of all types can help eliminate fear and teach coping techniques." 3. "You are very nervous. I think these classes would be best for you." 4. "Most classes are geared toward couples. Since your husband doesn't want to take them, these classes won't benefit you."
Correct Answer: 2 Rationale 1: This is an inappropriate statement, and does not inform the patient of choices available to her. Rationale 2: All programs in prepared childbirth have an educational component to help eliminate fear and teach coping mechanisms. The classes vary in coverage of subjects related to the maternity cycle, but all teach relaxation techniques and all prepare the participants for what to expect during labor and birth. Rationale 3: Being nervous is not a reason to take the class. It would be better to encourage the patient to take the class so she will be knowledgeable on the birth experience and because it could reduce any anxiety she might have about the experience. Rationale 4: Childbirth classes are geared toward teaching about relaxation techniques and preparing participants on what to expect. Single parents and non-couple participants often take the classes.
In addition to breathing with contractions, what action will the nurse instruct a woman in labor to do during the first stage of labor? 1. Lie in the lithotomy position. 2. Perform effleurage. 3. Practice Kegel exercises. 4. Push with each contraction.
Correct Answer: 2 Rationale 1: This position is not supportive of labor and birth. Rationale 2: Effleurage is light massage that can soothe the mother during labor. Rationale 3: Kegel exercises will not help the mother work with her labor. Rationale 4: Pushing is not done during the first stage of labor.
While teaching a preconception class, the nurse should include which recommendation to decrease the risk of neural tube defects? 1. 500 mg vitamin C every day 2. 0.4 mg folate every day 3. 1500 mg calcium every day 4. 400 IUs vitamin A daily
Correct Answer: 2 Rationale 1: Vitamin C does not have anything to do with development of neural tube defects. Rationale 2: Folic acid supplementation prior to conception is recommended, since this decreases the risk of neural tube defects. Rationale 3: Calcium does nor decrease the risk of neural tube defects. Rationale 4: Vitamin A does not decrease the risk of neural tube defects.
The nurse is asked by a pregnant patient about the benefits of a breastfeeding class. The nurse's best response is that the programs offer: Select all that apply. 1. La Leche League's Web site. 2. Practical instruction. 3. Resources. 4. Encouragment. 5. Support for 1 month.
Correct Answer: 2,3,4 Rationale 1: La Leche is not the only group providing breastfeeding information and support. Rationale 2: Breastfeeding programs offer practical instruction for parents. Rationale 3: Breastfeeding programs offer resources for the parents. Rationale 4: Breastfeeding programs in the prenatal period offer encouragement to parents. Rationale 5: Mothers are encouraged to breastfeed for 1 year. Support will be given for longer than 1 month.
The prenatal nurse plans on teaching prenatal classes based on broad concepts. The nurse will include information about: Select all that apply. 1. Healthy prenatal lifestyles. 2. Relaxation techniques. 3. Breathing techniques. 4. Unique roles of grandparents. 5. Body-toning exercises.
Correct Answer: 2,3,5 Rationale 1: Healthy lifestyles should be discussed before the pregnancy, not after. Rationale 2: Most childbirth classes include information on relaxation techniques. Rationale 3: Most childbirth classes include information on breathing methods. Rationale 4: The unique roles of grandparents may be presented, but is not a broad concept of prenatal classes. Rationale 5: Most childbirth classes include information on body-toning exercises.
The nurse is planning for an adolescent parenting class. Which topics would be priorities for the nurse to include in the adolescent class? Select all that apply. 1. Sexuality in pregnancy 2. Newborn care 3. Birth settings 4. Health dangers for the baby 5. How to be a good parent
Correct Answer: 2,4,5 Rationale 1: Sexuality in pregnancy would not be a priority. Rationale 2: Areas of concern for teens include how to care for the new baby. Rationale 3: Birth settings are not a priority. Rationale 4: Areas of concern for teens include health dangers to the baby. Rationale 5: Areas of concern for teens include how to be a good parent.
The nurse has received a phone call from a 29-year-old married patient pregnant with her first child. The patient is at 10 weeks' gestation. Which class would be most appropriate for this patient to attend at this point in her pregnancy? 1. Breastfeeding class 2. Birthing classes 3. Early pregnancy class 4. Adolescent pregnancy class
Correct Answer: 3 Rationale 1: Breastfeeding class would be better late in the third trimester. Rationale 2: Birthing classes are best in the third trimester. Rationale 3: Patients learn most from prenatal classes when they are offered in chronologic order, so that the class content correlates with what they are experiencing. This patient is in her first trimester; early pregnancy classes discussing fetal development are the best option at this time. Rationale 4: This patient is not an adolescent; therefore, adolescent pregnancy classes are not appropriate for this patient.
The childbirth educator nurse states that the primary rationale for providing general information as well as breathing and relaxation exercises in childbirth education is: 1. So that mothers who are doing breathing exercises during labor will refrain from yelling. 2. Because breathing and relaxation exercises are less exhausting than crying and moaning. 3. Knowledge learned at childbirth education classes helps to break the fear-tension-pain cycle. 4. Childbirth education classes help to promote positive maternal-newborn bonding.
Correct Answer: 3 Rationale 1: Childbirth educators are not concerned with possible yelling. Rationale 2: Breathing and relaxation exercises and crying and moaning are all exhausting for the mother in labor. Rationale 3: The hope of the educators presenting the classes is that knowledge learned at childbirth education classes helps to break the fear-tension-pain cycle. Rationale 4: Even though bonding is discussed, it is not the primary goal of childbirth education classes.
An expectant couple desire to determine their compatibility with a care provider. They ask the nurse for assistance. Which question should be addressed first? 1. "Can my children attend the birth?" 2. "If I have a cesarean birth, can my husband attend?" 3. "What is your philosophy of birth?" 4. "What percentage of your patients have episiotomies?"
Correct Answer: 3 Rationale 1: Children's attendance is a component of the provider's philosophy. Rationale 2: A husband's presence for a cesarean birth is indicative of the provider's philosophy. Rationale 3: A thorough understanding of the provider's philosophy is essential to determining compatibility. Rationale 4: Episiotomy percentages are indicative of the provider's philosophy.
A nurse is teaching childbirth education classes to a group of pregnant teens. Which strategy would promote learning by the young women? 1. Avoiding the discussion of uncomfortable procedures like vaginal exams and blood tests 2. Focusing the discussion on baby care rather than labor and delivery 3. Providing more extensive teaching and a forum for verbalization of fears and concerns 4. Having the classes at a location other than high school to reduce their embarrassment
Correct Answer: 3 Rationale 1: It is important to include all information in childbirth classes, regardless of the age group. Rationale 2: Both baby care and labor and delivery are important in any childbirth class. Rationale 3: Adolescents often need more support and more extensive teaching during pregnancy. Prenatal education classes specifically designed for teens can provide a forum for verbalization of fears and concerns. Rationale 4: Conducting the classes at a school enables more teens to attend.
A couple would like their 5-year-old child to attend the birth of their baby. Which statement by the nurse would assist in the plan of care for the child? 1. "You should let your child stay home, because you will be focusing on the birth." 2. "Children under 12 are not allowed to be present at the birth." 3. "You should bring someone who can tend solely to any specific needs of your child." 4. "Bring some toys to keep your child occupied."
Correct Answer: 3 Rationale 1: Telling the parents their child should remain at home does not assist them with their wish to have their child present at the birth. Rationale 2: Children are allowed to be present at births. Rationale 3: A sibling should have his own support person whose primary responsibility is to take care of the child's needs. Rationale 4: Although the child might want to bring toys, this is not the best response by the nurse.
A new patient to the clinic is 8 weeks pregnant with her second child. She asks the nurse about having a doula, since her husband is so nervous that he is no help. What will the nurse tell the patient about having a doula? 1. The doula will assist with pain medication. 2. The doula will be examining the patient periodically to see how labor is progressing. 3. The doula provides support and information, and is an advocate for the wishes of the patient and family. 4. The doula will be teaching breathing techniques and telling the patient when she can push.
Correct Answer: 3 Rationale 1: The doula is not involved with the administration of medications. Rationale 2: The doula does not examine the patient. Rationale 3: The doula is there for support and comfort, and to answer questions from the family. She is an advocate for patient and her family. Rationale 4: The doula does not teach breathing techniques or tell the patient when to push.
A couple discusses their childbirth preparation options with the nurse. They want the father to be actively involved, and for the expectant mother to avoid medications during the birthing process. The nurse's best response is: 1. "The hospital will follow your wishes." 2. "The Leboyer method will provide what you want." 3. "The Bradley method will provide for your needs." 4. "The Lamaze method will be easy to follow."
Correct Answer: 3 Rationale 1: The hospital method is not an option for preparation. Rationale 2: The Leboyer method emphasizes the provision of a gentle and peaceful environment for the birth process. Rationale 3: The Bradley method is referred to as partner- or husband-coached natural childbirth. Rationale 4: The Lamaze method involves the breathing technique that facilitates delivery by relaxing at the proper time.
The nurse is working with a prenatal patient. Which statement indicates that additional teaching is necessary? 1. "I will have Rh testing, even though this is my first pregnancy." 2. "My vagina will be cultured at 36 weeks for group B strep." 3. "Because I am married, I won't have the STI screening." 4. "My blood will be checked for hemoglobin level."
Correct Answer: 3 Rationale 1: This is a true statement. All patients are screened for blood type, Rh factor, and Rh antibodies, regardless of how many previous pregnancies (if any) they have had. Rationale 2: This is a true statement. Women are tested for group B strep to prevent neonatal infection. Rationale 3: All women should be screened for syphilis, gonorrhea, and hepatitis B. Rationale 4: This is a true statement. All women will have their hemoglobin assessed.
A new patient is having a preconception physical exam. During the exam, the clinic nurse assesses the patient for: Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Pattern of exercise. 2. An acceptable birth plan. 3. Body mass index over 30. 4. Diarrhea. 5. Hemoglobin under 12 g/dl.
Correct Answer: 3,4,5 Rationale 1: The pattern of exercise is important, and would be part of the history, not of the physical exam. Rationale 2: An acceptable birth plan is important, but not until after conception has occurred. Rationale 3: The prenatal physical must include the body mass index measurement to assess for obesity, which is indicated by a body mass index over 30. Rationale 4: The prenatal physical must include data concerning diarrhea, which could indicate an intestinal infection. Rationale 5: The prenatal physical must include a hemoglobin test to ensure that anemia is not present. Hemoglobin under 12 g/dl indicates anemia.
Following the birth of her infant, a patient states that her childbirth classes assisted her in dealing with labor and birth. The nurse understands that current research on childbirth education demonstrates which benefit? 1. Patients develop a strong attachment to the birth attendant. 2. Patients avoid the use of medication for labor. 3. Patients become dependent upon their partners. 4. Patients have a feeling of control over the birthing process.
Correct Answer: 4 Rationale 1: An increased attachment to the birth attendant is not necessarily a benefit of childbirth classes. Rationale 2: Childbirth education participants might use less medication during labor, but not all will avoid medication. Rationale 3: Childbirth classes do not increase the dependence on the partner. Rationale 4: Current research indicates that parents who participate in childbirth education have a greater sense of control over their labor and birth experience.
A nurse is teaching a class of pregnant couples about the benefits of using a breathing technique for the latent phase of labor. Which benefit does the nurse include? 1. Aids visualization (imagery). 2. Increased physical and mental alertness 3. Increased response to soothing music 4. Helps the mother to focus attention.
Correct Answer: 4 Rationale 1: Breathing techniques do not promote visualization. Rationale 2: Breathing techniques can increase physical and mental relaxation. Rationale 3: Breathing techniques do not increase the mother's response to soothing music. Rationale 4: Breathing techniques help keep the mother and her unborn baby adequately oxygenated, and help the mother relax and focus her attention appropriately.
The patient who experienced an emergency cesarean birth with her first child expresses anxiety about her upcoming birth. How can the nurse teaching the patient's prenatal classes help decrease her anxiety? 1. Encourage muscle tightening with each contraction. 2. Explain that patterned breathing increases anxiety, and should be avoided. 3. Instruct the patient to hire a therapeutic massage therapist for labor. 4. Encourage the patient to practice progressive relaxation and use the technique in labor.
Correct Answer: 4 Rationale 1: Muscle tightening with each contraction will make the contraction more intense and painful and should be discouraged Rationale 2: Patterned breathing techniques decrease, not increase, anxiety. Practice of patterned breathing prior to the onset of labor facilitates its use during labor. Rationale 3: Not all patients enjoy massage, and not all patients have the resources to hire this type of professional for their labor. Rationale 4: Progressive relaxation (and all relaxation techniques), when practiced prior to labor, is a valuable tool to facilitate relaxation and therefore decrease anxiety during labor.
The nurse is assisting an expectant couple in developing a birth plan. Which instruction would the nurse include in the teaching plan? 1. The birth plan includes only patient choices, and does not take into account standard choices of the healthcare provider. 2. The birth plan allows the patient to make choices about the birth process; however, these choices cannot be altered. 3. The birth plan is a legally binding contract between the patient and the healthcare provider. 4. The birth plan is a communication tool between the patient and the healthcare provider.
Correct Answer: 4 Rationale 1: The birth plan does not include only the patient's choices. Rationale 2: The written plan identifies options that are available, and can be altered. Rationale 3: The birth plan is not a legal document. Rationale 4: The birth plan is used as a tool for communication among the expectant parents, the healthcare provider, and the healthcare professionals at the birth setting.
