Intrapartum

A nurse is caring for a client with a diagnosis of dystocia. The nurse specifically collects data regarding which of the following?

Characteristics of contractions

A nurse is assisting in performing Leopold's maneuvers. When the client asks what these are for, the nurse's best response is that these maneuvers help to determine:

Fetal position

A nurse is caring for a client in preterm labor when her membranes rupture. The initial nursing action is to:

Monitor the fetal heart rate.

A nurse has assisted in developing a plan of care for a client experiencing dystocia and includes several nursing interventions in the plan of care. The nurse prioritizes the plan and selects which nursing intervention as the highest priority?

Monitoring fetal status

The client is admitted to the labor suite complaining of painless vaginal bleeding. The nurse assists with the examination of the client, knowing that a routine labor procedure that is contraindicated with this client's situation is:

A manual pelvic examination

Majority of breech are delivered?

Cesarean

Before attempting to deliver the placenta after a precipitate delivery, the nurse waits for which sign as an indication of placental separation?

Change in uterine shape

A nurse reviews the results of an ultrasound performed on a woman admitted to the maternity unit. The results indicate that the placenta is covering the entire internal cervical os. The nurse understands that the client is experiencing:

Complete placenta previa

A nurse prepares to explain the purpose of effleurage to a client in early labor. The nurse tells the client that effleurage:

Is light stroking of the abdomen to facilitate relaxation during labor

Which documentation concerning the characteristics of amniotic fluid supports the determination that the fluid is normal?

It is pale, straw-colored with flecks of vernix.

The nurse is caring for a client who is in labor. The nurse rechecks the client's blood pressure and notes that it has dropped. To decrease the incidence of supine hypotension, the nurse should encourage the client to remain in which position?

Left lateral

A pregnant client at 36 weeks' gestation experiences painless bleeding and is admitted to the labor room. Which action should the nurse initially include in the plan of care?

Maintain complete bedrest, monitor IV fluid intake, and monitor the fetal heart rate.

Immediately following the delivery of a newborn, the nurse prepares to assist in the delivery of the placenta. What is the appropriate action to deliver the placenta?

Pull gently on the cord as the mother bears down.

A client in labor has been pushing effectively for 1 hour and the presenting part is at a +2 station. The nurse determines that the client's primary physiological need at this time is:

Rest between contractions

Following delivery, a client experiences subinvolution of the uterus. The nurse develops a plan of care, recalling that which of the following is the primary cause for this occurrence?

Retained placental fragments

A woman with preeclampsia is receiving magnesium sulfate. The nurse assigned to care for the client determines that the magnesium sulfate therapy is effective if:

Seizures do not occur.

A nurse caring for a client who is receiving oxytocin (Pitocin) for the induction of labor notes a nonreassuring fetal heart rate (FHR) pattern on the fetal monitor. On the basis of this finding, the nurse would first:

Stop the oxytocin infusion.

A nurse is caring for a client scheduled for a cesarean delivery. The nurse reviews the client's health record, knowing that which finding needs to be further investigated before delivery?

White blood cell count of 35,000 mm3

A client delivers a viable male neonate who is given APGAR scores of 8 and 9 at 1 and 5 minutes. The nurse determines the physical condition of the neonate to be:

good

cephalic is

head down, breech, buttocks down

restitution

head is delivered it moves to realign with the body and shoulders

cephalocaudal is

head to buttocks axis

Common antianxiety meds...

hydroxyzine ( Vistaril) diazepam ( Valium)

true pelvis is divided by

linea terminalis

engagement

occurs when the biparietal diameter of the fetal head crosses the pelvin inlet; the head is said to be fixed or engaged in the pelvis

extension

occurs when the occiput passes under the symphysis pubis

During the delivery of the placenta what medication can be administered

oxytocin or methylergonovine maleate - stimulates uterine contractions

a full bladder can interfere with?

progress of labor

position of mother is

standing, walking, side lying, squatting, on hands and knees

A nurse is caring for a client in labor. The nurse notes the presence of fetal bradycardia on the fetal monitor and suspects that the umbilical cord is compressed. The nurse immediately places the client in what position?

with the lips elevated

pelvimetry

xray films from different views, accurately measue bony prominences. Not for women who are pregnant but have an injury or known developmental problem

early latent phase is

0-3cm dilation, contractions are 5-8 mins apart last 20-35 seconds

The nurse is assigned to care for a client who is in early labor. When collecting data from the client, it is most important for the nurse to first determine which of the following?

Baseline fetal heart rate

A nurse is reviewing the record of a client in the labor room and notes that the nurse midwife has documented that the fetus is at minus one station. The nurse determines that the fetal presenting part is:

1 cm above the ischial spines

A primigravida's membranes rupture spontaneously. The nurse's first action is to:

Determine the fetal heart rate.

When should enemas not be given?

Vaginal bleeding or premature labor if the presenting part is not engaged or presenting is not vertex

descent

downward progress of the presenting part

pudendal block intervention

provide reassurance and explanation; monitor FH tones and maternal vital signs closely injection: area of pudendal nerve for birth

secondary powers is

women's voluntary bearing down efforts

A nurse tells a client she is now beginning the second stage of labor. The nurse realizes the client understands the occurrences of this stage when the client says:

"My cervix is completely dilated."

A nurse is reviewing the record of a client in the labor room and notes that the nurse-midwife has documented that the fetus is at minus one station. The nurse determines that the fetal presenting part is:

1 cm above the ischial spines

transitional phase

7-10 cm dilation, contractions are 2-3 minutes, lasting up to 80 seconds

FHR decreases or increases oxygen level?

8-10L/min per face mask

A client in labor has an underlying diagnosis of sickle cell anemia. During labor the client is at high risk for sickling crisis. The nurse should take which priority action to assist in preventing a crisis from occurring during labor?

Administer oxygen as prescribed throughout labor.

A 31-week preterm labor client dilated to 4 centimeters has been started on magnesium sulfate. Her contractions have stopped. If the client's labor can be inhibited for the next 48 hours, what medication does the nurse anticipate will be prescribed?

Betamethasone

A nurse in the labor room is caring for a client in the first stage of labor. On assessing the fetal patterns, the nurse notes an early deceleration of the fetal heart rate (FHR) on the monitor strip. Which is the appropriate nursing action?

Document the findings and continue to monitor the fetal patterns.

The advantages of using spinal anesthesia for delivery of a fetus include which of the following? Select all that apply.

Ease of administration Absence of fetal hypoxia Immediate onset of anesthesia Blockade of sympathetic fibers

A client is scheduled to have an elective cesarean delivery. The nurse preparing the client for the procedure plans to allay the client's feelings of anxiety by:

Encouraging the client to discuss her concerns and desires regarding anesthesia options

A client in labor asks the nurse why it is so important to void frequently during labor. The nurse responds, using knowledge that the important reason is to:

Ensure labor progress and prevent injury.

A nurse observes that a client in the transition stage of labor is crying out in pain with pushing efforts. The nurse recognizes this behavior as:

Fear of losing control

A nurse is asked to assist the primary health care provider in performing Leopold's maneuvers on a client. Which nursing intervention should be implemented before this procedure is performed?

Have the client empty her bladder.

For the previous 4 hours, a client in labor has been experiencing contractions every 2 minutes, lasting 60 to 70 seconds, and strong to palpation. She is 2 cm dilated and complaining of severe pain. The nurse understands that the client is experiencing which type of dystocia?

Hypertonic

Leopold's maneuvers will be performed on a pregnant client. The client asks the nurse about the procedure. The nurse responds, knowing that this procedure:

Is a systematic method for palpating the fetus through the maternal abdominal wall

The nurse prepares to administer erythromycin ophthalmic ointment to a newborn infant immediately after delivery. The nurse understands that this ointment:

Is effective in protecting the newborn from Neisseria gonorrhoeae and chlamydia

The maternity nurse prepares the client for which of the following techniques commonly used to relieve shoulder dystocia?

McRoberts' maneuver

The client at 38 weeks' gestation is admitted to the birthing center in early labor. The client is carrying twins, and one of the fetuses is in a breech presentation. The nurse assists with planning care for the client and identifies which of the following as the lowest priority for the care of this client?

Measuring the fundal height

A woman in active labor has contractions every 2 to 3 minutes that last for 45 seconds. The fetal heart rate between contractions is 100 beats per minute. On the basis of these findings, the priority nursing intervention is to:

Notify the registered nurse (RN) immediately.

A nurse is monitoring a client in active labor and notes that the client is having contractions every 3 minutes that last 45 seconds. The nurse notes that the fetal heart rate between contractions is 100 beats per minute. Which of the following nursing actions is appropriate?

Notify the registered nurse (RN).

A nurse notes that a client in labor has foul-smelling amniotic fluid, a maternal temperature of 101° F, and a urine output of 150 mL during the past 2 hours. The nurse should do which of the following at this time?

Notify the registered nurse of a possible maternal infection.

A client was admitted to the maternity unit 12 hours ago and has been experiencing strong contractions every 3 minutes, and the fetus is currently at station 0. The fetal heart rate on admission was 140 beats per minute and regular. The fetal heart rate is decreasing and a persistent nonreassuring fetal heart rate pattern is present. What is the appropriate nursing action?

Prepare the client for a cesarean delivery.

A nurse assisting in the labor room is preparing to care for a client with hypertonic dysfunction. The nurse is told that the client is experiencing uncoordinated contractions that are erratic in their frequency, duration, and intensity. The priority nursing intervention in caring for the client is to:

Provide pain relief measures.

A nurse is caring for a client following a precipitate delivery. In addition to fundal massage, the nurse understands that which nursing action will promote the birth of the placenta?

Putting the baby to the mother's breast and letting the baby suck

A nurse is preparing a client for a cesarean delivery. A urinary catheter is to be inserted into the client's bladder, and the client asks the nurse why this is necessary. The nurse appropriately replies by telling the client that its primary purpose is to:

Reduce the risk of injuring the bladder during the surgery.

A client is admitted for an emergency cesarean section delivery. Contractions are occurring every 15 minutes. The client has a temperature of 100° F and ate 2 hours ago. Which intervention has priority?

Report the time of last food intake to the health care provider.

A pregnant client is receiving magnesium sulfate for the management of preeclampsia. A nurse determines that the client is experiencing toxicity from the medication if which of the following is noted on data collection?

Respirations of 10 breaths per minute

A nurse is monitoring the status of a client in active labor. The nurse interprets that which finding is consistent with dystocia? Select all that apply.

Signs of fetal distress High level of maternal anxiety Failure of the fetus to descend

The client who is being prepared for a cesarean delivery is brought to the delivery room. To maintain the optimal perfusion of oxygenated blood to the fetus, the nurse places the client in the:

Supine position with a wedge under the right hip

A client has just had surgery to deliver a nonviable fetus because of abruptio placentae. She has just been told that she is developing disseminated intravascular coagulopathy. She begins to cry and screams, "God, just let me die now!" Which problem should direct care for this client?

The client feels hopeless about the situation.

A nurse collecting data on a client during the second stage of labor notes a slowing of the fetal heart rate (FHR) with a loss of variability and determines that these are indicators of possible complications. Which priority interventions should the nurse perform?

Turn client to her side and administer oxygen by mask at 8 to 10 L/min

In providing initial care to the newborn following delivery, the priority action of the nurse is to:

Turn the infant's head to the side.

The nurse is assigned to assist with caring for a client with abruptio placentae who is experiencing vaginal bleeding. The nurse collects data from the client, knowing that abruptio placenta is accompanied by which additional finding?

Uterine tenderness on palpation

oxytocin action

acts directly on myofibrils producing uterine contractions, stimulates milk ejection

Early deceleration

decreases in FHR below basleine. The rate at the lowest point of the deceleration

cultural consideration - African American

may arrive at hospital in advance labor emotional support often provided by other women,vaginal bleeding seen as sickness, tub baths and shampooing of hair prohibited

footling breech is

no flexion and one foot or two feet present

cultural consideration - Hispanic

stoic about pain until second stage, father and female relatives present, loud behavior in labor

magnesium sulfate use

stop preterm labor, stopping seizures in preeclamptic and eclamptic clients

meconium

the infants first stool, a viscid, sticky, dark greenish brown, almost black, sterile odorless stool

passageway is...

the pelvis and soft tissues

effacement

thinning and shortening or obliteration of the cercix that occurs during late pregnancy

When examining the umbilical cord immediately after birth, the nurse expects to observe:

two arteries

A client arrives at the birthing center in active labor. Her membranes are still intact and the nurse-midwife performs an amniotomy. The nurse explains to the client that after this procedure, she will likely have:

increased efficiency of contractions

cultural consideration - India

father not present, natural childbirth method used

oxytocin implication

monitor intake and output ratio, contractions, FHR, BP, Pulse and respirations

tocotransducer

monitor uterine activity via a pressure sensing device placed on the maternal abdomen

5Ps:

passageway, passenger, powers, position of mother, psyche

placental seperation indicates

firm contracting fundus, change in uterus from discoid to globular ovoid as the placenta moves to the lower segment

variability

fluctuation in the baseline FHR

A client asks, "What does it mean that the baby is at minus one?" The nurse should explain to the client that the fetal presenting part is isolated:

1 cm above the ischial spines

normal FHR is

120 to 160 bpm

before induction of anesthesia the woman breathes

3-5 minutes or deep breaths to increase her oxygen stores and those of her fetus for the short period of apnea

cultural consideration - Iran

father not present, female caregivers,

true pelvis is divided into 3 segments

inlet, cavity or midpelvis and outlet

primary powers is

involuntary uterine contractions

A nurse is caring for the nullipara woman in labor. The nurse understands that the health care provider must be contacted if which one of the following becomes apparent?

Decreased periods of uterine relaxation between contractions

A multigravida woman with a history of cesarean births is admitted to the maternity unit in labor. The client is having excessively strong contractions, and the nurse monitors the client closely for uterine rupture. Which finding would be noted if complete rupture occurs?

Decreasing blood pressure

A nurse is monitoring a preterm labor client who is receiving magnesium sulfate intravenously. The nurse monitors for which adverse effect(s) of this medication? Select all that apply.

Depressed respirations Extreme muscle weakness Flushing

A nurse is monitoring a client in labor whose membranes rupture spontaneously. The initial nursing action is to:

Determine the fetal heart rate.

cultural consideration - native americans

birth may be attended by whole family, herbs may used to promoteo uterine activity, squatting position, herbs used to stop postpartum bleeding, burry placenta for good luck

true pelvis is called

bones aid in directing the fetus into the interior portion of the pelvis

what are tocolytics?

produce uterine relaxation and suppress uterine activity, used to stop uterine contractions and prevent preterm birth

psyche

psychological response

ferguson's reflex

release of oxytocin that triggers the maternal urge to bear down

molding is

reshaping of the skull bones in response to pressure against maternal pelvis

expulsion

shoulders are delivered, the delivery ends with it.

cultural consideration- Laos

squat for birth, prefer female attendants

A client has just delivered a viable newborn. The first nursing action to initiate attachment is to:

Determine the parents' desires for contact with the newborn.

The client is in the second stage of labor. As the baby begins to crown, the health care provider administers a pudendal nerve block in preparation for an episiotomy. The nurse should:

Continue to assess vital signs and fetal heart rate the same as before the nerve block.

A nurse is assigned to care for a client experiencing dystocia. In planning care, the nurse would consider the highest priority to be frequent:

Monitoring for changes in the physical and emotional condition of the mother and fetus

A client who experienced abruptio placentae is at risk for disseminated intravascular coagulopathy (DIC). The nurse should monitor this client for which manifestation of this complication?

Oozing from injection sites

leopolds maneuver

a method of palpation for determining the presentation and position of the fetus, an aid for locationg fetal heart, Head is in the fundus

hydroxyzine action

antianxiety antepartum and postpartum adjunctive therapy

A mother experiencing dystocia looks alarmed and asks, "What's going on? Why are you all poking and prodding? Is my baby okay?" Based on the client's statement, the nurse understands that the client is experiencing which of the following problem?

anxiety and fear

passenger

fetus and placenta

interventions with magnesium sulfate

monitor vitals esp. resp. q30-60 mins., I&O, magnesium levels,

A client in active labor with intact membranes is complaining of back discomfort. An analgesic was administered 1 hour ago but has not relieved the discomfort. The nurse should avoid doing which of the following at this time to assist in relieving the back discomfort?

Assist the client to ambulate in the room.

A 30-week gestational prenatal client with complaints of painless vaginal bleeding presents at the labor and birthing department of the hospital. The nurse prepares the client for which expected diagnostic procedure?

Contraction stress test

A client has been admitted to the maternity unit for a scheduled cesarean section. As she is getting into bed for preliminary preparation for surgery, the client states, "I don't need the cesarean section after all because I think my baby has moved around." The appropriate response by the nurse is which of the following?

"Tell me what you mean when you say that your baby has moved."

A client tells the nurse her contractions are getting stronger and that she is getting tired. She appears restless, asks the nurse not to leave her alone, and states, "I can't take it anymore." Considering the client's behavior, the nurse suspects she is dilated:

8-10cm

A nurse in the labor room is assisting in caring for a client in the active stage of labor. The nurse is told that the fetal patterns show a late deceleration on the monitor strip. Based on this finding, the nurse prepares for which appropriate nursing action?

Administering oxygen via face mask

A nurse is monitoring a client who is in the active stage of labor. The nurse notes a late deceleration on the fetal monitor. Based on this observation, the nurse immediately:

Administers oxygen via face mask to the mother

The nurse is collecting data from a client who has been diagnosed with placenta previa. Choose the findings that the nurse would expect to note. Select all that apply.

Bright red vaginal bleeding Soft, relaxed, nontender uterus

A nurse in the delivery room is assisting with the delivery of a newborn. Which observation would indicate that the placenta has separated from the uterine wall and is ready for delivery?

Changes in the shape of the uterus

A nurse is caring for a client in labor. The fetal heart rate is 156 beats per minute and regular. The client's contractions are occurring every 4 minutes with a duration of 42 seconds and moderate intensity. The nurse should do which of the following at this time?

Continue monitoring the client because the data reflect acceptable progress.

The nurse is assigned to assist with caring for a client who is being admitted to the birthing center in early labor. On admission, the nurse would initially:

Determine the maternal and fetal vital signs.

A licensed practical nurse (LPN) is assisting in gathering data on a client who is scheduled for a cesarean delivery. Which of the following findings would indicate a need to contact the registered nurse (RN)?

Fetal heart rate of 180 beats per minute

At 5:00 AM a client is admitted to the maternity unit after experiencing 3 hours of labor at home. The assessment determines that the fetal heart rate (FHR) is 140 beats per minute with the fetus at station 0 and strong contractions occurring every 3 minutes. It is now 7:00 AM with little progress, and the FHR is decreasing. It is most appropriate for the nurse to anticipate the need to:

Prepare the client for a cesarean delivery.

The nurse institutes measures for the client with placental abruption to minimize alterations in fetal tissue perfusion. The nurse determines that fetal tissue perfusion is adequate if which of the following is noted?

Presence of accelerations

A nurse is caring for a client with sickle cell disease who is in labor. The nurse ensures that the client receives appropriate intravenous (IV) fluid intake and oxygen consumption to primarily:

Prevent dehydration and hypoxemia.

During the intrapartum period, a nurse is caring for a laboring client with sickle cell disease. The nurse ensures that the client receives appropriate intravenous (IV) fluid intake and oxygen consumption to primarily:

Prevent dehydration and hypoxemia.

A client in labor is transported to the delivery room and is prepared for a cesarean delivery. The client is positioned on the delivery room table and the nurse places the client in the:

Supine position with a wedge under the right hip

A nurse is assisting in caring for a client with abruptio placentae and is monitoring the client for disseminated intravascular coagulopathy (DIC). Which of the following findings is least likely associated with DIC?

Swelling of the calf of one leg

A client becomes increasingly more anxious and hyperventilates during the transition phase of labor. The nurse recognizes that the client needs:

To regain her breathing pattern

A nurse is collecting initial data on a newborn in the delivery room. Which observation would the nurse expect to note when examining the umbilical cord of the newborn?

Two arteries and one vein

A nurse is preparing a client for an emergency cesarean delivery. Which of the following information regarding the client has priority?

When was the last time the client ate or drank?

A nurse is providing emergency measures to a pregnant client with a prolapsed cord. The mother becomes anxious and frightened and says to the nurse, "Why are all of these people in here? Is my baby going to be all right?" Which of the following most appropriately describes the mother's problem at this time?

Fear about what is happening

A nurse assisting to monitor a client in labor is told that the client's cervix is 3 cm dilated with contractions occurring every 2 to 3 minutes. When monitoring the client's psychological status, the nurse anticipates the client to reflect an attitude of:

excitement

A nurse is monitoring a client who is receiving oxytocin (Pitocin) to augment labor. The nurse determines that the dosage should be decreased and notifies the registered nurse if which of the following is noted?

fetal tachycardia

A nurse assisting in the care of a woman in labor should focus primarily on which of the following at the time of delivery?

infant

The nurse is assigned to assist with caring for a client who has been admitted to the labor unit. The client is 9 cm dilated and is experiencing precipitous labor. A priority nursing action is to:

keep the client in a side lying position

A nurse is caring for a woman in labor who is experiencing a precipitate delivery. Until help arrives, the nurse places the client into which optimal position?

lateral sims'

A client in preterm labor is placed on bedrest. The nurse assists the client to which of the following advantageous positions?

left lateral

middle or active phase is

4-7cm dilation, contractions are 3-5minutes, lasting 40-60 seconds

tocotransducer nursing care

palpate fundus every 30 to 60 mins to assess strength, adjust pen-set between contractions to print between 10 and 20 mm Hg on monitor strip.

hydroxyzine implication

being used less freq. aspirate IM carefully

accleration

brief, temporary increases in the FHR of at least 15 beats above the baseline and lasting at least 15 seconds

frank breech is

buttocks present and the thigh are extended across abd and chest

complete breech is

buttocks present and thighs are well flexed on abd

methods to minimize adverse effects:

restrict intake to clear fluids or maintain NPO admin drugs to raise gastric pH and make secretions less acidic such as sodium citrate and citric acid ( Bictra), ranitidine ( Zantac), cimetidine ( Tagamet) or famotidine ( Pepcid) Admin drugs to reduce secretion - glycopyrrolate ( Robinul) Use cricoid pressure (Sellicks maneuver) or block the esophagus by pressing the rigid trachea against it.

A nurse is caring for a client who was admitted to the maternity unit at 8:00 AM with contractions occurring every 2 minutes, lasting 1½ minutes, and is dilated 4 cm with a cervical effacement of 60%. At 10:30 AM, the contractions cease. The client reports chest pain and manifests signs and symptoms of shock. The nurse quickly plans care, suspecting which of the following?

ruptured uterus

prostaglandin E action

stimulate uterine contractions like those seen in normal labor

A nurse assists the nurse-midwife to examine the client. The midwife documents the following data: cervix 80% effaced and 3 cm dilated, vertex presentation minus (−) 2 station, membranes ruptured. The nurse anticipates that the midwife will prescribe which of the following activity for the client?

complete bedrest

A nurse assists in developing a plan of care for a multigravida client who has a history of cesarean birth. It is determined that the client is at high risk of uterine rupture. The nurse plans to monitor the client closely for:

signs of shock

A nurse is assisting in caring for a client in labor. The nurse recognizes that the risks for uterine rupture during labor and delivery include:

shoulder dystocia

adverse effects of magnesium sulfate

cause resp. depression reflexes, flushing, hypotension, extreme muscle weakness, prescribed 12 to 24 hours postpartum

valsva manuever

closed glottis and prolonged bearing down

powers is

contractions

prostaglandin E implication

use caution to prevent contact with skin, wash thoroughly after admin, bring to room temp before admin, remain supine for 15-30 mins after insertion

paracervical block nursing intervention

closely monitor FH tones and maternal vital signs and contractions injection : either side of cervix at 4cm dilation

station

comparing lowest point of the presenting part to the ischial spines

internal rotation

enables the fetal head to progess through the maternal pelvis

cultural considerations southeast asia ( china, japan, korea)

father usually not present; stoic response to pain; side lying position preferred, shower and bathing prohibited

LIGHTENING

fetus seems to have settled or dropped into the pelvis

Caudal and lumbar epidural intervention

injection : caudal canal and epidural space intervention: monitor FH tones and maternal vital signs closely, use excellent aseptic technique

Saddle block intervention

injection: under dura of spinal cord for birth

preciptious labor is

labor that lasts less than 3 hours from onset of contractions

most commonly used analgesics are...

meperdine hydrochloride ( Demerol) butorphanol tartrate ( Stadol)

The client is having moderate contractions that are occurring every 5 minutes and lasting 60 seconds. The fetal heart rate (FHR) is 150 beats per minute and regular. Based on these findings, what is the appropriate nursing action?

Continue to monitor the client.

A prenatal client with severe abdominal pain is admitted to the labor and birthing department. Which data indicate to the nurse the presence of concealed bleeding?

increase in fundal height

A pregnant client with severe uterine bleeding is admitted to the labor and birthing department. Which of the following data would best alert the nurse to early signs of hypovolemic shock?

Restlessness and agitation

A nurse is evaluating the effectiveness of meperidine hydrochloride (Demerol) for pain management for a client in labor. The client describes her pain level as "9" during contractions. The nurse determines that the medication was effective if the client exhibited which reasonable goal for pain relief?

Pain level is "4" while a progressive labor pattern continues.

A nurse is assisting in preparing to care for a client undergoing an induction of labor with an infusion of oxytocin (Pitocin). The nurse includes which of the following in the plan of care?

Maintain continuous electronic fetal monitoring.