L&D

Fetal heart rate monitoring reveals baseline tachycardia in the fetus. Which rate would be most likely?

164 beats per minute

A nurse is monitoring the fetal heart rate (FHR) of a client in labor using an electronic fetal monitor. The reading shows a late deceleration. Which intervention will the nurse implement?

Change maternal position to side-lying position.

A client has asked that an opioid be kept on standby in case she needs it for pain control. As a precaution, the nurse will also have which of medication readily available to reverse the effects of that opioid?

naloxone

he injection of a local anesthetic to block specific nerve pathways is referred to as:

pudendal block.

Prior to infusing medication into an epidural catheter inserted into a laboring mother, which vital sign is a priority?

Blood pressure

The nurse has provided care to a client throughout labor and delivery and is comparing assessment findings with expected norms. When tracking the client's cardiac assessments, the nurse should predict that cardiac output will likely be the highest at which time?

Immediately after birth

The nurse is assessing a client for rupture of membranes. Which findings would confirm the presence of ruptured membranes? Select all that apply.

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

Which neonatal assessment is the highest priority if the mother received meperidine during labor?

Respiratory rate

A nurse is assessing a female client in the labor admission unit. The client has been having contractions every 5 minutes for the past 6 hours. Which finding would the nurse use to determine if the client is experiencing true labor?

The client's cervix has changes of effacement and dilation (dilatation).

The nurse has been monitoring the progression of labor for a primipara. At which time is the nurse most correct to prepare for delivery?

When the fetus is crowning

The above nurse's note was documented in the client's record by the labor room nurse. In which position was the client born?

With the occiput facing the right anterior quadrant of the pelvis

A nurse is reviewing the fetal heart rate pattern and observes abrupt decreases in FHR below the baseline, appearing as a U-shape. The nurse interprets these changes as reflecting which type of deceleration?

variable decelerations

A nurse knows that a doula can be part of a laboring client's health care team. Which intervention would the nurse explain to the client is part of the doula's responsibility?

providing support and explanations during labor and birth

A woman in labor received an opioid close to the time of birth. The nurse would assess the newborn for which effect?

respiratory depression

While waiting for the placenta to deliver during the third stage of labor the nurse must assess the new mother's vital signs every 15 minutes. What sign would indicate impending shock?

tachycardia and a falling blood pressure

A pregnant client is admitted to the labor and birth unit in the first stage of labor. A nurse reviews a pregnant client's birth plan. Which response from the client would indicate to the nurse that further teaching is indicated?

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

A nurse is teaching a woman in her third trimester about Braxton Hicks contractions. When describing these contractions, which information would the nurse likely include? Select all that apply

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

A nurse is caring for a client in her third stage of labor. The nurse would predict the placenta is separating from the uterus based on which assessment findings? Select all that apply.

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

Which fetal adaptation is anticipated in a vaginal birth? Select all that apply.

Decreasing pH throughout labor Changing heart rate during contractions Excretion of respiratory tract mucus

In which manner is the fetal status best assessed during the active and transition stages of labor?

Fetal heart rate at the peak of a contraction

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?

Maternal tachycardia and falling blood pressure

A primigravida is 1 cm dilated, in early latent labor, and interested in avoiding epidural anesthesia. After asking about which nonpharmacologic options for pain relief she can use at this time, which option(s) should the nurse point out to the client? Select all that apply.

Simple breathing exercises Effleurage Walking and then using a birthing ball

The nurse determines that the fetal heart rate averages approximately 140 beats per minute over a 10-minute period. The nurse identifies this as:

baseline FHR.

A nurse is caring for woman in labor. The woman's membranes just ruptured. The nurse assesses the characteristics of the fluid. Which finding would the nurse identify as normal?

clear

The nurse is determining how often contractions occur measuring from the beginning of the one contraction to the beginning of the next contraction. The nurse documents this finding as:

frequency.

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.

lightening bloody show backache

A nurse is caring for a client who is in the first stage of labor. The client is experiencing extreme pain due to the labor. The nurse understands that which factors are causing the extreme pain in the client? Select all that apply.

lower uterine segment distention stretching and tearing of structures dilation (dilatation) of the cervix

After conducting a review class on the labor and birth process for a group of nurses working in the community clinic, the nurse determines that the teaching was successful when the group identifies which factors as affecting the labor process? Select all that apply.

powers passenger patience

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?

transition phase

A woman is in the second stage of labor and is crowning. Which diameter of the fetal skull that is smallest should align with the anteroposterior diameter of the mother's pelvis, which is the narrowest diameter at the pelvic inlet?

transverse (biparietal)