Nursing Management During Labor and Birth

Jane S. is a gravida 1, in the active phase of stage l labor. The fetal position is LOA. When Jane's membranes rupture, the nurse should expect to see:

Moderate amount of clear to straw-colored fluid

The laboring patient is on continuous fetal monitoring when the nurse notes a decrease in the fetal heart rate with variable deceleration to 75 bpm. What is the initial nursing intervention?

Change the position of the patient

When assessing a woman in the first stage of labor, the nurse recognizes that the most conclusive assessment that uterine contractions are effective would be:

Dilatation of cervix

As a woman enters the second stage of labor, which of the following would you expect to assess?

Feelings of being frightened by the change in contractions

If a fetus were not receiving enough oxygen during labor because of uteroplacental insufficiency, which of the following patterns would you anticipate seeing on the monitor?

Fetal heart rate declining late with contractions and remaining depressed

Your client is in active labor. When you check the EFM tracing, you note variables that are nonreassuring. What would be your first nursing intervention?

Help the woman change positions

The labor and delivery nurse knows that internal monitoring during labor is an invasive technique. She correctly identifies an increase in the risk of which of the following for both mother and fetus if this is done?

Infection

The laboring patient is on continuous fetal monitoring when the nurse notes a decrease in the fetal heart rate with variable deceleration to 75 bpm. What is the initial nursing intervention?

Meconium in the amniotic sac

While monitoring the EFM tracing you note decelerations with each contraction. You know that for a deceleration to be classified as early it has to meet three criteria. What is one of these criteria?

The nadir of the deceleration coincides with the acme of the contraction

What is the most important thing that you can do during labor and delivery to prevent maternal and fetal infection?

Thoroughly wash your hands before and after patient contact