Ch 13 labor & birth process

: Softens cervix

One of the theories about the onset of labor is the prostaglandin theory. While not being conclusively proven that the action of prostaglandins initiate labor, it is known that prostaglandins do play a role in labor. What is an action of prostaglandins?

At the level of the umbilicus

The nurse is assessing a client who has given birth within the past hout. The nurse would expect to find the woman's fundus at which location?

• Begin irregularly but become regular and predictable • Felt first in lower back and sweep around to the abdomen in a wave • Increase in duration, frequency, and intensity

During a prenatal visit a pregnant client asks the nurse how to tell whether the contractions she is having are true contractions or Braxton Hicks contractions. Which of the following should the nurse mention as characteristic of true contractions?

Fetal position

The RN in labor and delivery documents the fetus as ROA. To what does this documentation refer for a fetus?

Correct response: Nothing. Normal time for stage three is 5-30 minutes

When caring for a client in the third stage of labor, the nurse notices that the expulsion of the placenta has not occurred within 5 minutes after delivery of the infant. What should the nurse do?

• Reduction in cervical resistance • Myometrial contractions • Softening and thinning of the cervix

The assessment of a pregnant client, who is toward the end of her third trimester, reveals that she has increased prostaglandin levels. Fore which factors should the nurse assess the client? Select all that apply.

• Increase in the fetal cortisol levels • Release of oxytocin by the pituitary • Prostaglandin production in the myometrium

When educating a group of nursing students about the theories of onset of labor, the nurse identifies which of the following factors as the possible causes for onset of labor? Select all that apply.

• Hand holding • Massaging • Acupressure

A nurse is caring for a pregnant client during labor. Which methods should the nurse use to provide comfort to the pregnant client? Select all that apply.

Dilation of cervix diameter to 10 cm

A nurse is caring for a pregnant client in labor in a health care facility. The nurse knows that which sign marks the termination of the first stage of labor in the client?

Continue to monitor the client

A client in her third trimester of pregnancy arrives at a health care facility with a report of cramping and low back pain; she also notes that she is urinating more frequently and that her breathing has become easier the past few days. Physical examination conducted by the nurse indicates that the client has edema of the lower extremities, along with an increase in vaginal discharge. What should the nurse do next?

To constrict the uterine blood vessels

A client in the third stage of labor has experienced placental separation and expulsion. Why is it necessary for a nurse to massage the woman's uterus briefly until it is firm?

Second

The laboring patient is having contractions every 2-3 minutes, lasting 45-60 seconds and of strong intensity. The fetal head crowns when the client pushes. The cervix is completely dilated (10 centimeters) and 100 percent effaced. The nurse assesses the patient to be in what stage or phase of labor?

latent phase

The nurse is working with a patient in labor. She is happy and cheerful, and states she is "ready to see her baby." What stage or phase of labor would she anticipate the patient to be in right now

• Lower uterine segment distention • Stretching and tearing of structures • Dilation of the cervix

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 to be causea of the extreme pain in the client? Select all that apply.

Suppresses the uterine irritability throughout pregnancy

(see full question) A nurse is teaching a group of nursing students about the role of progesterone in labor. Which of the following should the nurse explain as the function of progesterone?

Occiput

(see full question) Assessment reveals that the fetus of a client in labor is in the vertex presentation. The nurse determines that the presenting part is which of the following?

Catecholamines

A client in labor is agitated and nervous about the birth of her child. The nurse explains to the client that fear and anxiety cause the release of certain compounds which can prolong labor. Which of the following is the nurse referring to in the explanation?

Transition phase

A multigravid patient 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 patient is in which of the following phases of labor?

Gynecoid and platypelloid, respectively

A new OB/GYN physician has just finished evaluating her one hundredth patient. In reviewing the documentation from all patients thus far, which types of pelvis would you assume the physician has seen the most and the least?

• Provide the client clear information on procedures involved • Encourage the client to have a sense of mastery and self-control • Encourage the client to have a positive reaction to pregnancy

A nurse is assigned the task of educating a pregnant client about childbirth. Which nursing interventions should the nurse perform as a part of prenatal education for the client to ensure a positive childbirth experience? Select all that apply.

• Increase in heart rate • Increase in blood pressure • Increase in respiratory rate

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 childbirth? Select all that apply.

Poorly ossified cranial vault

A nurse is educating a group of nursing students about the molding of the fetal skull during the birth process. Which of the following would the nurse include as the usual cause of molding?

It helps to rotate fetus in a posterior position.

A pregnant client is admitted to a maternity clinic for childbirth. The client wishes to adopt the kneeling position during labor. The nurse knows that which to be an advantage of adopting a kneeling position during labor?

Long axis of fetus is perpendicular to that of client.

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

The cervix takes around 12 to 16 hours to dilate during first pregnancy.

A pregnant client wants to know why the labor of a first-time-pregnant woman usually lasts longer than that of a woman who has already delivered once and is pregnant a second time. What explanation should the nurse offer the client?

The frequency of the contractions is every 5 minutes

A pregnant woman calls her provider's office to report she thinks she is in labor. The patient reports contractions have been fairly strong and at these times: 12:05, 12:10, 12:15, and 12:20. What information is gathered based on this data?

Radiating to the front of the abdomen from the back

A pregnant woman comes to the emergency department because she thinks she is in labor. The nurse determines that the client is in true labor when assessment of contractions reveals which of the following? You selected: Radiating to the front of the abdomen from the back

false

An infant born by cesarean birth is usually able to establish respirations more easily than one born vaginally.

Uterine distension

Assessment of a pregnant client reveals that she is experiencing Braxton -Hicks contractions. Which of the following would the nurse explain as the cause of these contractions?

50% effaced

Assessment reveals that a woman's cervix is approximately 1 cm in length. The nurse would document this as:

Duration

The nurse is measuring a contraction from the beginning of the increment to the end of the decrement for the same contraction. She would document this as which finding?

latent phase

The nurse is working with a patient in labor. She is happy and cheerful, and states she is "ready to see her baby." What stage or phase of labor would she anticipate the patient to be in right now?

Labor can be indicated by which of the following?

The patient complains of back pain and the cervix is effacing and dilating.

Nothing. Normal time for stage three is 5-30 minutes

When caring for a client in the third stage of labor, the nurse notices that the expulsion of the placenta has not occurred within 5 minutes after delivery of the infant. What should the nurse do?

Platypelloid

When educating a group of nursing students about the different types of pelvis, the nurse describes one type as being flat, having a wider transverse diameter than anterior-posterior diameter, with ischial spines that are wide apart, and a short sacrum. The students are correct when they identify which of the following?

Android

When reviewing the history of a woman in labor, the nurse notes that the client has a funnel-shaped pelvis. The nurse would identify this pelvic shape as which of the following?

• Round-shaped inlet • Dull ischial spines • Wide pubic arch

When teaching a group of nursing students about the different types of pelvis, the nurse describes which of the following as the features of a gynecoid pelvis? Select all that apply

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 of the following terms is the nurse referring to in the explanation?

Rupture of amniotic membranes

Which assessment finding in a client reporting uterine contractions would be most consistent as an indicator of approaching labor?