Chapter 13: OB
During the examination, the HCP mentions the fetus has a good attitude. The nurse explains to the parents that this means:
- The posture of the fetus is with all joints flexed for delivery.
Relaxin
As pregnancy progresses, the hormones relaxin and estrogen cause the connective tissues to become more relaxed and elastic and cause the joints to become more flexible to prepare the mothers pelvis for birth.
A fetus in the LST position. The nurse interprets this as indicating which presenting part?
Buttocks rationale: "S" Indicates the sacrum or buttocks as the presenting part. Fetal head would be noted by the letter "O" indicating occiput. The fetal chin would be noted by the letter "M" mentum. And fetal should would be noted by the letter "A" indicating Acromion process.
A new dad is alarmed at the shape of his newborn's head. You remind him this is due to: a. Cranial bones overlapping at the suture lines b. Prolonged labor c. A congenital defect d. Extreme pressure in the vaginal vault
Cranial bones overlapping at the suture lines due to molding , it is temporary will correct it self, it is due tp the fetus passing through the pelvis.
fetal presentation
In vertex it is the occiput. In face it is the mentum (chin). In breech it is the sacrum. In shoulder it is the scapula.
Lightening occurs when:
The fetal presenting part begins to descend into the maternal pelvis, in primiparae, lightening can occur two week or more before labor begins, among multiparae it may not occur until labor.
Anterior fontanelle:
about 2-3 cm in size, diamond shaped, and closes 12 to 18 months after birth. - the posterior fontanelle closes about 8-12 weeks after birth and is triangular .
The nurse is providing care to a client in labor. On examination, the nurse determines the fetus is at? 1 station. The nurse interprets this as indicating that the fetus is:
answer: 1 cm above the ischial spines Station refers to the relationship of the presenting part to the level of the maternal pelvic ischial spines .When the presenting part is above the ischial spines, the distance is recorded as minus stations. When below the ischial spine recorded as plus stations.
A pregnant women at 37 weeks gestation calls the clinic to say she thinks that she is in labor. The nurse instructs the woman to go to the health care facility base d on the clients report of contractions that are occurring.
answer: occurring about every 5 minutes rationale: In constrast to Braxton hicks contractions that typically last about 30 seconds and occur primarily in the abdomen and groin and are relieved by walking. If contractions last longer than 30 seconds and occur more often than 4-6 times per hour, the nurse should have the woman evaluated
Assessment reveals that a woman's cervis is approximately 1 cm in length. The nurse would document this as:
-50% effaced Rationale: a cervix 1 cm in length is described as 50% effaced. A cervis that measures approximately 2 cm in length is described as 0% effaced. A cervix that is 0 CM in length would be described as 100% effaced.
A 19 year old female in advanced labor. Examination reveals the fetus is in frank breech position. The nurse interprets this finding as indicating?
The buttock are presenting with both legs extended up toward the face.
A new dad is alarmed at the chase of his newborns head. Assessment reveals swelling at the area of the presenting part. The swelling crosses the suture lines. The nurse suspects which condition?
- MOLDING Rationale: Changed shape of fetal skull at birth. Along with molding, fluid can also collect in the scalp(caput succedaneum) or beneath the scalp (cephalohematoma). Caput succedaneum is edema of the scalp at the presenting part, swelling crosses suture lines and disappear within 3-4 days. Cephaloheamtoma is a collection of blood that occurs after birth in the skull. IT DOES NOT CROSS SUTURE LINES.
The nurse notes that the fetal head is at the vaginal opening and does not regress between contractions. The nurse interprets this finding as which process?
-Crowning, occurs when the top of the fetal head appears at the vaginal orifice. Engagement occurs when the greatest transverse diameter of the head passes through the pelvic inlet.
factors affecting the labor process?
5 p's: Paasageway, passenger, powers, position, and psychological response. also philosophy, partners, patience, client, preparation, and pain control.
The nurse is assessing a client who has given birth within the past hour. The nurse would expect to find the woman's fundus at which location?
At the level of the umbilicus; Rationale: After birth the fundus is located midline between the umbilicus and pubis but then slowly rises to the level of the umbilicus during the first hour after birth.
