Labor and Birth Process
The patient is having a routine prenatal visit and asks the nurse what the childbirth education teacher meant when she used the term zero station. What is the best response by the nurse?
"The presenting part is at the true pelvis and is engaged."
Place the following stages of labor in order from what occurs first to last.
1. Latent stage 2. Active stage 3. Transition stage 4. Second stage 5. Third stage
Assessment reveals that a woman's cervix is approximately 1 cm in length. The nurse would document this as:
50% effaced
A fetus is in the LST position. The nurse interprets this as indicating which of the following as the presenting part?
Buttocks
There are four essential components of labor. The first is the passageway. It is composed of the bony pelvis and soft tissues. What is one component of the passageway?
Cervix
A 37-year-old woman in the final weeks of her first pregnancy visits the doctor's office for a scheduled check-up. What might a nurse note as a sign of labor in speaking with the woman prior to the examination?
Contraction, regular and lasting longer and stronger
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 of the following?
Crowning
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?
Effacement
Place the cardinal movements of labor in the order in which they occur.
Engagement, then descent Flexion Internal rotation Extension External rotation Expulsion
The nurse is reviewing the laboratory tests results of a client in labor. Which of the following would the nurse consider a normal finding?
Increased white blood cell count
The five "P's" of labor are
Passageway, Passenger, Position, Powers, Psych
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?
Poorly ossified cranial vault
A 32-year-old woman presents to the labor-and-delivery suite in active labor. She is multigravida, relaxed, and talking with her husband. When examined by the nurse, the fetus is found to be in a cephalic presentation. His occiput is facing toward the front and slightly to the right of the mother's pelvis, and he is exhibiting a flexed attitude. How does the nurse document the position of the fetus?
ROA
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?
Radiating to the front of the abdomen from the back
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?
Softens cervix
Labor can be indicated by which of the following?
The patient complains of back pain and the cervix is effacing and dilating.
A post delivery CBC has noted an elevated WBC count of 22,000/mm3. Which rationale is accurate regarding the elevated WBC count?
This is a normal variation due to stress of labor
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?
Transition phase.
A woman is in the second stage of labor and is crowning. Which diameter of the fetal skull, which is the smallest, should align with the anteroposterior diameter of the mother's pelvis, which is the narrowest diameter at the pelvic inlet?
Transverse (biparietal)
During the second stage of labor, a woman is generally
turning inward to concentrate on body sensations.
After teaching a pregnant client who is in her last weeks of pregnancy about the signs and symptoms of approaching labor, which of following if identified by the client would indicate effective teaching? Select all that apply.
• Lightening • Bloody show • Backache
A woman is documented on the labor and delivery board to be 7cm dilated. Her family wants to know how long she will be in labor. The nurse should provide which information to the family?
"She is in active labor, she is progressing at this point and we will keep you posted."
When teaching a group of students about the structures of the fetal skull, the nurse describes the anterior fontanelle. Which of the following would the nurse include?
Approximately 2 to 3 cm in size
The nurse should initially implement which intervention when a nulliparous woman telephones the hospital to report that she is in labor.
Ask the woman to describe why she believes that she is in labor
Braxton Hicks contractions are termed "practice contractions" and occur throughout pregnancy. When the woman's body is getting ready to go into labor, it begins to show anticipatory signs of impending labor. Among these signs are Braxton Hicks contractions that are more frequent and stronger in intensity. What differentiates Braxton Hicks contractions from true labor?
Braxton Hicks contractions usually decrease in intensity with walking
A petite, 5-foot tall, 95-pound woman who is 28 years old is about to deliver her first child and would like to have a vaginal delivery. She has two sisters, both of whom have given birth vaginally. She has gained 25 pounds during a normal, uneventful pregnancy. What type of pelvis would a nurse expect this woman to have upon assessment of the patient?
Cannot be determined
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?
Catecholamines
A nurse is performing a physical assessment of a woman in labor. As part of her assessment, she examines the outer and inner surfaces of her lips. What is the best rationale for this assessment?
Detection of herpes virus infection
The initial descent of the fetus into the pelvis to zero station is which one of the cardinal movements of labor?
Engagement
A nurse performs an initial assessment of a laboring woman and reports the following findings to the primary care provider: fetal heart rate is 152 bpm, cervix is 100% effaced and 5 cm dilated, membranes are intact, and presenting part is well applied to the cervix and at -1 station. The nurse recognizes that the client is in which stage of labor?
First, active
During a spontaneous vaginal birth several things need to occur to the fetus in sequence. As the fetus encounters resistance, what is its usual reaction?
Flexion
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?
Latent Phase
A client in labor has been admitted to the labor and birth suite. The nurse assessing her notes that the fetus is in a cephalic presentation. Which of the following should the nurse identify by the term presentation?
Part of the fetal body entering the maternal pelvis first
Which phase of the involuntary uterine contraction pattern should the nurse be observing that is beneficial to the pH of the fetal scalp?
Relaxation
A nurse is performing a vaginal examination of a woman in the early stages of labor. The woman has been at 2 cm dilated for the past 2 hours, but effacement has progressed steadily. Which of the following should the nurse do to best encourage the client regarding her progress?
Say, "you are still 2 cm dilated, but the cervix is thinning out nicely."
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?
Uterine distension
A nurse is assisting a client who is in the first stage of labor. Which of the following principles should the nurse keep in mind to help make this client's labor and birth as natural as possible?
Women should be able to move about freely throughout labor
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?
• 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
A nurse is caring for a client in her third stage of labor. Which of the following would the nurse assess as indicating placental separation? Select all that apply.
• Fresh gushing of blood from the vagina • Umbilical cord descending lower down • Renewed bearing down efforts by client
