Mom Baby Exam 2

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While evaluating the fetal heart monitor tracing on a client in labor, the nurse notes that there are fetal heart decelerations present. Which assessment must the nurse make at this time? a. The relationship between the decelerations & the labor contractions b. The maternal blood pressure c. The gestational age of the fetus d. The placement of the fetal heart electrode in relation to the fetal position

Answer A - Decelerations are defined by their relationship to the contraction pattern. It is essential that the nurse determine which of the three (3) types of decelerations is present. Early decelerations mirror contractions, late decelerations develop at the peak of contractions & return to baseline well after contractions are over, & variable decelerations can occur at any time & are unrelated to contractions.

Which choice includes the correct order of the cardinal moves of labor? a. Internal rotation, extension, external rotation b. External rotation, descent, extension c. Extension, flexion, internal rotation d. External rotation, internal rotation, expulsion

Answer A - Descent & flexion must occur first. If the fetus does not descend into the birth canal & the fetus does not flex the head, the fetus will not be able to traverse through the bony pelvis. Second, internal rotation must occur before external rotation. In between internal rotation & external rotation is extension, the delivery of the head. And, finally, expulsion of the body

A client in labor is talkative and happy. How many centimeters dilated would a labor nurse suspect that the client is at at this time? a. 2 cm b. 4 cm c. 8 cm d. 10 cm

Answer A - In the latent phase of labor, clients are often very excited because labor has finally begun. They frequently are very talkative & easily distracted from the contractions.

The childbirth educator is teaching a class of pregnant couples the breathing technique that is most appropriate during the second stage of labor. Which technique did the nurse teach the women to do? a. Alternately pant & blow b. Take rhythmic, shallow breaths c. Push down with an open glottis d. Do slow chest breathing

Answer C - During the second stage of labor the woman will change from using breathing techniques during contractions to pushing during contractions in order to birth the fetus. Open glottis pushing is recommended since pushing against a closed glottis can decrease the mother's oxygen saturation.

A multiparous client who has been in labor for almost 3 hours suddenly announces that the baby is coming. The nurse sees the infant crowning. Which intervention should the nurse do immediately? A. Ask the woman to pant while preparing to place gentle counterpressure on the infant's head as it is delivered B. Quickly obtain sterile gloves & a towel C. Retrieve the precipitous delivery tray from the nursing station D. Telephone the health care provider using the bedside phone

Answer: A.

The nurse monitors a client during a vaginal delivery of a breech infant for which of the following as the greatest risk? A. Umbilical cord prolapse B. Intracranial hemorrhage C. Meconium aspiration D. Fracture of the clavicle.

Answer: A.

The nurse is performing a vaginal exam on a client in labor. The client is found to be 5cm, 90% and -2. What has the nurse palpated? a. A thin cervix b. Bulging fetal membranes c. Head at the pelvic outlet d. Closed cervix

Answer A - During pregnancy & early labor, the cervix is closed, long, & thick. During the labor process, however, the cervix changes shape, becoming paper thin& dilating to 10 cm. This is a universal finding. No matter how tall or short, young or old a woman is, her cervix will dilate to 10 cm & efface 100% if she has a vaginal delivery.

On exam, it is noted that a full-term primipara in active labor is right occipitoanterior position (ROA), 7 cm dilated, & +2 station. What should the nurse report to the health care provider? a. Descent is progressing well. b. Fetal head is not yet engaged. c. Vaginal delivery is imminent. d. External rotation is complete.

Answer A - In a 7 cm dilated primipara, with a fetus at +2 station, vaginal delivery is not imminent, but the fetal head is well past engagement & descent is progressing well. External rotation has not yet occurred since the baby's head has not yet been birthed.

A nurse is assisting an anesthesiologist who is inserting an epidural catheter. Which position should the nurse assist the client into? a. Fetal position b. Lithotomy position c. Trendelenburg position d. Lateral recumbent position

Answer A - In order for the anesthesiologist to be able to insert the epidural catheter into the epidural space, the client must be placed in either the fetal position or sitting with her chin on her chest & her back convex. In both of those positions, the client's vertebrae separate, providing the anesthesiologist access to the required space.

While caring for a client in the transition phase of labor, the nurse notes that the fetal monitor tracing shows moderate short-term & long-term variability with a baseline of 142 beats/minute. What should the nurse do? a. Provide caring labor support b. Administer oxygen via face mask c. Change the client's position d. Increase the client's IV rate

Answer A - The baseline fetal heart variability is one of the most important fetal heart assessments. If the fetus' heart rate shows moderate variability, the nurse can assume that the fetus is not hypoxic or acidotic.

The L&D nurse performs Leopold's maneuvers. A soft round mass is felt in the fundal region. A flat object is noted on the left & small objects are noted on the right of the uterus. A hard round mass is noted above the symphysis. Which position is consistent with these findings? a. Left occipital anterior (LOA) b. Left sacral posterior (LSP) c. Right mentum anterior (RMA) d. Right sacral posterior (RSP)

Answer A - The fetal back ("flat object") is felt on the mother's left side, the "small objects" are felt on her right side, the buttocks ("soft round mass") are felt in the fundal region, & the head ("hard round mass) is felt above her symphysis.

The nurse auscultates a fetal heart rate of 152 on a client in early labor. Which action by the nurse is appropriate? a. Inform the client that the fetal heart rate is normal. b. Reassess in 5 minutes to verify the results. c. Immediately report the rate to the health care provider. d. Place the client on her left side & apply oxygen by face mask.

Answer A - The normal fetal heart rate range is 110-160 beats/min. A rate of 152, therefore is within normal limits. No further action is needed at this time.

Which actions would the nurse expect to perform immediately before a client is to have an epidural placed for labor pain management? (Select all that apply.) a. Assess FHR b. Infuse 1000cc of LR c. Place the client in Trendelenburg position d. Monitor blood pressure every 5 minutes for 15 minutes e. Have the client empty her bladder

Answer A, B & E - Before any medication, whether analgesia, anesthesia, labor inducing/ augmenting, antiemetic, is administered during labor, FHR should be assessed to make sure that the fetus is not already compromised. Before regional anesthesia administration, a liter of fluid should be infused to increase the client's vascular fluid volume. This will help to maintain her blood pressure after the epidural insertion. And the client's bladder should be emptied because she will not have the sensation of a full bladder once the epidural is in place.

When during the latent phase of labor should the nurse assess the fetal heart pattern of a low-risk woman, G1 P0? (Select all that apply.) a. After vaginal exams b. Before administration of analgesics c. Periodically at the end of a contraction d. Every ten (10) minutes e. Before ambulating

Answer A, B, C, & E - Except for invasive procedures, assessment of the FHR pattern is the only way to evaluate the well-being of a fetus during labor. The FHR pattern should, therefore, be assessed whenever there is a potential for injury to the fetus or to the umbilical cord. At each of the times noted in the scenario either the cord could be compressed or the fetus could be compromised.

A woman has just arrived at the labor & delivery suite. In order to report the client's status to her health care provider, which assessments should the nurse perform? (Select all that apply.) a. Fetal heart rate b. Contraction pattern c. Contraction stress test d. Vital signs e. Biophysical profile

Answer A, B, D - A contraction stress test &/or a biophysical profile would only be done if ordered by the health care provider. A, B & D would be completed prior to contacting the provider to provide the provider with a picture of the health status of the client & her fetus.

A nurse is caring for a laboring client who is in transition. Which signs/symptoms would indicate that the client is progressing into the second stage of labor? (Select all that apply.) a. Bulging perineum b. Increased bloody show c. Spontaneous rupture of membranes d. Uncontrollable urge to push e. Inability to breathe through contractions

Answer A, B, D - The three (3) phases of the first stage of labor - latent, active, & transition are related to changes in cervical dilation & maternal behaviors. The three (3) stages of labor are defined by specific labor progressions - cervical change to full dilation (stage 1); full dilation to birth of the baby (stage 2); birth of the baby to birth of the placenta (stage 3).

The nurse is assessing a client who states, "I think I'm in labor." Which finding would positively confirm the client's belief? a. She is contracting every 5 min x 60 sec b. Her cervix has dilated from 2 to 4 cm. c. Her membranes have ruptured. d. The fetal head is engaged.

Answer B - Although laboring women experience contractions, contractions alone are not an indicator of true labor. Only when the cervix begins to dilate is the client in true labor. False labor contractions are usually irregular & mild, but, in some situations, they can appear to be regular & can be quite uncomfortable.

The nurse is assessing the internal fetal heart monitor tracing of an unmedicated, full-term gravida who is in transition. Which heart rate pattern would the nurse interpret as normal? a. Baseline of 140, moderate variability with V-shaped decelerations to 120 unrelated to contractions. b. Baseline of 140, moderate variability with decelerations to 100 that mirror each of the contractions. c. Flat baseline of 140 with decelerations to 120 that return to baseline after the end of the contraction. d. Flat baseline of 140 with no obvious decelerations or accelerations.

Answer B - Decelerations that mirror contractions are early decelerations. These are related to head compression and are expected during transition & second stage labor.

A nurse is assessing the vital signs of a client in labor at the peak of a contraction. Which finding would the nurses expect to see? a. Decreased pulse rate b. Hypertension c. Hyperthermia d. Decreased respiratory rate

Answer B - During contractions, the blood from the placenta is forced into the peripheral vascular system & there is an increase in cardiac output. As a result, the client's blood pressure rises: an average of 35 mmHg systolic & 25 mmHg diastolic. The blood pressure should never be assessed during a contraction because the reading will be a marked distortion of the client's true blood pressure.

A client is in the third stage of labor. Which assessment should the nurse make/observe for? a. Fetal heart assessment after each contraction b. Uterus rising in the abdomen & feeling globular c. Rapid cervical dilation to ten (10) cm d. Maternal complaints of intense rectal pressure

Answer B - It is important to differentiate between the stages of labor. Stage 1, what is usually referred to as "labor", ends with full cervical dilation. At the end of stage 2, the baby is born. At the conclusion on stage 3, the placenta is expelled.

The nurse is assessing the fetal station during a vaginal exam. Which structures should the nurse palpate? a. Sacral promontory b. Ischial spines c. Cervix d. Symphysis pubis

Answer B - Station is determined by creating an imaginary line between the ischial spines. The descent of the presenting part of the fetus is then compared with the level of that "line".

The nurse is performing fetal scalp stimulation. Which fetal response would the nurse expect to see? a. Spontaneous fetal movement b. Fetal heart acceleration c. Increase in fetal heart variability d. Resolution of late decelerations

Answer B - The fetal scalp stimulation test is performed by the health care provider or nurse when FHT are equivocal. For example, if the variability is questionable, the practitioner may perform the stimulation test. If FHT accelerate in response to the test, the nurse interprets the response as a positive sign.

A client had a baby by normal spontaneous vaginal delivery 10 minutes ago. The nurse notes that a gush of blood was just expelled from the vagina & the umbilical cord lengthened. What should the nurse conclude? a. The client has an internal laceration. b. The client is about to deliver the placenta. c. The client has an atonic uterus. d. The client is experiencing a postpartum hemorrhage

Answer B - The following are normal signs of placental separation: the uterus rises in the abdomen & becomes globular; there is a gush of blood expelled from the vagina; & the umbilical cord lengthens. The placenta should be delivered between 5-30 minutes after delivery of the baby.

A woman, G1P0, 40 weeks' gestation entered the labor suite stating that she is in labor. Upon examination it is noted that the woman is 2cm dilated, 30% effaced, contracting every 12 minutes x 30 seconds. FHR is in the 140s with moderate variability and spontaneous accelerations. What should the nurse conclude when reporting the findings to the health care provider? a. The woman is high risk and should be placed on tocolytics. b. The woman is in early labor and could be sent home. c. The woman is high risk and could be induced. d. The woman is in active labor and should be admitted to the unit.

Answer B - The key facts in this scenario about a primigravida are the cervical dilation, the contraction pattern & the FHR. The woman is in the latent phase because she is only 2cm dilated, 30% effaced, & is contracting infrequently at every 12 minutes with short duration. Plus, the FHR is excellent. She could be sent home as she awaits progression of labor.

A client in labor, G2 P1, was admitted 1 hour ago at 2 cm dilated & 50% effaced. She was talkative & excited at that time. During the past 10 minutes she has become serious, closing her eyes & breathing rapidly with each contraction. Which is an accurate nursing assessment of the situation? a. The client had poor childbirth education prior to labor. b. The client is exhibiting an expected behavior for labor. c. The client is becoming hypoxic & hypercapnic. d. The client needs her alpha-fetoprotein levels checked.

Answer B - The multiparous client in the scenario entered the labor suite in the latent phase of labor when being talkative & excited is normal, but after 1 hour she has progressed into the active phase of labor in which being serious & breathing rapidly with contractions is expected behavior.

During a vaginal exam, the nurse palpates fetal buttocks that are facing the left posterior & are 1 cm above the ischial spines. This is consistent with which assessment? a. LOA -1 station b. LSP -1 station c. LMP +1 station d. LSA +1 station

Answer B - The understanding that palpation of the fetal buttocks indicates that the presenting part is the sacrum (S) eliminates two (2) of the possible responses (A & C). The sacrum was palpated on the mother's left side toward her rectum indicating left posterior. When the presenting part is above the ischial spines, the station is negative (-).

Immediately following administration of an epidural anesthesia, the nurse must monitor the client for: a. Paresthesias in her feet & legs b. Drop in blood pressure c. Increase in central venous pressure d. Fetal heart accelerations

Answer B - Virtually all clients will show signs of hypotension after epidural administration. The change is related to two (2) phenomena: dilation of the vessels of the pelvis & increased compression of the vena cava.

An obstetrician is performing an amniotomy on a gravid client in transition. Which assessment must the nurse make immediately following the procedure? a. Maternal blood pressure b. Maternal pulse c. Fetal heart rate d. Fetal fibronectin level

Answer C - Amniotomy is the artificial rupture of the amniotic membranes. During the procedure, there is a risk that the umbilical cord may become compressed. Because there is no direct way to assess cord compression, the nurse must assess the fetal heart rate for any adverse changes.

A gravid client at term calls the labor suite at 7pm questioning whether she was in labor. The nurse determined that the client was likely in labor after the client stated: a. "At 5pm, the contractions were about 5 minutes apart. Now they're about 7 minutes apart." b. "I took a walk at 5pm, & now I talk through my contractions easier that I could then." c. "I took a shower about half an hour ago. The contractions seem to hurt more since I finished." d. "I had some tightening in my belly late this afternoon, & I still feel it after waking up from my 2-hour nap."

Answer C - As labor progresses, the frequency, duration, & intensity of contractions increase. The client utilized comfort measures (showering) which actually intensified her contractions. She should be seen.

A client is in active labor & is being monitored electronically. She has just received Stadol 2 mg IV for pain. Which fetal heart response would the nurse expect to see on the internal monitor tracing? a. Variable decelerations b. Late decelerations c. Decreased variability d. Transient accelerations

Answer C - The analgesics used in labor are opiates. The CNS-depressant effect of opiates is therapeutic for the client who is in pain, but the fetus is also affected by the medication, often exhibiting decreased variability.

During delivery, the nurse notes that the baby's head has just been delivered. The nurse concludes that the baby has just gone through which cardinal move of labor? a. Flexion b. Internal rotation c. Extension d. External rotation

Answer C - The baby must move through the cardinal movements because the fetal head is widest anterior-posterior but the fetal shoulders are widest laterally. On the other hand, the maternal pelvis is widest laterally in the inlet but anterior-posterior at the outlet.

The childbirth education nurse is evaluating the learning of four (4) women, 38-40 weeks' gestation, regarding when they should go to the hospital. The nurse determines that the client who makes which statement needs additional teaching? a. The client who says, "If I feel a pain in my back & lower abdomen every 5 minutes." b. The client who says, "When I feel a gush of clear fluid from my vagina." c. The client who says, "When I go to the bathroom & see the mucus plug on the toilet tissue." d. The client who says, "If I ever notice greenish discharge from my vagina."

Answer C - The mucus plug protects the uterine cavity from bacterial invasion. It is expelled shortly before or during the early phase of labor. But, since the client is experiencing no other signs of labor, there is no need for the client to go to the hospital for assessment at this time.

Which response is the primary rationale for providing general information as well as breathing & relaxation exercises in childbirth education classes? a. Mothers who are doing breathing exercises during labor will refrain from yelling. b. Breathing & relaxation exercises are less exhausting than crying & moaning. c. Knowledge learned at childbirth education classes helps to break the fear-tension-pain cycle. d. Childbirth education classes help to promote positive maternal-newborn bonding.

Answer C - When a frightened woman enters the labor suite, she is likely to be very tense. It is known that pain is often worse when tensed muscles are stressed. Once the woman feels pain, she may become even more frightened & tense. This process becomes a vicious cycle. The information & skills learned at childbirth education classes are designed to break the cycle.

A woman who states that she "thinks "she is in labor enters the labor suite. Which assessment will provide the nurse with the most valuable information regarding the client's labor status? a. Leopold's maneuvers b. Fundal contractility c. Fetal heart assessment d. Vaginal examination

Answer D - All of the assessments listed are performed. However, the only assessment that will determine whether or not the client is in true labor is a vaginal exam. Only when there is cervical change - dilation &/or effacement - is it determined that the client is in true labor.

A nurse is teaching a class of pregnant couples the most therapeutic breathing techniques for the latent phase of labor. Which technique did the nurse teach? a. Alternately panting & blowing b. Rapid, deep breathing c. Grunting & pushing with contractions d. Slow paced breathing

Answer D - Because the latent phase is the first phase of the first stage of labor, contractions are usually mild & they rarely last longer than 30 seconds. A slow paced breathing technique, therefore, is effective & does not tire the woman out for the remainder of her labor.

After analyzing an internal fetal monitor tracing, the nurse concludes that there is moderate short-term variability. Which interpretation should the nurse make in relation to this finding? a. The fetus is becoming hypoxic b. The fetus is becoming alkalotic c. The fetus is in the middle of a sleep cycle d. The fetus has a healthy nervous system

Answer D - Normal situations that can decrease the variability include fetal sleep, administration of CNS depressant medications, & prematurity. A normal situation that can increase the variability is fetal activity.

A woman, 40 weeks' gestation, calls the labor unit to see whether or not she should come to the hospital to be evaluated. Which statement by the woman indicates that she is probably in labor & should proceed to the hospital? a. "The contractions are 5 to 20 minutes apart." b. "I saw a pink discharge on the toilet tissue when I went to the bathroom." c. "I have had cramping for the past 3 or 4 hours." d. "The contractions are about a minute long & I am unable to talk through them."

Answer D - Not only are the contractions lasting a full minute but she is stating that they are so uncomfortable that she is unable to speak through them. She should be seen.

It is 4pm. A client, G1P0, 3cm, asks the nurse when the dinner tray will be served. The nurse replies a. "Laboring clients are never allowed to eat." b. "Believe me, you will not want to eat by the time it is the dinner hour. Most women throw up, you know." c. "The dinner tray should arrive in an hour or two." d. "A heavy meal is discouraged. I can get clear fluids for you whenever you would like them, though."

Answer D - Peristalsis slows dramatically during labor. Because of this, women rarely become hungry during labor, but they do need fluids & some nourishment. Clear liquids are often allowed. Ultimately, though, it is the health care provider's decision what & how much the client may consume.

The nurse sees the fetal head through the vaginal introitus when a client pushes. The nurse, interpreting this finding, tells the client, "You are pushing very well." In addition, the nurse could also state: a. "The baby's head is engaged." b. "The baby is floating." c. "The baby is at the ischial spines." d. "The baby is almost crowning."

Answer D - The baby is crowning when the client's perineal tissues are stretched around the fetal head at the same location where a crown would sit. The station at this time is +4/+5

A woman, who is in active labor, is told by her obstetrician, "Your baby is in the flexed attitude." When she asks the nurse what that means, what should the nurse say? a. The baby is in the breech position. b. The baby is in the horizontal lie. c. The baby's presenting part is engaged. d. The baby's chin is resting on its chest.

Answer D - The diameter of the fetal head is dependent upon whether or not the head is flexed with the chin on the chest or extended with the chin elevated. When the fetus is in the flexed attitude, with the chin on the chest, the diameter of the fetal head entering the pelvis averages 9.5 cm (the suboccipitobregmatic diameter), whereas is the fetus is in the extended attitude, with the chin elevated, the diameter of the fetal head can be as large as 13.5 cm (the occipitomental diameter). In order for the fetal head to pass through the mother's pelvis, therefore, it is best for the head to be in the flexed attitude.

The nurse may help a client with a fetus in a ROP position by avoiding which action: A. Positioning her on her left side B. Positioning her on her right side C. Helping her walk around the room D. Assisting her to a knee-chest position

Answer: B.

The pregnant client is receiving oxytocin (Pitocin) to induce labor. The nurse should monitor the client for which adverse maternal effects? A. Bradycardia B. Decreased urine output C. Dehydration D. Jaundice E. Uterine hyperstimulation.

Answer: B. & E.

The client who has had a previous cesarean birth asks about vaginal birth after cesarean (VBAC). The nurse concludes that which factors from her history in a contraindication for VBAC? A. Previous cesarean was for breech presentation B. Client had a classic uterine incision C. The abdominal incision was vertical rather than transverse D. An induction of labor is planned for this delivery

Answer: B. - a classical incision involves the upper uterine segment & is more likely to separate or rupture with subsequent uterine contractions

Following amniotomy, the nurse would implement which important nursing actions? (Select all that apply.) A. Position the mother in lithotomy position for delivery B. Place a clean underpad (chux) on the bed C. Note FHR D. Observe the color & consistency of the amniotic fluid E. Take vital signs every 4 hours to monitor for infection.

Answer: B., C., D., & E

During augmentation of labor with IV oxytocin (Pitocin), a multiparous client becomes pale and diaphoretic and complains of severe lover abdominal pain with a tearing sensation. Fetal distress is noted on the monitor. The nurse should suspect: A. Precipitous labor B. Amniotic fluid embolus C. Rupture of the uterus D. Uterine prolapse.

Answer: C.

In addition to routine assessment & care, nursing care of a client who is receiving terbutaline (Brethine) to prevent premature labor should include assessing: A. Temperature every 2 hours B. Fetal heart tones every 30 minutes C. Breath sounds every 4 hours D. Deep tendon reflexes every 4 hours

Answer: C.

The client is receiving IV magnesium sulfate at 2 gm/hr to stop premature labor. The nurse determines that the most important nursing assessment of this client includes: A. I & O, LOC & BP B. BP, P & uterine activity C. DTRs, hourly urine output & respiratory rate D. I & O, BP & DTRs

Answer: C.

The nurse determines that fetal distress is occurring after noting which sign? A. Moderate amount of bloody show B. Pink-tinged amniotic fluid C. Meconium-stained amniotic fluid D. Acceleration of fetal heart rate w/each contraction

Answer: C.

The nurse discovers a loop of the umbilical cord protruding through the vagina when preparing to perform a vag exam. The most appropriate intervention is to: A. Call the health care provider immediately B. Place a moist, clean towel over the cord to prevent drying C. Immediately turn the client on her side & listen to the fetal heart rate D. Perform a vag exam & apply upward digital pressure to the presenting part while having the mother assume a knee-chest position.

Answer: D

A client is hospitalized on the antepartum unit with premature rupture of membranes at 37 weeks' gestation. Which routine physician prescription would the nurse question for this client? A. Limited sterile vaginal exams B. Diet as tolerated C. External fetal monitor prn D. Vital signs every shift

Answer: D.

A nulliparous client was admitted to the birthing unit 9 hours ago. She progressed from 3 cm and 0 station to 6 cm and +1 station, but has not made any additional progress for almost 2 hours. FHR is in the normal baseline range w/moderate variability. There are no decelerations. Contractions are presently every 3 minutes, 40 seconds duration & of strong intensity. Following the vaginal exam, what other assessments will you make at this time?

Assess the contraction frequency, duration and intensity, and compare this to previous contractions. A common cause of nonprogressive labor is hypotonic uterine dysfunction or poor contraction quality. In addition, assess fetal and maternal response to contractions to detect distress in the fetus and tension and anxiety in the mother. Maternal psyche can also impact labor progress.

What nursing interventions will be most helpful to this client at this time?

Reassuring the client & repositioning her on her left side may help with rotation of the fetal head from ROP to an ROA/LOA position. Continue to assess contractions and maternal response to them. Encourage relaxation. Laboring in hands and knees position for several contractions, pelvic rocking and tailor sitting position have been reported to be helpful for rotation and descent of the fetus.

During the vaginal exam, you determine that the posterior fontanel is toward the mother's back on the right side. What is the fetal position?

Right occiput posterior (ROP)

The client's husband asks you why labor has not progressed very much. How will you answer him?

The most common reasons are decreased contraction quality, shape of the mother's pelvic bones & the way the baby is positioned. "Your baby seems to be facing upward position; that is more difficult to deliver than the usual facing downward position. It may take your wife a little longer to deliver, but there doesn't seem to be any sign of a problem for the baby right now."

Should you notify her health care provider (HCP) at this time? If so, what info will you give and what medical interventions do you anticipate?

Yes. Her HCP needs to be aware of lack of progress, contraction status & fetal position. Augmentation of labor with oxytocin (Pitocin) may be prescribed to correct hypotonic uterine dysfunction. Continuous assessment of contractions, fetal heart rate, maternal response and labor progress is warranted.


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