Which characteristic is associated with false labor contractions? Show
A. Lead to cervical change B. Decrease in intensity with ambulation False labor does not lead to changes in the cervix. Although false labor contractions decrease with activity, true labor contractions are enhanced or stimulated with activity such as ambulation. A regular pattern of frequency is a sign of true labor. A progression of intensity and duration indicates true labor. When managing the care of a woman in the second stage of labor, the nurse uses various measures to enhance the progress of fetal descent. These measures include: A. encouraging the woman to try various upright positions, including squatting and standing. A. encouraging the woman to try various upright positions, including squatting and standing. Upright positions and squatting may enhance the progress of fetal descent. Many factors dictate when a woman will begin pushing. Complete cervical dilation is necessary, but it is only one factor. If the fetal head is still in a higher pelvic station, the physician or midwife may allow the woman to "labor down" (allowing more time for fetal descent, thereby reducing the amount of pushing needed) if she is able. The epidural may mask the sensations and muscle control needed for the woman to push effectively. Closed-glottic breathing may trigger the Valsalva maneuver, which increases intrathoracic and cardiovascular pressure, reducing cardiac output and inhibiting perfusion of the uterus and placenta. In addition, holding the breath for longer than 5 to 7 seconds diminishes the perfusion of oxygen across the placenta, resulting in fetal hypoxia. For the labor nurse, care of the expectant mother begins with which situations? (Select all that apply.) A. The onset of progressive, regular contractions A. The onset of progressive, regular contractions Labor care begins with the onset of progressive, regular contractions. The woman and the nurse can formulate their plan of care before labor or during treatment. Labor care begins when the blood-tinged mucoid vaginal discharge appears. The woman and the nurse can formulate their plan of care before labor or during treatment. Labor care begins when amniotic fluid is discharged from the vagina. The woman and the nurse can formulate their plan of care before labor or during treatment. Labor care begins when progressive, regular contractions begin, the blood-tinged mucoid vaginal discharge appears, or fluid is discharged from the vagina. The woman and the nurse can formulate their plan of care before labor or during treatment. Nursing care begins when patient identifies painful contractions. The onset of progressive, regular contractions signals the beginning of labor; not the intensity of the pain. Which position would the nurse suggest for second-stage labor if the pelvic outlet needs to be increased? A. Semirecumbent C. Squatting A semirecumbent position does not assist in increasing the size of the pelvic outlet. Although sitting may assist with fetal descent, this position does not increase the size of the pelvic outlet. Kneeling or squatting moves the uterus forward and aligns the fetus with the pelvic inlet; this can facilitate the second stage of labor by increasing the pelvic outlet. A side-lying position is unlikely to assist in increasing the size of the pelvic outlet. Which test is performed to determine if membranes are ruptured? A. Urine analysis B. Fern test A urine analysis should be performed on admission to labor and delivery. This test is used to identify the presence of glucose and protein. In many instances a sterile speculum examination and a Nitrazine (pH) and fern test are performed to confirm that fluid seepage is indeed amniotic fluid. The nurse performs Leopold maneuvers to identify fetal lie, presenting part, and attitude. Artificial rupture of membranes (AROM) is the procedure of artificially rupturing membranes, usually with a device known as an AmniHook. A pregnant couple has formulated a birth plan and is reviewing it with the nurse at an expectant parent's class. Which aspect of their birth plan would be considered unrealistic and require further discussion with the nurse? A. "My husband and I have agreed that my sister will be my coach since he becomes anxious with regard to medical procedures and blood. He will be nearby and check on me every so often to make sure everything is OK." D. "We do not want the fetal monitor used during labor since it will interfere with movement and doing effleurage." These are acceptable requests during labor and delivery. These are acceptable requests during labor and delivery. These are acceptable requests during labor and delivery. Since monitoring is essential to assess fetal well-being, it is not a factor that can be determined by the couple. The nurse should fully explain its importance. The option for intermittent electronic monitoring could be explored if this is a low risk pregnancy and as long as labor is progressing normally. Which description of the phases of the second stage of labor is accurate? A. Latent phase: Feels sleepy, fetal station is 2+ to 4+, duration is 30 to 45
minutes. C. Active Pushing (Descent) phase: Significant increase in contractions, Ferguson reflux activated, average duration varies. The latent phase is the lull, or "laboring down," period at the beginning of the second stage. It lasts 10 to 30 minutes on average. The active phase occurs in the first stage of labor indicating cervical progression from 5 to 7 cm. The active pushing (descent) phase begins with a significant increase in contractions, the Ferguson reflex is activated, and the duration varies, depending on a number of factors. The transition phase is the final phase in the first stage of labor; contractions are strong and painful. Vaginal examinations should be performed by the nurse under which of these circumstances? (Select all that apply.) A. An admission to the hospital at the start of labor. A. An admission to the hospital at the
start of labor. Vaginal examinations should be performed when the woman is admitted to the hospital or birthing center at the start of labor. An accelerated fetal heart rate (FHR) is a positive sign; variable decelerations, however, merit a vaginal examination. When the woman perceives perineal pressure or the urge to bear down is an appropriate time to perform a vaginal examination. After rupture of membranes (ROM) a vaginal examination should be performed. The nurse must be aware that there is an increased risk of prolapsed cord immediately after ROM. Examinations are never done by the nurse if vaginal bleeding is present since the bleeding could be a sign of placenta previa and a vaginal examination could result in further separation of the low-lying placenta. Evidence-based care practices designed to support normal labor and birth recommend which practice during the immediate newborn period? A. The healthy newborn should be taken to the nursery for a complete assessment. C. Encourage skin-to-skin contact of mother and baby. Although this is the practice in many facilities, it is neither evidence based nor supportive of family-centered care. This is a common practice and more family friendly than separating mother and baby; however, ideally the baby should be placed skin to skin. The unwrapped infant should be placed on the woman's bare chest or abdomen, then covered with a warm blanket. Skin-to-skin contact keeps the newborn warm, prevents neonatal infection, enhances physiologic adjustment to extrauterine life, and fosters early breastfeeding. The father or support person is likely anxious to hold and admire the newborn. This can happen after the infant has been placed skin to skin and breastfeeding has been initiated. A woman who is 39 weeks pregnant expresses fear about her impending labor and how she will manage. The nurse's best response is: A. "Do not worry about it. You will do fine." B. "It is normal to be anxious about labor. Let us discuss what makes you afraid." This statement negates the woman's fears and is not therapeutic. This statement allows the woman to share her concerns with the nurse and is a therapeutic communication tool. This statement negates the woman's fears and offers a false sense of security. This statement is not true. A number of criteria must be met for use of an epidural. Furthermore, many women still experience the feeling of pressure with an epidural. What does the nurse know that occurs in the second stage of labor the descent phase quizlet?The nurse knows that the second stage of labor, the descent phase, has begun when: the woman experiences a strong urge to bear down. Nurses can help their clients by keeping them informed about the distinctive stages of labor.
What is an indication of the second stage of labor quizlet?The second stage of labor begins when the cervix is completely dilated (open), and ends with the birth of your baby. Contractions push the baby down the birth canal, and you may feel intense pressure, similar to an urge to have a bowel movement. Your health care provider may ask you to push with each contraction.
Which of the following refers to 2nd stage of labor?The second stage of labor begins when the cervix is completely opened and ends with the delivery of the baby. The second stage is often referred to as the "pushing" stage. During the second stage, the woman becomes actively involved by pushing the baby through the birth canal to the outside world.
What instructions does the nurse give a patient to ensure fetal safety during the second stage of labor?The active pushing phase occurs in the second stage of labor. The client would be instructed to use spontaneous open-glottis pushing to promote fetal oxygenation during this phase. Therefore, the client would be instructed to exhale while bearing down for 6 to 8 seconds at a time, followed by a cleansing breath.
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Which position would the nurse suggest for second stage labor if the pelvic outlet needs to be increased quizlet?
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