Questions and Answers
What indicates the beginning of true labor?
What will the nurse remind the patient about contractions during the first stage of labor?
What is the function of contractions during the second stage of labor?
What marks the end of the third stage of labor?
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What is the best nursing intervention when a patient is bearing down and crying out, 'The baby is coming!'?
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What is the most important nursing intervention during the fourth stage of labor?
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One hour post-delivery, the nurse notes that the new mother has saturated three perineal pads. What is the most appropriate nursing action?
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While caring for a laboring woman, the nurse notices a pattern of variable decelerations in fetal heart rate with uterine contractions. What is the nurse's initial action?
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At 1 and 5 minutes of life, a newborn's Apgar score is 9. What does this score indicate?
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What is the most appropriate nursing diagnosis for a woman in the fourth stage of labor?
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How might the nurse attempt to stimulate cervical effacement and intensify contractions in a patient uncertain if she is in true labor?
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What is the best nursing action to implement when late decelerations occur?
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What is the nurse primarily concerned about maintaining in the initial care of the newborn?
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What is the primary concern regarding complications for a woman desiring a VBAC (vaginal birth after cesarean section)?
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What will be the nurse's priority assessment immediately following an amniotomy performed on a laboring woman?
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Which interventions should a nurse provide cultural sensitivity for an Arab woman in labor? (Select all that apply)
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What are the advantages of a freestanding birth center? (Select all that apply)
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What do late decelerations indicate? (Select all that apply)
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What signs and symptoms would lead the nurse to suspect false (prodromal) labor? (Select all that apply)
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After the pregnant woman is admitted to the labor suite, the nurse assesses the position of the infant as ROA; this means that the infant's head is _________ __________ _________.
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The nurse explains that the four Ps of the birth process are __________, __________, __________, and __________.
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After the membranes have ruptured, the nurse should assess the fetal heart rate (FHR) for ________ minute(s).
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The nurse may assist the health care provider in determining the fetal position and presentation by abdominal palpations called _____________________________ _____________________________.
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A nursing student interprets the fetal position LSA as a ____________________ presentation.
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Place the seven mechanisms of labor in sequential order: a.Extension, b.Engagement, c.Descent, d.Flexion, e.Expulsion, f.Internal rotation, g.External rotation.
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Study Notes
Labor Phases and Contractions
- True labor is identified by regular contractions that become more frequent and intense, distinct from contractions that are relieved by activity.
- The first stage of labor involves the cervix dilating and effacing, leading to full cervical dilation.
- The second stage of labor is defined by contractions that assist in pushing the infant out of the mother's body.
- The third stage of labor concludes with the expulsion of the placenta and membranes.
Nursing Interventions
- If imminent birth is observed, the nurse should remain with the patient and call for assistance.
- Monitoring for signs of hemorrhage is critical during the fourth stage of labor, with special attention to fundus firmness and position post-delivery.
- In response to variable decelerations in fetal heart rate, repositioning the woman is the initial nursing action.
Newborn Assessment
- An Apgar score of 9 indicates a stable newborn, evaluated based on five criteria shortly after birth.
- Thermoregulation is the primary concern in the initial care of the newborn to prevent cold stress and hypoxia.
Complications and Risks
- Uterine rupture is a significant concern for women attempting a vaginal birth after cesarean (VBAC).
- Late decelerations in fetal heart rate indicate potential uteroplacental insufficiency and should be addressed with increased maternal oxygen supply.
Cultural Considerations
- Providing culturally sensitive care for Arab women includes ensuring extreme modesty, adequate pain control, and respect for protective amulets.
Birth Center and Labor Signs
- Freestanding birth centers offer a homelike environment at lower costs but are not designed for high-risk pregnancies.
- Signs that suggest false labor include painless abdominal tightening and a thick, non-effaced cervix.
Fetal Positioning and Mechanisms of Labor
- The term ROA (right occiput anterior) means the infant's right occiput is oriented toward the mother's anterior.
- The four Ps of the birth process are powers, passenger, passage, and psyche, crucial for understanding labor dynamics.
- The sequence of labor mechanisms includes descent, engagement, flexion, internal rotation, extension, external rotation, and expulsion.
Clinical Protocols
- Post-rupture of membranes, the fetal heart rate should be assessed for one full minute to monitor for distress due to potential cord compression.
- Leopolds maneuver is utilized for examining fetal position and presentation during labor.
Fetal Presentation Terms
- LSA (Left Sacrum Anterior) indicates a breech presentation of the fetus, requiring close monitoring and considerations for delivery methods.
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Description
This quiz focuses on Chapter 6 of nursing care, highlighting the mother's and infant's needs during labor and birth. It features flashcards that help reinforce understanding of key concepts, including the signs of true labor. Ideal for nursing students preparing for exams or clinical practice.