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During the third stage of labor, what may the birthing person experience?
- A. expulsion of their fetus with vaginal bleeding
- B. cramping, gush of fresh vaginal bleeding, lengthening of the umbilical cord
- C. frequent episodes of dyspnea
- D. increased blood pressure and pain due to expulsive efforts
Correct Answer: B
Rationale: During the third stage of labor, the birthing person may experience cramping, a gush of fresh vaginal bleeding, and lengthening of the umbilical cord. This is due to the delivery of the placenta. Cramping helps expel the placenta, fresh vaginal bleeding is normal after delivery, and the lengthening of the umbilical cord indicates that the placenta is detaching. Choices A, C, and D are incorrect as they do not accurately describe the typical experiences during the third stage of labor.
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The clinical nurse educator is providing instruction to a group of new nurses during labor orientation. Which information regarding the factors that have a role in the initiation of labor should the educator include in this teaching session? (Select all that apply.)
- A. Progesterone levels become higher than estrogen levels.
- B. Natural oxytocin in conjunction with other substances plays a role
- C. Stretching, pressure, and irritation of the uterus and cervix increase
- D. The secretion of prostaglandins from the fetal membranes decreases.
Correct Answer: B
Rationale: Step 1: Natural oxytocin is a hormone that plays a crucial role in initiating labor by stimulating uterine contractions.
Step 2: Other substances like prostaglandins also contribute to the initiation of labor by promoting cervical ripening and uterine contractions.
Step 3: Therefore, the correct answer is B as it accurately reflects the role of natural oxytocin and other substances in the initiation of labor.
Summary:
A: Progesterone levels becoming higher than estrogen levels is not directly related to the initiation of labor.
C: While stretching, pressure, and irritation of the uterus and cervix can contribute to labor, they are not the primary factors in labor initiation.
D: The secretion of prostaglandins from the fetal membranes actually increases during labor to facilitate the process, so this statement is incorrect.
Which assessment finding would cause a concern for a patient who had delivered vaginally?
- A. Estimated blood loss (EBL) of 500 mL during the birth process
- B. White blood cell count of 28,000 mm3 postbirth
- C. Patient complains of fingers tingling
- D. Patient complains of thirst
Correct Answer: B
Rationale: The correct answer is B - White blood cell count of 28,000 mm3 postbirth. This finding indicates a possible infection or inflammation, which can be concerning after vaginal delivery. A high white blood cell count may suggest an ongoing infection that needs immediate attention.
A: Estimated blood loss of 500 mL is within normal range for vaginal delivery and is not a cause for concern.
C: Fingers tingling may be due to various reasons unrelated to the delivery process and is not a typical concern post vaginal delivery.
D: Thirst is a common symptom post-delivery and is not indicative of a serious complication.
Which physiologic event is the key indicator of the commencement of true labor?
- A. Bloody show
- B. Cervical dilation and effacement
- C. Fetal descent into the pelvic inlet
- D. Uterine contractions every 7 minutes
Correct Answer: B
Rationale: The correct answer is B: Cervical dilation and effacement. This is because true labor is defined by progressive cervical changes, including dilation (opening of the cervix) and effacement (thinning of the cervix). These changes indicate that the body is preparing for childbirth. A: Bloody show may occur during early labor but is not a definitive indicator. C: Fetal descent into the pelvic inlet is a later event in labor. D: Uterine contractions every 7 minutes are not necessarily indicative of true labor as they need to be regular, increasing in frequency, intensity, and duration.
What makes up the powers of labor and birth?
- A. contractions and pushing efforts
- B. pelvis and pelvic floor tissues
- C. fetal position, attitude, lie, and presentation
- D. oxytocin
Correct Answer: A
Rationale: The correct answer is A (contractions and pushing efforts) because they are the main physiological components of labor and birth. Contractions help to thin and dilate the cervix, while pushing efforts help the baby descend through the birth canal. Pelvis and pelvic floor tissues (B) play a role in the mechanics of birth but do not make up the powers of labor. Fetal position, attitude, lie, and presentation (C) are important factors influencing labor progress but do not constitute the powers of labor. Oxytocin (D) is a hormone that stimulates contractions but is not a direct component of the powers of labor.
A woman who is 39 weeks pregnant presents to the labor and delivery unit stating that she thinks she is in labor. Her contractions are irregular at 7 to 10 minutes apart. Which sign is definitive for true labor?
- A. Pain decreases when walking.
- B. Cervical dilation is occurring.
- C. The fetal membranes rupture.
- D. The fetal head is at –1 station.
Correct Answer: B
Rationale: The correct answer is B: Cervical dilation is occurring. During true labor, the cervix begins to dilate and efface in preparation for childbirth. This process is a definitive sign of active labor. In contrast, the other choices are not definitive signs of true labor. Choice A is incorrect because pain decreasing when walking is not a specific indicator of true labor. Choice C, the fetal membranes rupturing, indicates the beginning of labor but is not the definitive sign. Choice D, the fetal head at –1 station, signifies the descent of the baby into the pelvis but does not confirm active labor.