The nurse is providing discharge instructions to a person who was evaluated for possible labor. How does the nurse explain how losing the mucus plug could be a sign of impending labor?
- A. The mucus plug starts to be expelled due to increased estrogen before contractions begin.
- B. The mucus plug is expelled after the membranes rupture during labor.
- C. Effacement and dilation of the cervix decrease the area where the mucus plug sits.
- D. Labor is unable to begin until the mucus plug is expelled and creates a space for the fetus.
Correct Answer: A
Rationale: Step-by-step rationale:
1. Increased estrogen levels lead to softening of the cervix, causing the mucus plug to be expelled.
2. Contractions usually start after the mucus plug is expelled, not before.
3. The mucus plug is typically expelled before the membranes rupture.
4. Effacement and dilation of the cervix prepare the body for labor but are not directly related to the expulsion of the mucus plug.
In summary, Choice A is correct as increased estrogen leads to the expulsion of the mucus plug, indicating impending labor. Choices B, C, and D are incorrect as they do not accurately explain the relationship between the mucus plug and impending labor.
You may also like to solve these questions
Which factor ensures that the smallest anterior-posterior diameter of the fetal head enters the pelvis?
- A. Station
- B. Flexion
- C. Descent
- D. Engagement
Correct Answer: B
Rationale: Flexion is the correct answer. During labor, fetal head flexion allows the smallest anterior-posterior diameter of the head to enter the pelvis first, reducing the risk of cephalopelvic disproportion. Station refers to the level of the presenting part in the maternal pelvis, not the head orientation. Descent is the downward movement of the fetus in the birth canal, not related to head position. Engagement occurs when the widest part of the presenting part reaches the level of the maternal ischial spines, not specifically related to the orientation of the fetal head.
What changes in hormones initiate labor?
- A. decreased progesterone, decreased estrogen, absence of oxytocin
- B. increased progesterone, decreased estrogen, absence of oxytocin
- C. increased progesterone, decreased estrogen, presence of oxytocin
- D. decreased progesterone, increased estrogen, effects of oxytocin
Correct Answer: D
Rationale: The correct answer is D because decreased progesterone, increased estrogen, and the effects of oxytocin are the hormonal changes that initiate labor. Progesterone inhibits contractions, so its decrease allows labor to begin. Estrogen promotes uterine sensitivity to oxytocin, which stimulates contractions. Oxytocin is released in response to labor contractions and helps to strengthen contractions.
A: Incorrect because decreased progesterone is needed for labor to start, estrogen needs to increase, and oxytocin is present during labor.
B: Incorrect because increased progesterone inhibits labor, estrogen should increase, and oxytocin is present during labor.
C: Incorrect because progesterone should decrease, estrogen should increase, and oxytocin is present during labor.
Why is precipitous labor most often seen in multiparous women?
- A. The cervix weakens after each delivery.
- B. The cervix can dilate and efface simultaneously.
- C. The multigravida uterus is better able to coordinate muscle movements.
- D. It is more difficult for multiparous women to know when labor begins.
Correct Answer: C
Rationale: The correct answer is C because the multigravida uterus has undergone labor before, making muscle coordination more efficient. This allows for faster and more coordinated contractions, leading to precipitous labor. Choice A is incorrect because the cervix does not weaken after each delivery. Choice B is incorrect as simultaneous dilation and effacement are not specific to multiparous women. Choice D is incorrect because the ability to recognize labor onset is not a determining factor in the occurrence of precipitous labor.
Arrange the seven cardinal movements of labor, in order.
- A. Descent
- B. Expulsion
- C. Extension
- D. External rotation
Correct Answer: A
Rationale: The correct order of the seven cardinal movements of labor is: Descent, Flexion, Internal Rotation, Extension, Restitution, External Rotation, and Expulsion. Descent is the first cardinal movement, as the baby moves down the birth canal. Flexion follows to allow the baby's head to pass through the pelvis. Internal Rotation, Extension, and Restitution then occur to facilitate the baby's shoulders and body turning in alignment with the mother's pelvis. External Rotation follows to help the shoulders rotate to the correct position for delivery. Finally, Expulsion is when the baby is born. This sequence ensures a smooth and safe delivery. The other choices are incorrect as they are not part of the specific sequence of cardinal movements during labor.
A 28-year-old gravida 1, para 0 patient who is at term calls the labor and birth unit stating that she thinks she is in labor. She states that she does have some vaginal discharge and feels wet;
- A. She relates a contraction pattern that is irregular, ranging from 5 to 7 minutes and lasting 30 seconds. Which questions should the nurse pose to the patient during this telephone triage? (Select all that apply.)
- B. Does she think that her membranes have ruptured?
- C. Is there any evidence of bloody show?
- D. Instruct the patient to keep monitoring her contraction pattern and call you back if they become more regular.
Correct Answer: A
Rationale: The correct answer is A because the patient's irregular contraction pattern and timing indicate early labor. The nurse should ask about the frequency, duration, and intensity of contractions to assess progression. Choices B and C focus on specific signs of labor but do not address the need for continuous monitoring and assessment like choice A does. Choice D does not address the need to gather specific information about the contraction pattern to determine the appropriate next steps. Therefore, A is the correct choice as it directly addresses the patient's current situation and provides guidance on what information is necessary for appropriate triage.