Nokea
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.
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A 40-year-old G2, P1 woman is admitted to the labor and delivery unit with contractions 6 minutes apart. She is 36 weeks pregnant, has a history of placenta previa, and is currently experiencing moderate vaginal bleeding. What should the nurse be prepared to do?
- A. Perform a vaginal examination to determine cervical dilation
- B. Assist the health care provider to perform artificial rupture of the membranes
- C. Initiate external fetal monitoring
- D. Encourage patient to ambulate to intensify labor
Correct Answer: C
Rationale: The correct answer is C: Initiate external fetal monitoring. In this scenario, the patient is at 36 weeks of gestation with a history of placenta previa and moderate vaginal bleeding, indicating a high-risk situation. External fetal monitoring allows for continuous assessment of the fetal heart rate and uterine contractions, which is crucial for identifying signs of fetal distress or complications related to placenta previa. This monitoring can help guide timely interventions and decision-making to ensure the safety of the mother and baby. Performing a vaginal examination (A) may increase the risk of bleeding in cases of placenta previa. Artificial rupture of membranes (B) can also lead to increased bleeding and should be avoided in this situation. Encouraging ambulation (D) is not recommended due to the risk of exacerbating bleeding and potential complications.
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.
A 40-year-old G2, P1 woman is admitted to the labor and delivery unit with contractions 6 minutes apart. She is 36 weeks pregnant, has a history of placenta previa, and is currently experiencing moderate vaginal bleeding. What should the nurse be prepared to do?
- A. Perform a vaginal examination to determine cervical dilation
- B. Assist the health care provider to perform artificial rupture of the membranes
- C. Initiate external fetal monitoring
- D. Encourage patient to ambulate to intensify labor
Correct Answer: C
Rationale: The correct answer is C: Initiate external fetal monitoring. The nurse should initiate external fetal monitoring to assess the fetus's heart rate and uterine contractions, given the patient's history of placenta previa and vaginal bleeding. This helps to monitor the well-being of the fetus and detect any signs of distress. Performing a vaginal examination (Choice A) may aggravate the placenta previa and increase the risk of bleeding. Artificial rupture of membranes (Choice B) is contraindicated in cases of placenta previa due to the risk of increased bleeding. Encouraging ambulation (Choice D) is not advisable in this situation as it may also worsen bleeding.
The nurse is caring for a laboring patient with multiple family members in the room. How can the nurse address this situation?
- A. Educate the family that the pain the laboring person is experiencing is normal.
- B. Ask them all to leave the room.
- C. Explain that if the laboring person got an epidural, she would be more comfortable
- D. Assume the laboring person wants the family in the room
Correct Answer: B
Rationale: The correct answer is B because having multiple family members in the room during labor can be overwhelming and hinder the progress of labor. It is important for the laboring person to have privacy, focus, and reduce stress for a smoother labor experience. Asking the family members to leave the room ensures a calm and supportive environment for the laboring person.
Incorrect Choices:
A: Educating the family about pain normalcy is helpful, but privacy and focus are more crucial during labor.
C: Mentioning epidural may not be appropriate as it is the laboring person's decision and may not be the best option for everyone.
D: Assuming the laboring person wants family in the room without considering their preference may not be the best approach for their comfort and progress in 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. This is a definitive sign of true labor as it indicates that the cervix is opening up in preparation for childbirth. Contractions alone may not always indicate true labor, especially if they are irregular. Pain decreasing when walking (choice A) is not a definitive sign of true labor. The fetal membranes rupturing (choice C) is a sign of labor but not definitive on its own. The fetal head at –1 station (choice D) can indicate descent but is not as definitive as cervical dilation.