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Which is the best explanation for the use of hydration and relaxation in the treatment of hypertonic labor?
- A. Hydration promotes uterine relaxation by diluting endogenous oxytocin.
- B. Hydration improves uterine coordination by increasing perfusion.
- C. Hydration encourages contraction regulation by stimulating catecholamine release.
- D. Hydration stimulates the production of prostaglandins to relax the uterus.
Correct Answer: A
Rationale: Hydration helps to dilute endogenous oxytocin, which can reduce uterine contractions and relax the uterus. Hypertonic labor involves excessive uterine contractions, and hydration can counteract this by regulating contractions and improving perfusion, which ultimately aids in a more coordinated and effective labor progression.
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Which maternal factor may inhibit fetal descent during labor?
- A. A full bladder
- B. Decreased peristalsis
- C. Rupture of membranes
- D. Reduction in internal uterine size
Correct Answer: A
Rationale: A full bladder can inhibit fetal descent during labor by obstructing the pathway for the baby to descend through the birth canal. A distended bladder can physically block the baby's head from moving down and putting pressure on the cervix, which is necessary for the progress of labor. It is important for pregnant individuals to empty their bladder regularly during labor to optimize the conditions for fetal descent and facilitate a smoother delivery process.
On admission to the labor unit, a primigravid woman at 38 weeks gestation states, “I need to urinate more now but at least I can breathe easier.” The nurse is aware that this is likely due to which physiological process?
- A. Onset of labor
- B. Effacement
- C. Lightening
- D. Rupture of membranes
Correct Answer: C
Rationale: Increased urination and easier breathing are signs of lightening, where the fetal head drops lower into the pelvis.
Uncontrolled maternal hyperventilation during labor results in
- A. metabolic acidosis.
- B. metabolic alkalosis.
- C. respiratory acidosis.
- D. respiratory alkalosis.
Correct Answer: D
Rationale: Uncontrolled maternal hyperventilation during labor leads to excessive elimination of carbon dioxide, causing a decrease in the partial pressure of arterial carbon dioxide (PaCO2). This results in respiratory alkalosis, as the pH of the blood increases due to a decrease in PaCO2. Metabolic acidosis (Option A) would be associated with conditions such as lactic acidosis, while metabolic alkalosis (Option B) would involve excessive loss of acid or gain of base, but in this case, the primary effect is on the respiratory system. Respiratory acidosis (Option C) would be characterized by an increase in PaCO2 leading to a decrease in pH, which is the opposite of what occurs in maternal hyperventilation.
If the fetal attitude is assessed to be completely deflexed on sonogram or via Leopold's maneuvers, what presenting part do you anticipate palpating in a vaginal exam?
- A. brow
- B. breech
- C. face
- D. occiput
Correct Answer: D
Rationale: If the fetal attitude is assessed to be completely deflexed on sonogram or via Leopold's maneuvers, it means the baby is presenting in an extended position with the occiput being the lead point of the presenting part during a vaginal exam. This position is known as occiput posterior. The fetal occiput is the back of the head, and it is the optimal position for vaginal delivery as the smallest diameter of the baby's head will be presenting at the cervix, facilitating an easier descent through the birth canal.
The nurse hears the laboring patient making grunting noises. How will the nurse determine if the person is in the active second stage of labor?
- A. Assess for rupture of membranes.
- B. Assess for bloody show.
- C. Assess for dilation of the cervix.
- D. Assess for stool.
Correct Answer: C
Rationale: In the active second stage of labor, the cervix is fully dilated to 10 centimeters. Grunting noises can be a sign of the transition to the pushing stage, which occurs in the active second stage of labor. Therefore, assessing for dilation of the cervix is crucial to determine if the laboring person is in the active second stage of labor.