A woman who is 6 cm dilated has the urge to push. What will the nurse instruct the woman to do during the contraction?
Blow in short breaths.
What is a contraindication to an epidural block?
Abnormal blood clotting
One hour postdelivery the nurse notes the new mother has saturated three perineal pads. What is the most appropriate nursing action?
Check the fundus for position and firmness.
What assessment should be taken immediately after the anesthesiologist administers an epidural block to a laboring woman?
Blood pressure
The nurse coaches the primigravida not to bear down until the cervix is completely dilated. What may premature bearing down cause?
Cervical laceration
After several hours of labor, a nursing assessment reveals that a woman's cervix is 5 cm dilated, but contractions are becoming shorter and less frequent. What is this labor pattern considered?
Hypotonic
Why should the nurse encourage the mother to void during the fourth stage of labor?
A full bladder could predispose the woman to uterine hemorrhage.
A woman in labor has had an epidural block for pain relief. The nurse will be assessing carefully for what associated side effect of this type of regional anesthesia?
Bladder distention
When caring for the laboring patient, the nurse determines that the fetus is located in the right occiput posterior (ROP) position. What will the nurse anticipate?
(abbreviated wrong on test)
Severe lower back pain
The nurse observes on the fetal monitor a pattern of a 15-beat increase in the fetal heart rate that lasts 15-20 seconds. What does this pattern indicate?
A well-oxygenated fetus.
A patient who received an epidural block asks the nurse why her blood pressure is taken so often. What is the nurse's best response to explain the frequent blood pressure assessments?
They ensure adequate placental perfusion.
What is the most appropriate pain-relief intervention for the woman in precipitate labor?
Stay and breathe with her during contractions.
What does the nurse explain is used to soften the cervix with a "cervical ripening" agent?
Prostaglandin gel insertion.
What is the most important nursing intervention during the fourth stage of labor?
Assess for hemorrhage.
A pulsating structure is felt during a vaginal examination of a woman in labor. How would the nurse position the woman to prevent compression of a prolapsed cord?
On her back with her head lower than the rest of the body.
How can anxiety affect labor?
By reducing blood flow to the uterus.
A woman is having a difficult labor because the fetus is presenting in the right occipital position (ROP). What position will the nurse promote to encourage fetal rotation and pain relief?
Sitting up and leaning forward over the bedside table.
An infant is delivered with the use of forceps. What should the nurse assess for in the newborn?
Facial asymmetry
During a strenuous labor, the woman asks for some pain remedy for the sudden pain between her scapulae that seems to occur with every breath she takes. What is the best nursing action?
Notify the charge nurse immediately.
A woman who is 33 weeks pregnant is admitted to the obstetric unit because her membranes ruptured spontaneously. What complication should the nurse closely assess for with this patient?
Chorioamnionitis
What nursing action is best for meeting the client's needs during the transition phase of labor?
Praising the client frequently.
What typical classes are available to help expectant parents prepare for parenthood?
(three)
Infant care
Breastfeeding
Gestational diabetes
During evaluation of the client's contractions during the active phase of the first stage of labor, when is it important for the nurse to notify the healthcare provider?
When the fetal heart rate drops after the acme of a contraction
The client tells the nurse, "I feel like I need to push." What action should the nurse take first?
Check that the client's cervix is fully dilated.
What complications of overstimulation of the uterine contractions may occur?
(three)
Water intoxication
Impaired placental exchange of oxygen and nutrients
Uterine rupture