Labor and Delivery Concepts

Labor and Delivery Concepts

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Multiple Choice

When assessing cervical effacement of a client in labor, the nurse assesses which characteristic?

• extent of opening to its widest diameter

• degree of thinning

• passage of the mucous plug

• fetal presenting par

degree of thinning

Effacement refers to the degree of thinning of the cervix. Cervical dilation refers to the extent of opening at the widest diameter. Passage of the mucous plug occurs with bloody show as a premonitory sign of labor. The fetal presenting part is determined by vaginal examination and is commonly the head (cephalic), pelvis (breech), or shoulder.

Multiple Choice

When going through the transition phase of labor, women often feel out of control. What do women in the transition phase of labor need the most?

• positive reinforcement

• their significant other beside them

• intense nursing care

• just to be left alone

positive reinforcement

Any woman, even one who has taken natural childbirth classes, has a difficult time maintaining positive coping strategies during this phase of labor. Many women describe feeling out of control during this phase of labor. A woman in transition needs support, encouragement, and positive reinforcement.

Multiple Choice

A client has just given birth to a healthy baby boy, but the placenta has not yet delivered. What stage of labor does this scenario represent?

• First

• Second

• Third

• Fourth

third

Stage three begins with the birth of the baby and ends with delivery of the placenta.

Multiple Choice

A nulliparous client at 37 weeks' gestation calls the labor and delivery unit stating she thinks she is in labor. The nurse predicts she is in true labor based on which answer to her assessment questions?

• contractions, irregular, lasting 15 to 20 seconds

• bloody mucus in the toilet once earlier in the day

• contraction, regular and lasting longer and stronger

• scant amount of thick, white vaginal discharge, no odor

contraction, regular and lasting longer and stronger

True labor contraction will progressively get worse and last longer. The pain will come to a point where the woman will not be able to walk or talk through the contractions. Irregular contractions, bloody show, and white vaginal discharge are normal for pregnancy but do not indicate true labor.

Multiple Choice

The nurse is monitoring a client who is in labor and notes the client is happy, cheerful, and "ready to see the baby." The nurse interprets this to mean the client is in which stage or phase of labor?

• transition phase

• stage two

• latent phase

• stage three

latent phase

The woman in labor undergoes numerous psychological adaptations during labor. During the latent phase, she is often talkative and happy, and yet anxious. During transition, the client may show fear and anger. During stage 2 she may remain positive, but the work of labor is very intense.

Multiple Choice

A nurse is explaining the fetus's position to a female client whose baby is in the frank breech position. Which statement by the client would indicate that the teaching was understood?

• “My baby’s hips and the knees are flexed.”

• “My baby’s hips and knees are extended.”

• “My baby’s hips are flexed, and the knees are extended.”

• “My baby’s hips are extended, and the knees are flexed.”

“My baby’s hips are flexed, and the knees are extended.”

The frank breech position of the fetus indicates that the sacrum is the presenting part. The hips are flexed, and the knees are extended. Complete breech is when both the hips and knees are flexed and the sacrum is presenting. Kneeling breech is when the hips are extended, and the knees are flexed. Footling breech is when both the hips and knees are extended so that the fetus presents feet first.

Multiple Choice

Which feature would alert the nurse that the client is in the transition phase of labor?

• reduction of rectal pressure

• decrease in the bloody show

• enthusiasm in the client

• beginning urge to bear down

beginning urge to bear down

The beginning of the urge to bear down is a feature associated with the transition phase of labor. The transition phase is the last phase of the first stage of labor. In this phase, the process of cervical dilation (dilatation) is completed. During this phase the client experiences an increase in rectal pressure, an increase in the bloody show, and an urge to bear down. The contractions are stronger and hence the client feels irritable, restless, and nauseous. The client feels enthusiastic during the latent phase and not the transition phase.