NURS 2150 Labor & Delivery

The factors that affect the process of labor and birth, known commonly as the five Ps, include all except:

• Passenger
• Passageway
• Powers
• Pressure

With regard to the position of the laboring woman, maternity nurses should be able to tell the woman that:

• The supine position commonly used in the United States increases blood flow.
• The "all fours" position, on her hands and knees, is hard on her back.
• Frequent changes in position will help relieve her fatigue and increase her comfort.
• In a sitting or squatting position her abdominal muscles will have to work harder.

Which description of the four stages of labor is correct for both definition and duration?

• First stage: onset of regular uterine contractions to full dilation; less than 1 hour to 20 hours
• Second stage: full effacement to 4 to 5 cm; visible presenting part; 1 to 2 hours
• Third state: active pushing to birth; 20 minutes (multiparous women), 50 minutes (first-timer)
• Fourth stage: delivery of the placenta to recovery; 30 minutes to 1 hour

When a nulliparous woman telephones the hospital to report that she is in labor, the nurse initially should:

• Tell the woman to stay home until her membranes rupture
• Emphasize that food and fluid intake should stop
• Arrange for the woman to come to the hospital for labor evaluation
• Ask the woman to describe why she believes she is in labor

To assess the pain experience of the laboring woman, the nurse relies most on

• vital signs.
• labor progress.
• patient's description.
• availability of support.

Which of the following is not a realistic perspective of pain during labor?

• Psychological processes underlie the experience of pain.
• Pain serves a useful purpose.
• The belief that childbirth should not be painful.
• Pain is frequently intensified by fear, anxiety, and fatigue.

Which physiologic changes are indicative of maternal pain?

• Marked agitation, confusion, guarding
• Increased urine output, increased intestinal motility
• Decreased blood pressure and pulse rate, increased urine output
• Increased pulse rate and blood pressure, decreased urine output

During the active phase of labor, the laboring patient screams out "I quit; I cannot do this anymore." The nurse can respond most effectively by

• offering an epidural.

• offering words of support and encouragement.

• encouraging her to ambulate.

• offering a backrub.

The laboring patient using pattern-paced breathing reports lightheadedness, dizziness, and tingling of the fingers. The priority intervention for the nurse is to

• offer bicarbonate.
• instruct her to breathe into her cupped hands.
• encourage her to hold her breath.
• encourage her to exhale through pursed lips.

An active-labor patient is agitated and sends her husband to ask the nurse if she can have pain medication. Which nursing action takes priority?

• Notify the physician.
• Change her position and encourage deep breathing.
• Assess fetal heart rate, maternal vital signs, and labor progress.
• Ask the husband to leave while you help her focus and calm down.