A laboring client has external electronic fetal monitoring in place. Which of the following assessment data can be determined by examining the fetal heart rate strip produced by the external electronic fetal monitor?
Oxygenation of the fetus may be indirectly assessed through fetal monitoring by closely examining the fetal heart rate strip. Accelerations in the fetal heart rate strip indicate good oxygenation, while decelerations in the fetal heart rate sometimes indicate poor fetal oxygenation.
Fetal presentation refers to which of the following descriptions?
Presentation is the fetal body part that enters the pelvis first; it’s classified by the presenting part; the three main presentations are cephalic/occipital, breech, and shoulder.
A client arrives at the hospital in the second stage of labor. The fetus’ head is crowning, the client is bearing down, and the birth appears imminent. The nurse should:
Gentle pressure is applied to the baby’s head as it emerges so it is not born too rapidly. The head is never held back, and it should be supported as it emerges so there will be no vaginal lacerations. It is impossible to push and pant at the same time.
Which of the following observations indicates fetal distress?
A fetal scalp pH below 7.25 indicates acidosis and fetal hypoxia.
A multiparous client who has been in labor for 2 hours states that she feels the urge to move her bowels. How should the nurse respond?
A complaint of rectal pressure usually indicates a low presenting fetal part, signaling imminent delivery. The nurse should perform a pelvic examination to assess the dilation of the cervix and station of the presenting fetal part.
A laboring client is to have a pudendal block. The nurse plans to tell the client that once the block is working she:
A pudendal block provides anesthesia to the perineum.
Which of the following fetal positions is most favorable for birth?
Vertex presentation (flexion of the fetal head) is the optimal presentation for passage through the birth canal.
During the period of induction of labor, a client should be observed carefully for signs of:
Uterine tetany could result from the use of oxytocin to induce labor. Because oxytocin promotes powerful uterine contractions, uterine tetany may occur. The oxytocin infusion must be stopped to prevent uterine rupture and fetal compromise.
A laboring client is in the first stage of labor and has progressed from 4 to 7 cm in cervical dilation. In which of the following phases of the first stage does cervical dilation occur most rapidly?
Cervical dilation occurs more rapidly during the active phase than any of the previous phases. The active phase is characterized by cervical dilation that progresses from 4 to 7 cm.
Labor is a series of events affected by the coordination of the five essential factors. One of these is the passenger (fetus). Which are the other four factors?
The five essential factors (5 P’s) are passenger (fetus), passageway (pelvis), powers (contractions), placental position and function, and psyche (psychological response of the mother).
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