Week 5 PPN 301 second stage of labour nursing assessments Questions and Answers 100% Correct
2. Active Pushing Phase:
Characteristics: correct answer The patient feels strong urges to push, known as the Ferguson reflex,
which happens when the baby's head presses on the pelvic floor.
This reflex causes the release of oxytocin, leading to stronger contractions that help push the baby out.
2. Active Pushing Phase:
Pushing Technique: correct answer Encourages spontaneous pushing: patients push when they feel the
urge rather than following directed instructions.
Promotes openglottis pushing: shorter, more controlled pushes that involve exhaling or making noise to
avoid pushing too forcefully.
BEARING DOWN EFFORTS:
2. VOCALIZATIONS:
COMMON RESPONSE
ENCOURAGMENT correct answer 2. Vocalization:
Common Response: Patients often make sounds like grunts or groans while pushing.
Encouragement: Nurses should not discourage these natural sounds; they often help with the pushing
process.
Bearing Down Efforts:
4. Recommendations:
Avoid:
Advocate
Benefits of Spontaneous Pushing correct answer Avoid: Prolonged breathholding and directed pushing.
Advocate: Encourage spontaneous pushing, especially in upright or lateral positions.
Benefits of Spontaneous Pushing:
Less fatigue for the patient.
Reduced risk of complications and trauma.
,More effective pushing, resulting in a shorter pushing stage.
Bearing-Down Efforts:
1. What is Bearing Down?
When:
What Happens:
How: correct answer 1. What is Bearing Down?
When: As the baby's head moves down towards the pelvic floor.
What Happens: The patient feels a strong urge to push, which is a natural reflex called the Ferguson
reflex.
How: The patient uses abdominal muscles to push while relaxing the pelvic floor.
Bearing-Down Efforts:
3. Types of Pushing:
Directed (Closed Glottis) Pushing
How
Drawbacks correct answer Directed (Closed Glottis) Pushing:
How: The patient holds their breath and pushes on command, often counting to 10.
Drawbacks: Can increase intrathoracic pressure (Valsalva maneuver), which:
Reduces blood flow to the heart.
Decreases blood flow to the uterus and placenta.
May lead to fetal distress (hypoxia) and acidosis.
Increases risk of pelvic floor and perineal trauma.
Bearing-Down Efforts:
3. Types of Pushing:
Instinctive (Spontaneous) Pushing:
When to Push:
Benefits: correct answer 3. Types of Pushing:
, Instinctive (Spontaneous) Pushing:
When to Push: Encourage patients to push when they feel the urge to do so naturally.
Benefits: Less fatigue and discomfort; more effective pushing.
Birthing Stools: correct answer Useful for maintaining an upright position similar to squatting.
Comfort and Support:
Beanbag Chairs and Floor Pillows: correct answer These can support the patient in various positions and
are useful for those actively involved in the birth process.
Duration:
New Understanding:
Average Time:
Nulliparous (firsttime mothers):
Multiparous (mothers who have given birth before): correct answer New Understanding:
The second stage of labour may last longer than previously thought.
Average Time:
Nulliparous (firsttime mothers): 60 to 70 minutes.
Multiparous (mothers who have given birth before): 20 to 30 minutes.
Effective Techniques:
Squatting: correct answer Helps with fetal descent and maximizes pushing efforts.
Use a supported squat or a squatting bar for better support.
A birth ball can also help maintain this position and provide comfort.
Effective Techniques:
Supported Standing: correct answer Increases pelvic outlet diameter by 1 cm, which may help if the
baby's head is stuck in the pelvis.
Birthing chairs or rocking chairs can support this position, though some patients might find them
restrictive.
2. Active Pushing Phase:
Characteristics: correct answer The patient feels strong urges to push, known as the Ferguson reflex,
which happens when the baby's head presses on the pelvic floor.
This reflex causes the release of oxytocin, leading to stronger contractions that help push the baby out.
2. Active Pushing Phase:
Pushing Technique: correct answer Encourages spontaneous pushing: patients push when they feel the
urge rather than following directed instructions.
Promotes openglottis pushing: shorter, more controlled pushes that involve exhaling or making noise to
avoid pushing too forcefully.
BEARING DOWN EFFORTS:
2. VOCALIZATIONS:
COMMON RESPONSE
ENCOURAGMENT correct answer 2. Vocalization:
Common Response: Patients often make sounds like grunts or groans while pushing.
Encouragement: Nurses should not discourage these natural sounds; they often help with the pushing
process.
Bearing Down Efforts:
4. Recommendations:
Avoid:
Advocate
Benefits of Spontaneous Pushing correct answer Avoid: Prolonged breathholding and directed pushing.
Advocate: Encourage spontaneous pushing, especially in upright or lateral positions.
Benefits of Spontaneous Pushing:
Less fatigue for the patient.
Reduced risk of complications and trauma.
,More effective pushing, resulting in a shorter pushing stage.
Bearing-Down Efforts:
1. What is Bearing Down?
When:
What Happens:
How: correct answer 1. What is Bearing Down?
When: As the baby's head moves down towards the pelvic floor.
What Happens: The patient feels a strong urge to push, which is a natural reflex called the Ferguson
reflex.
How: The patient uses abdominal muscles to push while relaxing the pelvic floor.
Bearing-Down Efforts:
3. Types of Pushing:
Directed (Closed Glottis) Pushing
How
Drawbacks correct answer Directed (Closed Glottis) Pushing:
How: The patient holds their breath and pushes on command, often counting to 10.
Drawbacks: Can increase intrathoracic pressure (Valsalva maneuver), which:
Reduces blood flow to the heart.
Decreases blood flow to the uterus and placenta.
May lead to fetal distress (hypoxia) and acidosis.
Increases risk of pelvic floor and perineal trauma.
Bearing-Down Efforts:
3. Types of Pushing:
Instinctive (Spontaneous) Pushing:
When to Push:
Benefits: correct answer 3. Types of Pushing:
, Instinctive (Spontaneous) Pushing:
When to Push: Encourage patients to push when they feel the urge to do so naturally.
Benefits: Less fatigue and discomfort; more effective pushing.
Birthing Stools: correct answer Useful for maintaining an upright position similar to squatting.
Comfort and Support:
Beanbag Chairs and Floor Pillows: correct answer These can support the patient in various positions and
are useful for those actively involved in the birth process.
Duration:
New Understanding:
Average Time:
Nulliparous (firsttime mothers):
Multiparous (mothers who have given birth before): correct answer New Understanding:
The second stage of labour may last longer than previously thought.
Average Time:
Nulliparous (firsttime mothers): 60 to 70 minutes.
Multiparous (mothers who have given birth before): 20 to 30 minutes.
Effective Techniques:
Squatting: correct answer Helps with fetal descent and maximizes pushing efforts.
Use a supported squat or a squatting bar for better support.
A birth ball can also help maintain this position and provide comfort.
Effective Techniques:
Supported Standing: correct answer Increases pelvic outlet diameter by 1 cm, which may help if the
baby's head is stuck in the pelvis.
Birthing chairs or rocking chairs can support this position, though some patients might find them
restrictive.
