Care, 6th Edition
The nurse is caring for a patient in the first stage of labor. What maternal
physiologic changes does the nurse expect?
1
Decrease in absorption of solid food
2
Increase in systolic and diastolic pressures
3
Increase in nausea and vomiting sensation
4
Increase in cardiac output by 30% to 50% - Answer-1
During the first stage of labor, gastrointestinal motility and absorption of
solid foods are decreased, and stomach-emptying time is slowed down. Only
systolic blood pressure increases during uterine contractions in the first stage of
labor. Systolic and diastolic pressures increase during contractions in the second
stage of labor and return to baseline levels between contractions. Nausea and
vomiting sensations may occur during the transition from first stage to second
stage of labor. In the first stage of labor, the cardiac output increases by 10% to
15%. Cardiac output increases by 30% to 50% only at the end of the first stage of
labor and not in the first stage.
, A primigravida asks the nurse about signs she can look for that indicate that
the onset of labor is getting closer. The nurse should describe:
1
weight gain of 1 to 3 lbs.
2
quickening.
3
fatigue and lethargy.
4
bloody show. - Answer-4
Passage of the mucous plug (operculum) also termed pink/bloody show
occurs as the cervix ripens. Women usually experience a weight loss of 1 to 3 lbs.
Quickening is the perception of fetal movement by the mother, which occurs at
16 to 20 weeks of gestation. Women usually experience a burst of energy or the
nesting instinct.
The nurse is teaching a patient, who is pregnant for the first time, about the
signals that indicate the beginning of labor. Which sign will the nurse mention as a
signal for the beginning of labor?
1
Involuntary contractions
2
Pain in the pelvic joints
3
100% effacement of the cervix
, 4
Full dilation of the cervix - Answer-1. Involuntary contractions
The nurse knows that the second stage of labor has begun when:
1
the amniotic membranes rupture.
2
full cervical dilation has occurred.
3
the woman experiences an urge to bear down.
4
the presenting part is below the ischial spines. - Answer-2
The second stage of labor begins with full cervical dilation. During the
descent phase of the second stage of labor, the woman may experience an
increase in the urge to bear down. Rupture of membranes has no significance in
determining the stage of labor. Many women may have an urge to bear down
when the presenting part is below the level of the ischial spines. This can occur
during the first stage of labor, as early as 5 cm of dilation.
What are the factors that enable the baby to initiate respiration
immediately after birth?
1
Fetal respiratory movements increase during labor.
2
Fetal lung fluid is cleared from the air passage.
, 3
Arterial carbon dioxide pressure is decreased.
4
Arterial pH and bicarbonate level is increased. - Answer-2
Fetal lung fluid is cleared from the air passage as the infant passes through
the birth canal during labor and vaginal birth. There is a decrease in fetal
respiratory movements during labor. Arterial carbon dioxide pressure (Pco2)
increases. There is a decrease in arterial pH and bicarbonate levels.
The nurse is assessing a patient in labor. The nurse documents the progress
in the effacement of the cervix and little increase in descent. Which phase of
labor is the patient in?
1
Latent phase
2
Active phase
3
Transition phase
4
Descent phase - Answer-1
The patient is in the latent phase of the first stage of labor. In this phase,
there is more progress in the effacement of the cervix and little increase in the
descent of the fetus. In the active and transition phases, there is more rapid
dilation of the cervix and increased rate of descent of the presenting part of the
fetus. The descent phase, or active pushing phase, occurs in the second stage of