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What does the nurse note when measuring the frequency of a laboring woman's
contractions? ---------CORRECT ANSWER-----------------Elapsed time (in minutes or
half minutes measured by fractions EX: 4 ½ minutes) from the beginning of one
contraction until the beginning of the next contraction.
Why are the intervals between contractions important? ---------CORRECT
ANSWER-----------------The intervals between contractions allow time for
replenishment of oxygen to the fetus.
What contraction duration and interval does the nurse recognize could result in
fetal compromise? ---------CORRECT ANSWER-----------------Contraction durations
longer than 90 seconds and intervals shorter than 60 seconds may reduce fetal
oxygen supply
Vaginal examination reveals the presenting part is the infant's head, which is well
flexed on the chest. What is this presentation? ---------CORRECT ANSWER------------
-----Vertex Presentation
,It is determined that the presenting part of the fetus is the buttocks. At delivery
the fetus's hips are flexed and the knees are extended. How would the nurse
record this presentation? ---------CORRECT ANSWER-----------------Frank Breech
What indicates the beginning of true labor? ---------CORRECT ANSWER----------------
-Regular contractions becoming more frequent and intense
When should the laboring pregnant women go to the hospital? ---------CORRECT
ANSWER-----------------Thinks her membranes has ruptured
What will the nurse remind the patient about contractions during the first stage
of labor? ---------CORRECT ANSWER-----------------Dilate and efface the cervix
What is the function of contractions during the second stage of labor? ---------
CORRECT ANSWER-----------------Push the baby out of the mother's body
What marks the end of the third stage of labor? ---------CORRECT ANSWER-----------
------Expulsion of the placenta and membranes
, Why should the nurse encourage the mother to void during the fourth stage of
labor? ---------CORRECT ANSWER-----------------Predispose the mother to uterine
hemorrhage, a full bladder immediately after birth can cause excessive bleeding
because it pushes the uterus upward and interferes with contractions.
The nurse observes the patient bearing down with contractions and crying out,
"The baby is coming!" What is the best nursing intervention? ---------CORRECT
ANSWER-----------------Stay with the woman
What is the most important nursing intervention during the fourth stage of labor?
---------CORRECT ANSWER-----------------Assess for hemorrhage
One hour post-delivery the nurse notes the new mother has saturated three
perineal pads. What is the most appropriate nursing action? ---------CORRECT
ANSWER-----------------Check the fundus for position and firmness
While caring for a laboring woman, the nurse notices a pattern of variable
decelerations in fetal heart rate with uterine contractions. What is the nurse's
initial action? ---------CORRECT ANSWER-----------------Reposition the woman to her
side
How should the nurse intervene to relieve perineal bruising and edema following
delivery? ---------CORRECT ANSWER-----------------Place an ice pack on the area.