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Ricci, Kyle & Carman: Maternity and Pediatric Nursing, Second Edition: Chapter 21: Nursing Management of Labor and Birth at Risk; PrepU Exam Questions And Answers$12.89
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Ricci, Kyle & Carman: Maternity and Pediatric Nursing, Second Edition: Chapter 21: Nursing Management of Labor and Birth at Risk; PrepU Exam Questions And Answers
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Course
Essentials Of Pediatric Nursing
Institution
Essentials Of Pediatric Nursing
A 26-year-old primigravida has brought her doula to the birthing center for support during her labor and birth. The doula has been helping her through the past 16 hours of labor. The laboring woman is now 6 cm. dilated. She continues to report severe pain in her back with each contraction. The clie...
Ricci,
Kyle
&
Carman:
Maternity
and
Pediatric
Nursing,
Second
Edition:
Chapter
21:
Nursing
Management
of
Labor
and
Birth
at
Risk;
PrepU
Exam A
26-year-old
primigravida
has
brought
her
doula
to
the
birthing
center
for
support
during
her
labor
and
birth.
The
doula
has
been
helping
her
through
the
past
16
hours
of
labor.
The
laboring
woman
is
now
6
cm.
dilated.
She
continues
to
report
severe
pain
in
her
back
with
each
contraction.
The
client
finds
it
comforting
when
her
doula
uses
the
ball
of
her
hand
to
put
counterpressure
on
her
lower
back.
What
is
the
likely
cause
of
the
woman's
back
pain?
-
ANS
occiput
posterior
position
A
labor
complicated
by
occiput
posterior
position
is
usually
prolonged
and
characterized
by
maternal
perception
of
increased
intensity
of
back
discomfort.
The
lay
term
for
this
type
of
labor
is
"back
labor."
Which
action
would
be
most
appropriate
for
the
woman
who
experiences
dysfunctional
labor
in
the
first
stage
of
labor?
-
ANS
Provide
ongoing
communication
about
what
is
happening.
Dysfunctional
labor
at
any
point
is
frustrating
to
women.
Maintaining
open
lines
of
communication
at
least
keeps
the
woman
well
informed
about
what
is
happening.
A
nursing
student
correctly
identifies
the
most
desirable
position
to
promote
an
easy
birth
as
which
position?
-
ANS
occiput
anterior
Any
presentation
other
than
occiput
anterior
or
a
slight
variation
of
the
fetal
position
or
size
increases
the
probability
of
dystocia.
A
client
with
a
pendulous
abdomen
and
uterine
fibroid
tumors
had
just
begun
labor
and
arrived
at
the
hospital.
After
examining
the
client,
the
primary
care
provider
informs
the
nurse
that
the
fetus
appears
to
be
malpositioned
in
the
uterus.
Which
fetal
position
or
presentation
should
the
nurse
most
expect
in
this
woman?
-
ANS
transverse
lie
A
transverse
lie,
in
which
the
fetus
is
more
horizontal
than
vertical,
occurs
in
women
with
pendulous
abdomens,
with
uterine
fibroid
tumors
that
obstruct
the
lower
uterine
segment,
with
contraction
of
the
pelvic
brim,
with
congenital
abnormalities
of
the
uterus,
or
with
hydramnios.
Anterior
fetal
position
and
cephalic
presentation
are
normal
conditions.
Occipitoposterior
position
tends
to
occur
in
women
with
android,
anthropoid,
or
contracted
pelves. A
client
in
week
38
of
her
pregnancy
has
an
ultrasound
performed
at
a
routine
office
visit
and
learns
that
her
fetus
has
not
moved
out
of
a
breech
position.
Which
intervention
does
the
nurse
anticipate
for
this
client?
-
ANS
external
cephalic
version
External
cephalic
version
is
the
turning
of
a
fetus
from
a
breech
to
a
cephalic
position
before
birth.
It
may
be
done
as
early
as
34
to
35
weeks,
although
the
usual
time
is
37
to
38
weeks
of
pregnancy.
A
trial
birth
is
performed
when
a
woman
has
a
borderline
(just
adequate)
inlet
measurement
and
the
fetal
lie
and
position
are
good
and
involves
allowing
labor
to
take
its
normal
course
as
long
as
descent
of
the
presenting
part
and
dilatation
of
the
cervix
continue
to
occur.
Forceps,
which
are
not
commonly
used
anymore,
and
vacuum
extraction
are
used
to
facilitate
birth
when
other
complications
are
present,
but
they
would
be
less
likely
to
be
used
with
a
fetus
in
breech
position.
Hypertonic
labor
is
labor
that
is
characterized
by
short,
irregular
contractions
without
complete
relaxation
of
the
uterine
wall
in
between
contractions.
Hypertonic
labor
can
be
caused
by
an
increased
sensitivity
to
oxytocin.
What
would
the
nurse
do
for
a
client
who
is
in
hypertonic
labor
because
of
oxytocin
augmentation?
-
ANS
Turn
off
the
pitocin.
Hypertonic
labor
may
result
from
an
increased
sensitivity
of
uterine
muscle
to
oxytocin
induction
or
augmentation.
Treatment
for
this
iatrogenic
cause
of
hypertonic
labor
is
to
decrease
or
shut
off
the
oxytocin
infusion.
Which
action
could
the
nurse
initiate
to
reduce
the
discomfort
of
a
woman
in
labor
whose
fetus
is
in
an
occiput
posterior
position?
-
ANS
Massage
her
lower
back.
Counterpressure
against
the
woman's
back
by
a
support
person
can
be
helpful
in
reducing
this
type
of
pain.
When
caring
for
a
client
requiring
a
forceps-assisted
birth,
the
nurse
would
be
alert
for:
-
ANS
potential
lacerations
and
bleeding.
Forcible
rotation
of
the
forceps
can
cause
potential
lacerations
and
bleeding.
Cervical
ripening
increases
the
risk
for
uterine
rupture
in
a
client
attempting
vaginal
birth
after
undergoing
at
least
one
previous
cesarean
birth.
There
is
an
increased
risk
for
cord
entanglement
in
multiple
pregnancies.
Damage
to
the
maternal
tissues
happens
if
the
cup
slips
off
the
fetal
head
and
the
suction
is
not
released.
A
woman
whose
fetus
in
in
the
occiput-posterior
position
is
experiencing
increased
back
pain.
Which
is
the
best
way
for
the
nurse
to
help
alleviate
this
back
pain?
-
ANS
applying
counter
pressure
to
the
back
Counter
pressure
applied
to
the
lower
back
with
a
fisted
hand
sometimes
helps
the
woman
cope
with
"back
labor"
associated
with
occiput-posterior
positioning.
The
others
are
not
recommended
or
used
techniques
for
a
woman
in
labor
with
back
pain.
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