A laboring client is inhaling gas through a mouthpiece just before the onset of her regular contractions.

As they inhale, a valve opens and gas is released.

They continue to inhale the gas slowly and deeply until the contraction starts to subside.

When the inhalation stops, the valve closes.

What is this procedure?

Choice A rationale:

Visceral pain arises from the internal organs and is often described as dull, aching, cramping, or squeezing. During the first stage of labor, the uterus contracts forcefully to dilate the cervix and move the baby down the birth canal. This stretching and pressure on the uterus, cervix, and other pelvic organs stimulate pain receptors, resulting in visceral pain. This pain is typically located in the lower abdomen, back, and groin.

Key points about visceral pain in the first stage of labor:

It's often described as dull, aching, cramping, or squeezing.

It's caused by the stretching and pressure on the uterus, cervix, and other pelvic organs.

It's typically located in the lower abdomen, back, and groin.

It can be intermittent or continuous.

It can vary in intensity from mild to severe.

It's often accompanied by other symptoms such as nausea, vomiting, sweating, and anxiety.

Choice B rationale:

Referred pain is pain that is felt in a different location from the source of the pain. It's not typically associated with the first stage of labor.

Choice C rationale:

Somatic pain arises from the skin, muscles, bones, and joints. It's often described as sharp, stabbing, burning, or throbbing. The somatic pain of the second stage of labor is caused by the stretching and distension of the perineum and vagina as the baby descends. It's typically located in the lower back, buttocks, and thighs.

Choice D rationale:

Pain during the third stage of labor is typically mild compared to the first and second stages. It's caused by the contractions of the uterus as it expels the placenta. It's usually located in the lower abdomen and may be accompanied by a feeling of pressure or fullness.

Choice A rationale:

Bishop score: A tool used to assess the readiness of the cervix for labor induction. It evaluates factors such as cervical dilation, effacement, consistency, position, and station of the fetal presenting part.

Score ranges from 0 to 13: A higher score indicates a more favorable cervix for induction.

Score of 6 or less: Induction is less likely to be successful.

Score of 9 or higher: Induction is more likely to be successful.

Nurses understand: The importance of the Bishop score in predicting the likelihood of successful induction.

Nurses use this information: To counsel patients about the risks and benefits of induction, to prepare for induction, and to monitor progress during induction.

Choice B rationale:

Not always done for medical reasons: Induction can also be elective, meaning it is chosen for non-medical reasons, such as convenience or a desire to avoid a post-term pregnancy.

Examples of medical reasons:

Gestational hypertension or preeclampsia

Fetal growth restriction

Prolonged pregnancy

Chorioamnionitis

Oligohydramnios

Choice C rationale:

Trial of labor (TOL): A term used to describe a vaginal birth attempt after a previous cesarean delivery.

Not synonymous with induction of labor: TOL can occur spontaneously or be induced.

Choice D rationale:

Not always electively done at 37 weeks' gestation: The decision to induce labor at 37 weeks is made on a case-by-case basis.

Factors considered:

Maternal and fetal health

Bishop score

Patient preferences