A nurse is caring for a client having contractions every 8 min that are 30 to 40 seconds in duration. The client's cervix is 2 cm dilated, 50% effaced, and the fetus is at a -2 station with a FHR around 140/min. Which of the following stages and phases of labor is the client experiencing?
First stage, latent phase
Second stage of labor
First stage, active phase
First stage, transition phase
The Correct Answer is A
A. First stage, latent phase: The first stage of labor consists of the latent, active, and transition phases. Latent phase: Cervical dilation 0-3 cm, contractions mild and irregular (every 5-10 minutes, lasting 30-45 seconds). Client in this scenario matches these criteria.
B. Second stage of labor: The second stage of labor begins at full cervical dilation (10 cm) and ends with birth. The client is only 2 cm dilated, so she is still in the first stage.
C. First stage, active phase: The active phase of labor occurs when the cervix is 4-7 cm dilated and contractions are stronger, longer, and more frequent (every 3-5 minutes). The client is only 2 cm dilated, so she is still in the latent phase.
D. First stage, transition phase: The transition phase occurs when the cervix is 8-10 cm dilated, and contractions occur every 2-3 minutes, lasting 60-90 seconds. The client is far from this stage.
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Related Questions
Correct Answer is B
Explanation
A. To stimulate uterine contractions: Terbutaline is a tocolytic (a medication that relaxes the uterus), not a uterotonic. It is not used to stimulate contractions.
B. To improve placental blood flow: Terbutaline relaxes uterine muscles, decreasing contraction frequency and intensity, thereby improving placental blood flow. It is often used in intrauterine resuscitation when there is uteroplacental insufficiency and fetal distress due to excessive contractions (tachysystole).
C. To decrease fetal heart rate variability: Terbutaline does not directly affect fetal heart rate variability. It is used to reduce uterine contractions, which can secondarily improve fetal oxygenation.
D. To prevent preterm labor: While terbutaline can be used to delay preterm labor, in this context, it is being used for intrauterine resuscitation, not for preventing labor.
Correct Answer is C
Explanation
A. No displacement of the gravid uterus is necessary during CPR on a pregnant woman. Displacement of the uterus is necessary in a pregnant woman (especially after 20 weeks gestation) to prevent supine hypotension syndrome.
B. Apply pressure on the abdomen above the umbilicus to displace the uterus. Applying pressure above the umbilicus is not an effective method of uterine displacement. The correct technique involves manual displacement to the left or tilting the woman to the left.
C. Tilt the woman's pelvis to the left to relieve pressure on the inferior vena cava. Tilting the uterus to the left helps relieve compression on the inferior vena cava, improving venous return and cardiac output. This is essential during CPR to optimize blood flow to the mother and fetus.
D. Apply pressure directly on the gravid uterus to maintain blood flow to the fetus. Applying direct pressure on the uterus could further compromise circulation rather than improving it.
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