A nurse is coaching a woman during the second stage of labor. Which of the following should the nurse encourage the client to do at this time?
Hold her breath while pushing during contractions
Begin pushing as soon as the cervix has dilated to 8cm
Push with contractions and rest between them
Pant while pushing
The Correct Answer is C
A. Holding her breath while pushing during contractions: Prolonged breath-holding increases intrathoracic pressure, reduces venous return, and can decrease uteroplacental perfusion. This may compromise fetal oxygenation and increase maternal fatigue, particularly during repeated pushing efforts.
B. Begin pushing as soon as the cervix has dilated to 8 cm: Initiating pushing before full cervical dilation increases the risk of cervical edema and lacerations. Effective bearing down requires complete dilation to allow fetal descent without maternal or cervical trauma.
C. Push with contractions and rest between them: Coordinating pushing with uterine contractions maximizes expulsive force while rest periods allow maternal recovery and fetal reoxygenation. This pattern supports efficient fetal descent and reduces exhaustion during the second stage of labor.
D. Pant while pushing: Panting is used during the transition phase or when pushing should be delayed, such as with an urge to push before full dilation. During the active second stage, panting interferes with effective bearing-down efforts.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. A newborn who is 24 hr post-delivery and has not voided: While voiding is expected within the first 24 hours, some healthy newborns may have delayed urination up to this point. Close monitoring is required, but it is not immediately life-threatening.
B. A newborn who is 18 hr post-delivery and has acrocyanosis: Acrocyanosis (bluish hands and feet) is a common, benign finding in the first 24–48 hours of life due to immature peripheral circulation and does not indicate urgent concern.
C. A newborn who is 24 hr post-delivery and has not passed meconium: Passage of meconium is expected within the first 24 hours, but a slight delay may occur in some healthy term infants. Monitoring and further evaluation may be needed, but it is not immediately critical.
D. A newborn who is 12 hr post-delivery and has a temperature of 100.5°F: Fever in a newborn can indicate infection or sepsis, which requires immediate assessment and intervention. Newborns have limited immune responses, making hyperthermia a priority concern requiring urgent attention.
Correct Answer is C
Explanation
A. Injection of factor X: Factor X is not deficient in hemophilia A. Administering it would not correct the coagulation defect or prevent bleeding in this child.
B. Intravenous infusion of iron: Iron is used to treat anemia, not acute bleeding episodes caused by coagulation factor deficiency. It would not address the immediate risk of joint or soft tissue hemorrhage.
C. Intravenous infusion of factor VIII: Hemophilia A is caused by a deficiency of clotting factor VIII. IV administration of factor VIII replaces the deficient protein, promotes clot formation, and prevents excessive bleeding after trauma such as a knee injury.
D. Intramuscular injection of iron using the Z-track method: IM injections are generally avoided in hemophilia patients due to the high risk of muscle hematoma. Iron would not stop active bleeding from a trauma-induced injury.
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