A primigravida at 39 weeks of gestation is observed for 2 hours in the intrapartum unit.

The fetal heart rate has been normal.

Contractions are 10 to 15 minutes apart, 20 to 30 seconds in duration, and of mild intensity.

Cervical dilation is 1 to 2 cm and uneffaced (unchanged from admission). Membranes are intact.

The nurse should expect the woman to be:

Choice A rationale
Valsalva maneuver involves forced expiration against a closed airway, increasing intrathoracic pressure and used to aid in expelling the fetus during labor.
Choice B rationale
Ferguson’s reflex involves the release of oxytocin due to vaginal and cervical stretching, resulting in stronger contractions during the second stage of labor.
Choice C rationale
Lightening refers to the descent of the fetus into the pelvis before labor, relieving pressure on the diaphragm and easing breathing.
Choice D rationale
Molding is the slight overlapping of cranial bones, allowing the fetal head to shape and fit through the birth canal during labor.

Choice A rationale
The occiput anterior position is optimal for labor and birth due to the fetal head's alignment with the maternal pelvis, reducing resistance and facilitating descent through the birth canal.
Choice B rationale
The occiput posterior position can lead to prolonged labor and increased discomfort because the fetal head does not align with the maternal pelvis as effectively as in the anterior position.
Choice C rationale
The mentum posterior position is uncommon and often requires medical intervention, as the chin-first presentation can obstruct labor progression and prevent the fetus from passing through the birth canal.
Choice D rationale
The occiput transverse position may result in a difficult labor due to the fetal head being oriented sideways, hindering descent and potentially necessitating medical assistance or operative delivery.