Ricci, Kyle & Carman: Maternity and Pediatric Nursing, Second Edition: Ch
ter 21: Nursing Management of Labor and Birth at Risk; PrepU
Study online at https://quizlet.com/_32wsbm
1. A 26-year-old primigravida occiput posterior position
has brought her doula to A labor complicated by occiput posterior position is usually pro-
the birthing center for sup- longed and characterized by maternal perception of increased
port during her labor and intensity of back discomfort. The lay term for this type of labor is
birth. The doula has been "back labor."
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 comfort-
ing when her doula uses
the ball of her hand to
put counterpressure on her
lower back. What is the like-
ly cause of the woman's
back pain?
2. Which action would be most Provide ongoing communication about what is happening.
appropriate for the woman
who experiences dysfunc- Dysfunctional labor at any point is frustrating to women. Maintain-
tional labor in the first stage ing open lines of communication at least keeps the woman well
of labor? informed about what is happening.
3. A nursing student correct- occiput anterior
ly identifies the most de- Any presentation other than occiput anterior or a slight variation of
sirable position to promote the fetal position or size increases the probability of dystocia.
an easy birth as which posi-
tion?
, Ricci, Kyle & Carman: Maternity and Pediatric Nursing, Second Edition: Ch
ter 21: Nursing Management of Labor and Birth at Risk; PrepU
Study online at https://quizlet.com/_32wsbm
4. A client with a pendulous transverse lie
abdomen and uterine fi-
broid tumors had just be- A transverse lie, in which the fetus is more horizontal than vertical,
gun labor and arrived at occurs in women with pendulous abdomens, with uterine fibroid
the hospital. After examin- tumors that obstruct the lower uterine segment, with contraction
ing the client, the primary of the pelvic brim, with congenital abnormalities of the uterus, or
care provider informs the with hydramnios. Anterior fetal position and cephalic presentation
nurse that the fetus ap- are normal conditions. Occipitoposterior position tends to occur in
pears to be malpositioned women with android, anthropoid, or contracted pelves.
in the uterus. Which fe-
tal position or presentation
should the nurse most ex-
pect in this woman?
5. A client in week 38 of external cephalic version
her pregnancy has an ultra-
sound performed at a rou- External cephalic version is the turning of a fetus from a breech
tine office visit and learns to a cephalic position before birth. It may be done as early as 34
that her fetus has not to 35 weeks, although the usual time is 37 to 38 weeks of preg-
moved out of a breech po- nancy. A trial birth is performed when a woman has a borderline
sition. Which intervention (just adequate) inlet measurement and the fetal lie and position
does the nurse anticipate are good and involves allowing labor to take its normal course
for this client? 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.
6. Hypertonic labor is la- Turn off the pitocin.
bor that is characterized
by short, irregular contrac- Hypertonic labor may result from an increased sensitivity of uterine
muscle to oxytocin induction or augmentation. Treatment for this
, Ricci, Kyle & Carman: Maternity and Pediatric Nursing, Second Edition: Ch
ter 21: Nursing Management of Labor and Birth at Risk; PrepU
Study online at https://quizlet.com/_32wsbm
tions without complete re- iatrogenic cause of hypertonic labor is to decrease or shut off the
laxation of the uterine wall oxytocin infusion.
in between contractions.
Hypertonic labor can be
caused by an increased sen-
sitivity to oxytocin. What
would the nurse do for a
client who is in hyperton-
ic labor because of oxytocin
augmentation?
7. Which action could the Massage her lower back.
nurse initiate to reduce the
discomfort of a woman in Counterpressure against the woman's back by a support person
labor whose fetus is in an can be helpful in reducing this type of pain.
occiput posterior position?
8. When caring for a client re- potential lacerations and bleeding.
quiring a forceps-assisted
birth, the nurse would be Forcible rotation of the forceps can cause potential lacerations and
alert for: 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 entan-
glement in multiple pregnancies. Damage to the maternal tissues
happens if the cup slips off the fetal head and the suction is not
released.
9. A woman whose fetus in applying counter pressure to the back
in the occiput-posterior po- Counter pressure applied to the lower back with a fisted hand
sition is experiencing in- sometimes helps the woman cope with "back labor" associated
creased back pain. Which is with occiput-posterior positioning. The others are not recommend-
the best way for the nurse ed or used techniques for a woman in labor with back pain.
ter 21: Nursing Management of Labor and Birth at Risk; PrepU
Study online at https://quizlet.com/_32wsbm
1. A 26-year-old primigravida occiput posterior position
has brought her doula to A labor complicated by occiput posterior position is usually pro-
the birthing center for sup- longed and characterized by maternal perception of increased
port during her labor and intensity of back discomfort. The lay term for this type of labor is
birth. The doula has been "back labor."
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 comfort-
ing when her doula uses
the ball of her hand to
put counterpressure on her
lower back. What is the like-
ly cause of the woman's
back pain?
2. Which action would be most Provide ongoing communication about what is happening.
appropriate for the woman
who experiences dysfunc- Dysfunctional labor at any point is frustrating to women. Maintain-
tional labor in the first stage ing open lines of communication at least keeps the woman well
of labor? informed about what is happening.
3. A nursing student correct- occiput anterior
ly identifies the most de- Any presentation other than occiput anterior or a slight variation of
sirable position to promote the fetal position or size increases the probability of dystocia.
an easy birth as which posi-
tion?
, Ricci, Kyle & Carman: Maternity and Pediatric Nursing, Second Edition: Ch
ter 21: Nursing Management of Labor and Birth at Risk; PrepU
Study online at https://quizlet.com/_32wsbm
4. A client with a pendulous transverse lie
abdomen and uterine fi-
broid tumors had just be- A transverse lie, in which the fetus is more horizontal than vertical,
gun labor and arrived at occurs in women with pendulous abdomens, with uterine fibroid
the hospital. After examin- tumors that obstruct the lower uterine segment, with contraction
ing the client, the primary of the pelvic brim, with congenital abnormalities of the uterus, or
care provider informs the with hydramnios. Anterior fetal position and cephalic presentation
nurse that the fetus ap- are normal conditions. Occipitoposterior position tends to occur in
pears to be malpositioned women with android, anthropoid, or contracted pelves.
in the uterus. Which fe-
tal position or presentation
should the nurse most ex-
pect in this woman?
5. A client in week 38 of external cephalic version
her pregnancy has an ultra-
sound performed at a rou- External cephalic version is the turning of a fetus from a breech
tine office visit and learns to a cephalic position before birth. It may be done as early as 34
that her fetus has not to 35 weeks, although the usual time is 37 to 38 weeks of preg-
moved out of a breech po- nancy. A trial birth is performed when a woman has a borderline
sition. Which intervention (just adequate) inlet measurement and the fetal lie and position
does the nurse anticipate are good and involves allowing labor to take its normal course
for this client? 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.
6. Hypertonic labor is la- Turn off the pitocin.
bor that is characterized
by short, irregular contrac- Hypertonic labor may result from an increased sensitivity of uterine
muscle to oxytocin induction or augmentation. Treatment for this
, Ricci, Kyle & Carman: Maternity and Pediatric Nursing, Second Edition: Ch
ter 21: Nursing Management of Labor and Birth at Risk; PrepU
Study online at https://quizlet.com/_32wsbm
tions without complete re- iatrogenic cause of hypertonic labor is to decrease or shut off the
laxation of the uterine wall oxytocin infusion.
in between contractions.
Hypertonic labor can be
caused by an increased sen-
sitivity to oxytocin. What
would the nurse do for a
client who is in hyperton-
ic labor because of oxytocin
augmentation?
7. Which action could the Massage her lower back.
nurse initiate to reduce the
discomfort of a woman in Counterpressure against the woman's back by a support person
labor whose fetus is in an can be helpful in reducing this type of pain.
occiput posterior position?
8. When caring for a client re- potential lacerations and bleeding.
quiring a forceps-assisted
birth, the nurse would be Forcible rotation of the forceps can cause potential lacerations and
alert for: 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 entan-
glement in multiple pregnancies. Damage to the maternal tissues
happens if the cup slips off the fetal head and the suction is not
released.
9. A woman whose fetus in applying counter pressure to the back
in the occiput-posterior po- Counter pressure applied to the lower back with a fisted hand
sition is experiencing in- sometimes helps the woman cope with "back labor" associated
creased back pain. Which is with occiput-posterior positioning. The others are not recommend-
the best way for the nurse ed or used techniques for a woman in labor with back pain.
