A patient who is 8 cm dilated develops circumoral numbness and dizziness. What is the nurse’s priority intervention?

Correct Answer: C

Rationale: The correct answer is C: Have the patient slow down her breathing. When a patient is 8 cm dilated and experiences circumoral numbness and dizziness, these are signs of hyperventilation caused by rapid breathing. Hyperventilation can lead to respiratory alkalosis, which can have serious implications for both the mother and baby. By having the patient slow down her breathing, it can help restore the balance of oxygen and carbon dioxide levels in the blood, reducing the risk of complications. Calling the healthcare provider immediately (choice A) may cause delay in addressing the immediate issue. Increasing intravenous fluid (choice B) is not indicated as the symptoms are not suggestive of hypovolemia. Having her start pushing (choice D) is not advisable as she is not fully dilated, and pushing prematurely can lead to complications.

Correct Answer: D

Rationale: The correct answer is D because residual amniotic fluid in the lungs can lead to a condition called transient tachypnea of the newborn (TTN), making spontaneous respirations difficult. This occurs more commonly in infants born via cesarean section before the onset of labor as they may not have had the opportunity to expel the fluid through the vaginal passage. A: Warm IV fluids can help maintain normal body temperature. B: Regional anesthesia may not directly cause respiratory depression in the infant. C: Maternal left tilt position is used to improve blood flow during labor, not relevant to respiratory issues in the newborn.

Correct Answer: B

Rationale: The correct answer is B: The fetus must be at least 34 weeks gestation. This is important because before using vacuum or forceps, the fetus should be mature enough to withstand the extraction process. Premature infants may not have fully developed skull bones to withstand the pressure, increasing the risk of injury. Explanation for other choices: A: The woman’s bladder is empty - While it's ideal for the bladder to be empty to prevent injury during the procedure, it's not a criteria that must be verified prior to vacuum or forceps use. C: There is a Category I tracing - Fetal heart rate monitoring is important during labor, but the tracing being Category I does not specifically correlate with the need for vacuum or forceps. D: The cervix must be completely dilated - While full cervical dilation is necessary for vaginal delivery, it is not a specific criteria to verify before vacuum or forceps use.

Correct Answer: C

Rationale: Step 1: In multiparous women, the uterus has gone through labor before, making muscle coordination more efficient. Step 2: Efficient muscle coordination helps in effective contractions, leading to faster labor progress. Step 3: Multiparous women have experienced labor before, allowing the uterus to contract more effectively. Step 4: This efficiency in muscle coordination is why precipitous labor is more often seen in multiparous women. Summary: A: The weakening of the cervix after each delivery is not a direct cause of precipitous labor. B: The ability of the cervix to dilate and efface simultaneously does not explain why precipitous labor is more common in multiparous women. D: The difficulty in knowing when labor begins is not a reason for the occurrence of precipitous labor in multiparous women.

Correct Answer: C

Rationale: The correct answer is C: Sitting on birthing ball. This position helps to open up the pelvis, allowing for optimal fetal positioning and descent. It also helps relieve pressure on the cervix, promoting dilation. Ambulation (A) may slow down labor progress, squatting (B) can increase pressure on the cervix and hinder descent, and resting on hands and knees (D) may not be as conducive to gravity-assisted descent.