A pregnant woman is discussing positioning and the use of leg stirrups for delivery with a labor nurse. In which of the following instances should the nurse provide further information to the client?

Correct Answer: B

Rationale: B: The nurse should provide further information to the client when she states, "I heard that for doctors to deliver babies safely, it is essential to have the mother's legs up in stirrups." This statement is incorrect because the use of leg stirrups during delivery is not necessary for all women, and it is not the only safe way to deliver a baby. It is important for the nurse to educate the client that there are various positions for giving birth, and the use of stirrups is not always required. Providing this information will help the client make informed decisions about her delivery. A: The client stating, "I am glad that deliveries can take place in a variety of places, including a Jacuzzi bathtub," does not require further information from the nurse. While water births in Jacuzzi bathtubs are an option for some women, it is essential for the nurse to ensure that the client has accurate information about the safety and appropriateness of this delivery method. C: When the client mentions, "During difficult deliveries it is sometimes necessary to put a woman's legs up in stirrups," the nurse does not need to provide further information. This statement acknowledges that there are situations where using leg stirrups may be necessary, such as during a difficult delivery. However, it is still important for the nurse to discuss other potential positions and options with the client. D: The client stating, "I heard that midwives often deliver their patients either in the side-lying or squatting position," does not require further information from the nurse. This statement demonstrates that the client is aware of alternative birthing positions besides using leg stirrups. It is valuable for the nurse to affirm this knowledge and provide additional information if needed to support the client's understanding of birthing positions.

Correct Answer: A

Rationale: During the latent phase of labor, contractions are typically mild to moderate in intensity and occur at regular intervals. Choice A is correct because if the woman is able to talk and laugh during contractions, it indicates that her contractions are not yet intense or close enough together to signify active labor. This aligns with the characteristics of the latent phase. Choice B is incorrect because complaining about severe back labor is more indicative of active labor, where contractions are stronger and more frequent. This symptom is not typically associated with the latent phase of labor. Choice C is incorrect because performing effleurage (light circular stroking of the abdomen) during a contraction is a coping mechanism often used in active labor to help manage pain. In the latent phase, contractions are usually not intense enough to necessitate coping techniques like effleurage. Choice D is incorrect because the urge to defecate is more commonly associated with the later stages of labor as the baby descends and puts pressure on the rectum. In the latent phase, the woman is typically still able to walk around and may not yet feel the urge to bear down. In summary, the ability to talk and laugh during contractions is a key characteristic of the latent phase of labor, making choice A the correct answer. Choices B, C, and D are all more indicative of active labor or the later stages of labor, making them incorrect in this context.

Correct Answer: D

Rationale: Before a woman undergoes regional anesthesia, it is crucial for the nurse to monitor her blood pressure every 5 minutes for the first 15 minutes after the anesthesia is administered. This is because regional anesthesia can cause a sudden drop in blood pressure, known as hypotension, which can be dangerous for both the mother and the fetus. By monitoring blood pressure closely, the nurse can quickly identify any signs of hypotension and take appropriate action to prevent any complications. Assessing the fetal heart rate (Choice A) is important during labor and delivery, but it is not a necessary step immediately before regional anesthesia. Infusing 1000 cc of Ringer's lactate (Choice B) is also not a standard pre-anesthesia procedure and may not be indicated for every patient. Having the woman empty her bladder (Choice C) is a common pre-anesthesia step to prevent discomfort during the procedure, but it is not as critical as monitoring blood pressure in this situation. Overall, monitoring blood pressure every 5 minutes for the first 15 minutes after regional anesthesia is the most important action to ensure the safety and well-being of the mother and fetus during the procedure.

Correct Answer: D

Rationale: The correct answer is D: pH of 7.30. Fetal blood sampling is a test used to assess the well-being of the fetus during pregnancy. The pH of the fetal blood is a crucial indicator of the fetus's oxygenation status. A pH of 7.30 is within the normal range for fetal blood, indicating adequate oxygenation. Choice A, oxygen saturation of 99%, is not typically reported in fetal blood sampling tests. Oxygen saturation levels are more commonly measured in maternal blood tests. Choice B, Hgb of 11 gm/dL, is a measurement of hemoglobin levels which is not typically reported in fetal blood sampling tests. Hemoglobin levels are more relevant in assessing anemia in adults rather than in fetal blood tests. Choice C, serum glucose of 140 mg/dL, is a measurement of glucose levels which is also not typically reported in fetal blood sampling tests. Glucose levels are more commonly monitored in maternal blood tests for gestational diabetes. In summary, the correct answer is D because the pH of the fetal blood is a critical indicator of oxygenation status in the fetus, while the other choices are not typically reported in fetal blood sampling tests and are more relevant to maternal blood tests.

Correct Answer: C

Rationale: Performing yoga exercises is a nonpharmacological intervention recommended by nurse midwives to help a client at full term go into labor. Yoga exercises can help promote relaxation, reduce stress, and increase circulation, all of which can potentially help stimulate labor. Additionally, certain yoga poses can help open up the pelvis and encourage the baby to move into the optimal position for birth. Engaging in sexual intercourse is also a commonly recommended nonpharmacological intervention to help induce labor. Sexual intercourse can help release oxytocin, a hormone that can stimulate contractions. Additionally, semen contains prostaglandins which can help soften the cervix. Ingesting evening primrose oil is not typically recommended as a method to induce labor. While evening primrose oil is sometimes used to help ripen the cervix, there is limited scientific evidence to support its effectiveness in stimulating labor. Massaging the breast and nipples is not a commonly recommended method to induce labor. While nipple stimulation can help release oxytocin and stimulate contractions, it should be done under the supervision of a healthcare provider due to the potential risks of overstimulation and uterine hyperstimulation.