How will the nurse determine if the person is in the active second stage of labor?

Correct Answer: C

Rationale: During the active second stage of labor, the cervix is fully dilated to 10 centimeters, allowing for the baby to pass through the birth canal. This is the stage where the woman experiences strong, regular contractions and has the urge to push. Therefore, assessing for dilation of the cervix is crucial in determining if the person is in the active second stage of labor. Assessing for rupture of membranes (choice A) is more relevant in the first stage of labor when the amniotic sac breaks, releasing amniotic fluid. This event typically occurs before the active stage of labor and helps to confirm that labor has begun. Assessing for bloody show (choice B) is also more indicative of the early stage of labor. Bloody show is a mixture of blood and mucus that is expelled from the cervix as it begins to soften and dilate. While it can occur in the active stage of labor, it is not a definitive sign that the woman has progressed to the second stage. Assessing for stool (choice D) is not a reliable indicator of the active second stage of labor. While some women may have a bowel movement during labor, it is not a consistent or defining characteristic of this stage. In conclusion, the correct answer is to assess for dilation of the cervix (choice C) because it is a key indicator that the person is in the active second stage of labor.

Correct Answer: D

Rationale: After the placenta is delivered, a decrease in blood pressure in the birthing person could indicate potential complications such as postpartum hemorrhage. This is a serious condition that requires immediate attention and intervention. Checking for possible hemorrhage should be the priority in this situation. Choice A, the birthing person being in pain, is less likely to cause a significant decrease in blood pressure after the placenta is delivered. Pain management can be addressed separately but should not be the immediate concern in this scenario. Choice B, placing the newborn skin-to-skin, is important for bonding and temperature regulation but is not directly related to addressing the birthing person's decrease in blood pressure. This action can be taken after addressing the potential hemorrhage. Choice C, the bladder being distended, could potentially cause discomfort but is not likely to be the main reason for a decrease in blood pressure after the placenta is delivered. Emptying the bladder may be necessary but is not the immediate priority. In summary, when a birthing person experiences a decrease in blood pressure after the placenta is delivered, the nurse should first check for possible hemorrhage as this could be a life-threatening complication that requires immediate attention and intervention.

Correct Answer: C

Rationale: Having support people present during labor can have a significant impact on the birthing experience and outcomes. Option A states that the presence of support people will improve the experience of the birthing person. This is partially true as support people can provide emotional and physical support, but it is not the only effect. Option B suggests that the presence of support people will improve the outcomes of the birthing person. While support during labor can lead to better outcomes such as reduced labor times and decreased need for interventions, it is not the complete picture. Option D is incorrect as it states that having support people present will cause birth trauma and/or postpartum depression. This is not supported by evidence. In fact, having a supportive presence during labor has been shown to reduce the risk of postpartum depression and can help prevent birth trauma. The correct answer is C because having support people present during labor can improve both the experience and outcomes of the birthing person. Support people can provide comfort, advocacy, and encouragement, leading to a more positive birth experience. Additionally, having a supportive presence has been linked to better birth outcomes, such as lower rates of interventions and complications. Overall, having support people present during labor can have a dual benefit of improving both the experience and outcomes for the birthing person.

Correct Answer: A

Rationale: A fetal heart rate (FHR) within the normal baseline typically ranges from 110-160 beats per minute (bpm). Choice A, 135 bpm, falls within this range and is considered a normal baseline FHR. This range is indicative of a healthy, oxygenated fetus. Choice B, 95 bpm, is below the normal baseline range and could indicate fetal distress or hypoxia. A FHR below 110 bpm may require further evaluation and monitoring to ensure the well-being of the fetus. Choice C, 170 bpm, is above the normal baseline range and could indicate fetal tachycardia. Fetal tachycardia can be caused by maternal fever, fetal infection, or maternal anxiety. It is important to investigate the cause of tachycardia and monitor closely for any signs of distress. Choice D, 105 bpm, falls within the lower end of the normal baseline range but is still within the normal range. However, it is not the best answer as 135 bpm is more representative of a typical normal baseline FHR. It is important to note that FHR can vary based on gestational age, maternal factors, and fetal well-being.

Correct Answer: C

Rationale: Intermittent auscultation is the correct answer because it allows for more patient mobility and freedom of movement during labor. With intermittent auscultation, the healthcare provider uses a handheld Doppler or fetoscope to listen to the fetal heart rate at regular intervals, typically every 15-30 minutes in active labor. This method does not restrict the mother's movement as she can change positions, walk, or use a birthing ball without being attached to any monitors or devices. Option A, internal electronic monitor, is incorrect because it involves placing a fetal scalp electrode or intrauterine pressure catheter (IUPC) inside the mother's uterus, which restricts her movement and limits her ability to change positions freely. This option is more invasive and is typically used in high-risk situations where continuous fetal monitoring is necessary. Option B, external electronic monitor, is also incorrect because it involves attaching external monitors to the mother's abdomen to monitor the fetal heart rate and uterine contractions continuously. While this method provides continuous monitoring, it restricts the mother's movement and may limit her ability to change positions comfortably. Option D, IUPC and scalp electrode, is incorrect for similar reasons as option A. Both IUPC and scalp electrodes are invasive methods of monitoring that restrict the mother's mobility and freedom of movement during labor. These methods are typically reserved for high-risk situations where continuous and more accurate monitoring is needed. In summary, intermittent auscultation is the preferred method for monitoring fetal heart rate in low-risk pregnancies as it allows for more patient mobility and freedom of movement during labor compared to the other options mentioned.