The laboring person asks the nurse to review the birth plan. What item is on a typical birth plan?

Correct Answer: C

Rationale: In maternal newborn nursing, a birth plan is a crucial tool that allows the laboring person to communicate their preferences and desires for labor and delivery. Option C, "what position they want to birth in," is typically found on a birth plan because it empowers the laboring person to choose a position that is most comfortable and conducive to their birthing experience. This choice can help facilitate labor progress and decrease discomfort. Option A, "where the patient will be staying after birth," is not typically included in a birth plan as it pertains more to postpartum care and logistics rather than the labor and delivery process. Option B, "who will be watching their other children," is also not typically included in a birth plan as it relates more to personal support and childcare arrangements rather than the birthing process itself. Option D, "how they will time contractions," is important during labor but is not typically included in a birth plan as it is more of a practical aspect of labor management rather than a preference or choice. Educationally, understanding the components of a birth plan is essential for nurses caring for laboring individuals as it allows for respectful and patient-centered care. By honoring the preferences outlined in a birth plan, nurses can support the laboring person in achieving a positive birth experience. It is important for nurses to communicate effectively with laboring individuals to ensure their birth plan preferences are respected and implemented whenever possible.

Correct Answer: C

Rationale: The gate control theory of pain proposes that non-painful input can close the "gates" to painful input, which helps to control and reduce pain perception. Massage, such as massaging the client's back, is a non-pharmacological intervention that can help close the gates and reduce the perception of pain. By massaging the client's back, the nurse is applying this theory to help manage the client's labor pain. Administering analgesic medication (Choice A) is a pharmacological intervention and not specifically related to the gate control theory. Choices B and D are also beneficial nursing actions but do not directly relate to the gate control theory of pain.

Correct Answer: A

Rationale: Cervical dilation is a key physiological change that confirms labor has begun. During the late stages of pregnancy, the cervix starts to soften, thin out (efface), and open up (dilate) in preparation for childbirth. Therefore, cervical dilation is a critical finding that indicates the onset of labor. Pain above the umbilicus, brownish vaginal discharge, and amniotic fluid in the vaginal vault are not definitive signs of labor and do not confirm the initiation of the labor process.

Correct Answer: B

Rationale: The correct response, option B, "It is molding caused by the pressure during birth and will disappear in a few days," is the most appropriate because it accurately addresses the mother's concerns about the baby's head shape. During birth, the baby's head may undergo molding due to the pressure exerted on it as it passes through the birth canal. This molding can lead to a temporary change in the shape of the baby's head. It is a normal physiological process and typically resolves within a few days as the baby's skull bones are flexible and can shift to accommodate the birth process. Option A, "You don't need to worry about it. It is perfectly normal after birth," is incorrect because it dismisses the mother's concerns without providing her with a proper explanation. Option C, "I will report it to the physician and recommend a diagnostic scan," is unnecessary as molding of the head is a common occurrence after birth and does not typically require diagnostic imaging. Option D, "It is a collection of blood related to the trauma of delivery and will absorb in a few weeks," is incorrect as it describes a different condition known as cephalohematoma, which is not the cause of a "cone head" appearance. In an educational context, it is essential for nurses to provide accurate and reassuring information to parents regarding newborn care and common postpartum changes. Understanding the normal variations in newborn appearance can help alleviate parental anxiety and promote bonding between parents and their newborn. Educating parents about molding of the head can empower them to care for their newborn confidently during the early postpartum period.

Correct Answer: A

Rationale: The large black and blue areas on the buttocks and legs of the newborn are likely Mongolian spots. Mongolian spots are common in infants with dark skin and are not a result of birth trauma. They are benign birthmarks caused by pigment that did not make it to the top layer of the skin before birth. These spots typically fade over time and may disappear completely within a few years. It is important to educate parents about Mongolian spots to alleviate any concerns they may have about their baby's skin markings.