The nurse is explaining the physiology of uterine contractions to a group of nursing students. Which statement best explains the maternal-fetal exchange of oxygen and waste products during a contraction?

Correct Answer: D

Rationale: Rationale for Correct Answer (D): - During uterine contractions, placental blood flow may be temporarily reduced but not completely halted. - Fetal-maternal exchange of oxygen and waste products continues to occur even during contractions. - This is because the placenta acts as a continuous filter, allowing exchange to happen unless placental functions are severely compromised. Summary of Other Choices: A: Incorrect. There is an effect on maternal-fetal exchange during contractions. B: Incorrect. Increased blood pressure does not necessarily correlate with increased exchange. C: Incorrect. Compression of spiral arteries may impact blood flow but does not completely stop exchange.

Correct Answer: B

Rationale: The correct answer is B: Cervical dilation and effacement. This is because true labor is defined by progressive cervical changes, including dilation (opening of the cervix) and effacement (thinning of the cervix). These changes indicate that the body is preparing for childbirth. A: Bloody show may occur during early labor but is not a definitive indicator. C: Fetal descent into the pelvic inlet is a later event in labor. D: Uterine contractions every 7 minutes are not necessarily indicative of true labor as they need to be regular, increasing in frequency, intensity, and duration.

Correct Answer: B

Rationale: The correct answer is B: Active phase. At 6 cm dilation, the active phase of labor begins, where cervical dilation accelerates. In this phase, contractions become stronger and closer together, promoting effacement and descent of the baby. The latent phase (choice A) occurs at 0-6 cm dilation, characterized by slower progress. The second stage (choice C) is when the baby is born, not based on cervical dilation. The third stage (choice D) is the delivery of the placenta, not determined by cervical dilation. Therefore, at 6 cm dilation, the patient is in the active phase of labor.

Correct Answer: D

Rationale: The correct answer is D: umbilical cord compression. In a breech presentation, the baby's bottom or feet are positioned to come out first, which can lead to potential umbilical cord compression during labor. This compression can compromise fetal oxygenation and circulation, posing a serious risk to the baby's well-being. The other choices are incorrect because a breech presentation is not typically associated with more rapid labor (choice A), a high risk of infection (choice B), or maternal perineal trauma (choice C). It is important for healthcare providers to be vigilant in monitoring for signs of umbilical cord compression in cases of breech presentation to ensure the safety of both the mother and baby.

Correct Answer: B

Rationale: The correct answer is B because a white blood cell count of 28,000 mm3 postbirth indicates a possible infection, such as endometritis, which is a common postpartum complication. Elevated WBC count is a sign of an inflammatory process or infection, requiring further investigation and treatment. A: EBL of 500 mL is within the normal range for a vaginal delivery and may not necessarily indicate a concern. C: Patient complaints of fingers tingling may suggest temporary nerve compression or positional discomfort, not a significant concern post vaginal delivery. D: Patient complaining of thirst is a common symptom and not necessarily indicative of a complication post vaginal delivery.