What changes in hormones initiate labor?

Correct Answer: D

Rationale: During labor, the body undergoes hormonal changes that help initiate and regulate the process. The correct answer is D because it accurately reflects the hormonal changes that occur. - Decreased progesterone: Progesterone levels drop before labor begins because progesterone inhibits uterine contractions. A decrease in progesterone allows the uterus to become more sensitive to other hormones that stimulate contractions. - Increased estrogen: Estrogen levels rise towards the end of pregnancy, which helps stimulate the production of oxytocin receptors in the uterus. This increase in estrogen also contributes to the ripening of the cervix in preparation for labor. - Effects of oxytocin: Oxytocin is a key hormone in labor, as it stimulates uterine contractions. As labor progresses, the body releases more oxytocin to help the uterus contract effectively and push the baby through the birth canal. Now, let's discuss why the other options are incorrect: - A: Decreased estrogen is incorrect because estrogen levels actually rise during late pregnancy. Additionally, the presence of oxytocin - not the absence - is necessary for the initiation of labor. - B: This option correctly includes the decreased progesterone, but it incorrectly states that estrogen levels decrease, which is inaccurate. Additionally, the absence of oxytocin is not a factor in labor initiation. - C: While this option correctly identifies the increased progesterone and decreased estrogen, the presence of oxytocin is essential for labor to begin. Without oxytocin, the contractions needed for labor would not occur. In conclusion, the correct answer is D because it accurately reflects the hormonal changes that occur during labor, including the decreased progesterone, increased estrogen, and effects of oxytocin.

Correct Answer: A

Rationale: Option A is the correct answer because it demonstrates effective communication and empathy towards the family members in the labor room. By educating the family that the pain experienced during labor is normal, the nurse can help them understand the process better and provide emotional support to both the laboring person and their family. This approach fosters a sense of inclusion and involvement in the birthing experience. Option B is incorrect because asking all family members to leave the room can create tension and conflict, especially if they are important sources of support for the laboring person. It is important to respect the wishes of the laboring person regarding who they want present during labor. Option C is incorrect because suggesting that the laboring person get an epidural to make them more comfortable may not align with their birth plan or preferences. It is essential to respect the autonomy and choices of the laboring person during childbirth. Option D is incorrect because assuming that the laboring person wants their family in the room without discussing it with them can lead to discomfort and stress during labor. It is crucial for the nurse to communicate openly with the laboring person and their family to ensure that everyone feels supported and respected during the birthing process.

Correct Answer: B

Rationale: Late decelerations are associated with fetal hypoxia. Late decelerations occur after the peak of the uterine contraction and can indicate decreased oxygen supply to the fetus. This is because late decelerations are caused by uteroplacental insufficiency, where there is a decrease in blood flow and oxygen to the placenta. This results in a delayed response from the fetus in reducing its heart rate, hence the term "late" deceleration. Early decelerations (choice A) are caused by head compression during contractions and are considered benign and not associated with fetal hypoxia. These decelerations mirror the contraction pattern and are typically reassuring. Variable decelerations (choice C) are caused by umbilical cord compression and can indicate fetal hypoxia if they are persistent, severe, or associated with other abnormal patterns. However, they are not specifically associated with fetal hypoxia like late decelerations. Accelerations (choice D) are an increase in the FHR above the baseline and are considered a reassuring sign of fetal well-being. They are typically seen with fetal movement and are not associated with fetal hypoxia. In summary, late decelerations are the only type of deceleration specifically associated with fetal hypoxia due to uteroplacental insufficiency, making them the correct answer. Early decelerations are benign, variable decelerations are caused by cord compression, and accelerations are reassuring signs of fetal well-being.

Correct Answer: A

Rationale: Leopold's maneuvers are a set of four steps used to determine the position of the fetus in the uterus during pregnancy. The correct answer is A because Leopold's maneuvers can help identify whether the fetal head or buttocks are in the uterine fundus, which is the top portion of the uterus. This information is crucial for determining the baby's presentation, such as whether it is in a cephalic (head-first) or breech (bottom-first) position. Choice B, location of the placenta, is incorrect because Leopold's maneuvers do not provide information about the placenta's location. The placenta's position is typically determined through methods such as ultrasound imaging. Choice C, stage of labor, is also incorrect because Leopold's maneuvers are performed during pregnancy, not labor. They are used to assess the fetus's position before delivery, not to determine the stage of labor. Choice D, detection of fetal movement, is incorrect because Leopold's maneuvers do not involve feeling for fetal movement. Fetal movement can be assessed through methods such as fetal kick counts or ultrasound monitoring. Leopold's maneuvers focus on the fetus's position within the uterus, specifically whether the head or buttocks are in the uterine fundus.

Correct Answer: A

Rationale: Intermittent auscultation is the correct choice because it is a non-invasive method of monitoring fetal heart rate during labor. This involves using a handheld Doppler device or a fetoscope to listen to the baby's heart rate at regular intervals. It is a safe and effective way to monitor the baby's well-being without continuous electronic monitoring. External monitoring, on the other hand, involves using belts placed on the mother's abdomen to monitor fetal heart rate and contractions. While external monitoring can provide continuous data, it is not always necessary and can sometimes be less accurate than intermittent auscultation. Internal monitoring involves placing a fetal scalp electrode on the baby's head to directly monitor the heart rate. This method is more invasive than both intermittent auscultation and external monitoring, and carries a higher risk of infection and other complications. Intrauterine pressure monitoring is a method used to measure the strength and duration of contractions during labor. This involves placing a catheter inside the uterus to monitor the pressure changes. While this can provide useful information about the progress of labor, it is not a type of monitoring that can offer information specifically about the baby's well-being, making it less relevant to the question at hand. Overall, intermittent auscultation is the preferred method of monitoring in many cases because it is non-invasive, safe, and effective at assessing fetal well-being during labor.