What may the birthing person experience during the third stage of labor?

Correct Answer: B

Rationale: During the third stage of labor, the birthing person will experience the expulsion of the placenta. Choice A is incorrect because the fetus is already delivered during the second stage of labor, not the third stage. Choice B is correct because the birthing person will indeed experience cramping, a gush of fresh vaginal bleeding, and lengthening of the umbilical cord during the third stage of labor. The cramping is caused by the uterus contracting to expel the placenta, the gush of fresh vaginal bleeding is due to the separation of the placenta from the uterine wall, and the lengthening of the umbilical cord occurs as the placenta is delivered. Choice C is incorrect because dyspnea, which refers to difficulty breathing, is not a common symptom experienced during the third stage of labor. Choice D is incorrect because increased blood pressure and pain due to expulsive efforts are more commonly associated with the first and second stages of labor, not the third stage when the placenta is being delivered. In conclusion, choice B is the correct answer as it accurately describes what the birthing person may experience during the third stage of labor, while the other choices do not accurately reflect this stage of labor.

Correct Answer: C

Rationale: A doula is a trained professional who provides physical, emotional, and informational support to women before, during, and after childbirth. The correct answer is C because suggesting a doula when the support person is in the military and unable to attend the birth ensures that the patient has continuous support during labor. This is important as having a supportive presence during childbirth has been shown to improve outcomes for both the mother and baby. Option A is incorrect because suggesting a doula solely based on the patient asking for an epidural does not address the patient's need for continuous support throughout labor. While a doula can certainly help with pain management techniques, their role is much broader than just assisting with pain relief. Option B is incorrect because if the nurse is unable to provide adequate support, it is their responsibility to seek additional resources or assistance within the healthcare team, rather than passing this responsibility onto a doula. The primary role of a nurse is to ensure the safety and well-being of the patient, so they should not rely on a doula to fulfill their own responsibilities. Option D is incorrect because suggesting a doula solely based on the patient having an emergency cesarean birth does not address the patient's need for support during labor. While a doula can certainly provide emotional support during a cesarean birth, their role is not limited to specific circumstances but rather to support the patient throughout the entire childbirth experience.

Correct Answer: A

Rationale: Early decelerations are a type of FHR deceleration that are considered benign and are actually a sign of possible fetal descent. These decelerations typically mirror the contractions during labor, meaning they start and end at the same time as the contraction. This is because early decelerations are caused by head compression during contractions, which stimulates the vagus nerve and leads to a reflex slowing of the fetal heart rate. Late decelerations, on the other hand, are a concerning type of FHR deceleration that occur after the peak of the contraction. They are often associated with uteroplacental insufficiency and are not a sign of fetal descent, but rather a sign of fetal distress. Variable decelerations are another type of FHR deceleration that are caused by cord compression. They are characterized by an abrupt and sharp decrease in the fetal heart rate, followed by a rapid return to baseline. Variable decelerations are typically not associated with fetal descent. Prolonged decelerations are FHR decelerations that last longer than 2 minutes but less than 10 minutes. They are often caused by various factors such as cord compression, maternal hypotension, or uterine hyperstimulation. Prolonged decelerations are not specifically indicative of fetal descent.

Correct Answer: B

Rationale: An intrauterine pressure catheter (IUPC) is the correct choice for measuring the strength of a contraction. This device is inserted into the uterus and directly measures the pressure generated by the contractions. This provides a more accurate measurement compared to other methods. Option A, a fetal scalp electrode, is used to monitor fetal heart rate and is not designed to measure the strength of contractions. It is important for assessing the well-being of the fetus during labor, but it does not provide information about the strength of contractions. Option C, a toco (tocodynamometer), is a device placed on the maternal abdomen to monitor uterine contractions by measuring changes in abdominal contour. While it can detect the frequency and duration of contractions, it does not provide an accurate measurement of the strength of contractions. Option D, ultrasound, is not used to measure the strength of contractions. Ultrasound is typically used to visualize structures inside the body, such as the fetus and placenta, but it does not directly measure the strength of uterine contractions. In summary, the intrauterine pressure catheter is the most appropriate choice for measuring the strength of contractions because it directly measures the pressure inside the uterus. The other options are not designed for this specific purpose and do not provide the same level of accuracy in assessing contraction strength.

Correct Answer: A

Rationale: Cardiac arrhythmia is the correct answer because it refers to abnormal heart rhythms that can affect the fetal heart rate tracing. This can manifest as irregular, fast, or slow heartbeats, leading to abnormal patterns in the tracing. Cardiac arrhythmias can be caused by various factors such as maternal medications, maternal medical conditions, or fetal factors. Monitoring and identifying cardiac arrhythmias are crucial to ensure the well-being of the fetus during labor and delivery. Fetal hypoxia, on the other hand, refers to a condition where the fetus is not receiving enough oxygen. While fetal hypoxia can lead to abnormal heart rate tracings, it is not the cause of the abnormal tracing in this scenario. Fetal hypoxia can be caused by factors such as placental insufficiency, umbilical cord compression, or maternal hypotension. Uterine rupture is a rare but serious complication that can occur during labor. It involves a tear in the wall of the uterus, leading to severe pain, fetal distress, and abnormal heart rate tracings. However, uterine rupture typically presents with a sudden and dramatic change in the fetal heart rate tracing, which is not described in the scenario provided. Labor dystocia refers to difficult or abnormal labor progression. This can result in prolonged labor, maternal exhaustion, and fetal distress. While labor dystocia can lead to abnormal heart rate tracings due to the stress placed on the fetus during prolonged labor, it is not the primary cause of the abnormal tracing described in the scenario. In conclusion, the correct answer is cardiac arrhythmia because it directly affects the fetal heart rate tracing, leading to abnormal patterns. Fetal hypoxia, uterine rupture, and labor dystocia can also result in abnormal heart rate tracings, but they are not the primary cause in this specific scenario.