What should the nurse encourage a woman in active labor to do?

Correct Answer: D

Rationale: In active labor, it is essential for the nurse to encourage the woman to shift to the next level of breathing techniques. This is because transitioning to a different breathing pattern can help the woman manage her pain and discomfort more effectively during labor. By focusing on her breathing, the woman can stay relaxed and in control, which can ultimately help progress labor. Option A, requesting an epidural, may provide pain relief but does not address the importance of breathing techniques in managing labor pain. It also involves medical intervention that may not be necessary if the woman can effectively utilize breathing techniques. Option B, requesting IV analgesics, also provides pain relief but does not address the holistic approach of incorporating breathing techniques for pain management. IV analgesics may have side effects that could affect the labor process. Option C, changing positions, is important during labor to help facilitate the progression of labor, but it does not specifically address the importance of breathing techniques. While changing positions can help alleviate pain and discomfort, it is not as directly related to pain management through breathing techniques as option D. Therefore, the best option for the nurse to encourage a woman in active labor to do is to shift to the next level of breathing techniques to help her effectively manage pain and discomfort during labor.

Correct Answer: C

Rationale: Direct sacral pressure is the correct answer because it specifically targets the pain associated with back labor. Back labor pain is caused by the baby pressing against the mother's spine during labor, resulting in intense lower back pain. By applying direct pressure to the sacrum, which is the triangular bone located at the base of the spine, the pressure from the baby can be relieved, thereby reducing the pain experienced by the mother. Breathing techniques, while helpful for managing pain during labor, may not specifically target the back pain experienced during back labor. Analgesics, such as pain medication, can help manage overall labor pain but may not specifically alleviate the back pain associated with back labor. Hydrotherapy, which involves using water for pain relief during labor, can help with overall pain management but may not directly target the back pain associated with back labor. In conclusion, direct sacral pressure is the most effective option for relieving back labor pain as it directly addresses the source of the pain. Breathing techniques, analgesics, and hydrotherapy may help manage pain during labor but may not specifically target the intense back pain experienced during back labor.

Correct Answer: A

Rationale: A doula's primary role is to provide physical, emotional, and informational support to pregnant individuals before, during, and after childbirth. Giving a back massage is an appropriate action for a doula because it can help alleviate discomfort, reduce stress, and promote relaxation during labor. This physical support can also help the individual cope with contractions and promote a sense of well-being. Assessing fetal heart rate (Choice B) is typically the responsibility of a healthcare provider, such as a midwife or obstetrician. This task requires specialized training and equipment to accurately monitor the baby's well-being during labor. Doulas are not qualified to interpret fetal heart rate patterns and should not attempt to do so. Assessing blood pressure (Choice C) is also a task that falls within the scope of practice of healthcare providers. Monitoring blood pressure is crucial for assessing the individual's overall health and detecting any potential complications during labor. Doulas do not have the training or equipment required to accurately measure blood pressure. Regulating IV (Choice D) involves administering intravenous fluids, medications, or other substances to support the individual during labor. This task should only be performed by trained medical professionals, such as nurses or doctors, who have the necessary knowledge and skills to safely manage IV therapy. Doulas do not have the qualifications to regulate IVs and should not attempt to do so. In conclusion, giving a back massage is an appropriate action for a doula because it aligns with their role of providing physical comfort and support during labor. Assessing fetal heart rate, blood pressure, and regulating IVs are tasks that should be left to healthcare professionals with the appropriate training and expertise.

Correct Answer: B

Rationale: If a client reports seeing blood-tinged mucus, the nurse's first priority should be to acknowledge the client's concerns (choice B). This is important because it shows empathy and validates the client's feelings, which can help establish trust and rapport. It also allows the nurse to gather more information from the client about the situation, such as how long it has been happening and if there are any other symptoms present. Assessing for a urinary tract infection (choice A) may be necessary at some point, but it is not the first step. The client's emotional well-being and concerns should be addressed before moving on to a physical assessment. Explaining that it is normal (choice C) may not be accurate and could potentially cause the client further distress. It is important for the nurse to gather more information and assess the situation before making any assumptions. Clarifying that it is not actual bleeding (choice D) may also be necessary, but it should not be the first action taken. The client's concerns should be acknowledged and addressed before providing any information or reassurance.

Correct Answer: A

Rationale: The correct sequence of cardinal moves of labor is internal rotation, extension, external rotation (Choice A). First, internal rotation is when the baby's head rotates to face the mother's back in order to navigate through the pelvis more easily. This is followed by extension, where the baby's head is able to pass under the pubic bone. Finally, external rotation occurs as the baby's head rotates back to its original position to facilitate delivery. Choice B (Descent, extension, external rotation) is incorrect because descent is not one of the cardinal moves of labor. Descent refers to the movement of the baby's head through the birth canal, but it is not a specific cardinal move in the sequence. Choice C (Flexion, internal rotation, extension) is incorrect because flexion, or the baby tucking their chin to their chest, is not one of the cardinal moves of labor. While flexion can occur during labor, it is not part of the specific sequence of cardinal moves. Choice D (Internal rotation, external rotation, expulsion) is incorrect because it skips the crucial step of extension, which is necessary for the baby to pass through the birth canal. Without extension, the baby's head cannot navigate under the pubic bone for delivery. In conclusion, the correct sequence of cardinal moves of labor is internal rotation, extension, external rotation, making Choice A the correct answer.