What type of monitoring can you offer?

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.

Correct Answer: D

Rationale: Starting an IV fluid bolus is the correct intervention in this scenario. When a pregnant woman presents with decreased fetal movement, it may indicate fetal distress, which could be due to poor oxygenation. Administering IV fluids can help increase blood flow to the fetus, improving oxygenation and potentially increasing fetal movement. Administering antibiotics (choice A) would not be the correct intervention in this situation because decreased fetal movement is not typically an indication for antibiotics. Antibiotics are typically used to treat infections, not fetal distress. Increasing oxytocin (choice B) would also not be the correct intervention. Oxytocin is a hormone that is typically used to induce or augment labor, not to address decreased fetal movement. In fact, increasing oxytocin could potentially exacerbate fetal distress. Performing fetal scalp stimulation (choice C) involves applying pressure to the fetal scalp to elicit a response in the fetus. While this can be a useful technique to assess fetal well-being, it is not the most appropriate initial intervention when decreased fetal movement is noted. Starting with IV fluids to improve oxygenation is more essential in this situation. In conclusion, starting an IV fluid bolus is the most appropriate intervention when a pregnant woman presents with decreased fetal movement. This intervention aims to improve oxygenation to the fetus, potentially addressing the underlying cause of fetal distress. Administering antibiotics, increasing oxytocin, and performing fetal scalp stimulation are not the most appropriate initial interventions in this scenario.

Correct Answer: C

Rationale: Terbutaline is a medication commonly used in obstetrics to relax the uterus and prevent or treat tachysystole, which is defined as excessive uterine contractions. Choice C, tachysystole with decelerations in FHR, is the correct indication for administering terbutaline because it helps to slow down the contractions and improve fetal heart rate patterns. Choice A, early decelerations, is not an indication for terbutaline because early decelerations are typically a normal response to head compression during labor and do not require intervention with terbutaline. Choice B, insufficient labor pattern, is not an indication for terbutaline either. Insufficient labor pattern refers to slow progress in labor, which may require artificial oxytocin (Pitocin) to stimulate contractions, not terbutaline to slow them down. Choice D, fetal tachycardia, is also not an indication for terbutaline. Fetal tachycardia is an increased fetal heart rate above 160 bpm and can be caused by various factors such as maternal fever or fetal distress, but terbutaline is not used to treat this condition. Terbutaline is specifically used for uterine relaxation in cases of tachysystole to improve fetal heart rate patterns.

Correct Answer: A

Rationale: A: Lavender oil is a commonly used essential oil known for its calming and relaxing properties. The scent of lavender has been shown to reduce anxiety and promote relaxation, making it an effective option for laboring individuals looking to manage stress and discomfort during labor. B: An epidural is a form of regional anesthesia commonly used during labor to provide pain relief. While an epidural can help manage pain, it does not specifically target relaxation or anxiety reduction, making it a less suitable option for individuals looking for holistic approaches to labor support. C: Nalbuphine hydrochloride (Nubain) is an opioid analgesic used for pain management during labor. While it can help reduce pain, opioids can have side effects such as drowsiness, nausea, and potential respiratory depression, which may not align with the goal of promoting relaxation and reducing anxiety. D: A cold rag is a non-pharmacological comfort measure that can provide temporary relief from heat or discomfort during labor. While it may offer some physical comfort, it does not address the emotional and psychological aspects of anxiety and relaxation that lavender oil can target effectively. In conclusion, lavender oil is the most appropriate choice among the options provided as it specifically targets relaxation and anxiety reduction, making it a suitable holistic approach for labor support.

Correct Answer: A

Rationale: Encouraging the person to breathe however is most comfortable (Option A) is the correct choice because open glottis breathing during pushing allows for more effective pushing and reduces the risk of maternal and fetal complications. By allowing the person to breathe as they feel is best, the nurse supports the natural process of labor and helps the person to push effectively. This option also empowers the person to listen to their body and adjust their breathing pattern as needed. Option B, telling the person to hold their breath for 10 counts, is incorrect because holding the breath during pushing can increase intra-abdominal pressure, decrease blood flow to the uterus, and lead to decreased oxygen supply to the baby. This can result in fetal distress and maternal exhaustion. Encouraging breath-holding can also lead to ineffective pushing and prolong the labor process. Option C, explaining that open glottis pushing is not effective, is incorrect because open glottis pushing is a widely accepted technique that has been shown to reduce the risk of fetal distress, perineal trauma, and maternal exhaustion. By coaching the person to use open glottis breathing, the nurse can help them to push more effectively and efficiently. Option D, discussing that the health-care provider would not allow them to use that breathing, is incorrect because open glottis breathing is a safe and effective technique for pushing during labor. It is important for the nurse to support the person's chosen breathing technique and provide guidance on how to push effectively using open glottis breathing. By working together with the person and their healthcare provider, the nurse can help to ensure a safe and positive birthing experience.