Which action supports a laboring woman's breathing?

Correct Answer: B

Rationale: Effleurage is the correct answer because it is a gentle massage technique that can help a laboring woman relax and focus on her breathing. This technique involves using light, rhythmic strokes on the skin to promote relaxation and reduce tension. By helping the woman relax, effleurage can support her breathing by encouraging slow, deep breaths and reducing the likelihood of shallow, rapid breathing that can increase anxiety and discomfort during labor. The incorrect choices are as follows: A: Lithotomy position is an incorrect choice because it involves the laboring woman lying on her back with her legs in stirrups. This position can actually impede breathing by compressing the diaphragm and restricting the woman's ability to take deep breaths. It can also increase the risk of complications during labor, such as pelvic floor damage. C: Kegel exercises are an incorrect choice because they are focused on strengthening the pelvic floor muscles, not supporting breathing during labor. While Kegel exercises can be beneficial for women both during and after pregnancy, they are not directly related to helping a laboring woman with her breathing. D: Pushing is an incorrect choice because it is a stage of labor that comes after the woman has fully dilated and is ready to deliver the baby. While controlled pushing can support the laboring woman's breathing during this stage, it is not specifically focused on supporting breathing throughout the entire labor process. Effleurage, on the other hand, can be used at any stage of labor to support breathing and relaxation.

Correct Answer: C

Rationale: After an amniotomy, which is the artificial rupture of the amniotic sac during labor to help induce or speed up labor, the priority assessment should be the fetal heart rate (Choice C). This is because the procedure directly affects the fetus by exposing it to the risk of umbilical cord compression or prolapse, which can compromise blood flow and oxygenation. Monitoring the fetal heart rate helps to assess the well-being of the fetus and detect any signs of distress promptly. Maternal blood pressure (Choice A) and pulse (Choice B) are important assessments during labor, but they are not the priority after an amniotomy. These vital signs help to monitor the mother's overall condition and detect any potential complications such as preeclampsia or hemorrhage. However, the fetal heart rate takes precedence in this situation. Fetal fibronectin (Choice D) is a protein that plays a role in the attachment of the fetal membranes to the uterine wall. It is used to predict preterm labor but is not typically assessed immediately after an amniotomy. Monitoring the fetal heart rate is more crucial in this scenario to ensure the safety and well-being of the fetus during labor.

Correct Answer: B

Rationale: True labor is indicated by cervical dilation. This is because as labor progresses, the cervix effaces (thins out) and dilates (opens up) to allow the baby to pass through the birth canal. Cervical dilation is a clear sign that the body is preparing for childbirth. Choice A, regular contractions without cervical change, is incorrect because regular contractions alone are not enough to indicate true labor. While contractions are a key component of labor, they must be accompanied by cervical changes such as dilation and effacement to confirm that true labor has begun. Choice C, rupture of membranes, is also incorrect as it is not a definitive indicator of true labor. While the rupture of membranes (water breaking) can be a sign that labor is imminent, it does not necessarily confirm that true labor has started. Some women may experience their water breaking before true labor begins, while others may have their water break well into the labor process. Choice D, engagement of the fetal head, is not a reliable indicator of true labor either. While the engagement of the fetal head (when the baby's head moves down into the pelvis) is a sign that labor is progressing, it does not confirm that true labor has begun. True labor is primarily defined by cervical changes, specifically dilation.

Correct Answer: C

Rationale: Contractions becoming stronger is a key indicator that a woman is in true labor. Stronger contractions are a sign that the uterus is effectively working to dilate the cervix and move the baby down the birth canal. This progression is necessary for labor to continue and for the baby to be born. Contractions becoming more frequent, as mentioned in option A, can occur in both true and false labor. However, frequency alone is not a definitive indicator of true labor. False labor contractions can also become more frequent without leading to actual labor. Contractions becoming milder, as mentioned in option B, is actually a sign of false labor. True labor contractions typically become stronger and more intense as labor progresses, not milder. Mild contractions are usually not effective in dilating the cervix and moving the baby down. The fact that the client sleeps through contractions, as mentioned in option D, is a sign that the contractions are not strong or intense enough to disrupt her sleep. In true labor, contractions are usually strong enough to be uncomfortable and prevent the mother from sleeping through them. Sleeping through contractions is more characteristic of false labor.

Correct Answer: C

Rationale: Station refers to the level of the presenting part of the fetus in relation to the maternal pelvis. When the fetal head is engaged, it means that it has descended into the pelvis and is at the level of the ischial spines in the maternal pelvis. Choice A: -1 station is incorrect because this would indicate that the fetal head is above the level of the ischial spines, which is not the case when the head is engaged. Choice B: (+)1 station is incorrect because this would indicate that the fetal head is 1 cm below the level of the ischial spines, which is also not accurate when the head is engaged. Choice D: (+)5 station is incorrect because this would indicate that the fetal head is 5 cm below the level of the ischial spines, which is too far down in the pelvis to be considered engaged. Therefore, the correct answer is C: 0 station, because when the fetal head is engaged, it is at the level of the ischial spines, which is considered 0 station.