Two hours ago, a client at 39 weeks' gestation was 3 cm dilated, ...

[Tirant22]

Two hours ago, a client at 39 weeks' gestation was 3 cm dilated, 40 effaced, and +1 station. Frequency of contractions was every 5 minutes with duration 40 seconds and intensity 50 mmHg.
 
  The current assessment is 4 cm dilated, 40 effaced, and +1 station. Frequency of contractions is now every 3 minutes with 40-50 seconds' duration and intensity of 40 mmHg. What would the priority intervention be? 1. Begin oxytocin after assessing for CPD.
  2. Give terbutaline to stop the preterm labor.
  3. Start oxygen at 8 L/min.
  4. Have the anesthesiologist give the client an epidural.

Question 2

During the initial prenatal visit, the pregnant teenager states that she does not know how she got pregnant. The nurse can help to educate her regarding anatomy by doing what?
 
  1. Allowing her to witness a pelvic exam on another teenager
  2. Encouraging her to ask her mother about the physiology of pregnancy
  3. Including anatomic models and drawings in the teaching session
  4. Discussing the process of fetal development with the client

[thall411]

Answer to Question 1

1
Explanation: 1. The client is having hypertonic contractions. Cephalopelvic disproportion (CPD) must be excluded. If CPD exists, oxytocin (Pitocin) augmentation should not be used. Oxytocin is the drug of choice for labor augmentation or labor induction.

Answer to Question 2

3
Explanation: 3. To teach the client about anatomy and physiology, use simple explanations and lots of audiovisuals.