While providing care to a patient in active labor, the nurse ...

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While providing care to a patient in active labor, the nurse should instruct the woman that:
 
  a. The supine position commonly used in the United States increases blood flow.
  b. The all fours position, on her hands and knees, is hard on her back.
  c. Frequent changes in position will help relieve her fatigue and increase her comfort.
  d. In a sitting or squatting position, her abdominal muscles will have to work harder.

Question 2

As relates to fetal positioning during labor, nurses should be aware that:
 
  a. Position is a measure of the degree of descent of the presenting part of the fetus through the birth canal.
  b. Birth is imminent when the presenting part is at +4 to +5 cm below the spine.
  c. The largest transverse diameter of the presenting part is the suboccipitobregmati c diameter.
  d. Engagement is the term used to describe the beginning of labor.

[cici]

Answer to Question 1

ANS: C
Frequent position changes relieve fatigue, increase comfort, and improve circulation. Blood flow can be compromised in the supine position; any upright position benefits cardiac output. The all fours position is used to relieve backache in certain situations. In a sitting or squatting position, the abdominal muscles work in greater harmony with uterine contractions.

Answer to Question 2

ANS: B
The station of the presenting part should be noted at the beginning of labor so that the rate of descent can be determined. Position is the relation of the presenting part of the fetus to the four quadrants of the mother's pelvis; station is the measure of degree of descent. The largest diameter usually is the biparietal diameter. The suboccipitobregmati c diameter is the smallest, although one of the most critical. Engagement often occurs in the weeks just before labor in nulliparas and before or during labor in multiparas.