A multiparous patient is admitted to the labor and delivery unit ...

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A multiparous patient is admitted to the labor and delivery unit with contractions that are regular, are 2 minutes apart, and last 60 seconds. She reports that her labor began about 6 hours ago, and she had bloody show earlier that morning.
 
  A vaginal exam reveals a vertex presenting, with the cervix 100 effaced and 8 cm dilated. The patient asks what part of labor she is in. The nurse should inform the patient that she is in the: 1. Early phase.
  2. Active phase.
  3. Transition phase.
  4. Fourth stage.

Question 2

The nurse is inducing the labor of a client with severe preeclampsia. As labor progresses, fetal intolerance of labor develops. The induction medication is turned off, and the client is prepared for cesarean birth.
 
  Which statement should the nurse include in her preoperative teaching? 1. Because of your preeclampsia you are at higher risk for hypotension after an epidural anesthesia.
  2. Because of your preeclampsia you might develop hypertension after a spinal anesthesia.
  3. Because of your preeclampsia your baby might have decreased blood pressure after birth.
  4. Because of your preeclampsia your husband will not be allowed into the operating room.

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Answer to Question 1

3
Rationale 1: This is not the early phase because dilatation is less than 8 cm, and contractions are less frequent and of shorter duration.
Rationale 2: This is not the active phase because dilatation is less than 8 cm, and contractions are less frequent and of shorter duration.
Rationale 3: The transition phase begins with 8 cm of dilatation, and is characterized by contractions that are closer and more intense.
Rationale 4: The fourth stage occurs after delivery of the placenta.

Answer to Question 2

1
Explanation: 1. Pregnancies complicated by preeclampsia are high-risk situations. The woman with mild preeclampsia usually may have the analgesia or anesthesia of choice, although the incidence of hypotension with epidural anesthesia is increased. If hypotension occurs with the epidural block, it provides further stress on an already compromised cardiovascular system.

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