The primiparous patient has asked the nurse why her cervix has ...

[vicotolentino]

The primiparous patient has asked the nurse why her cervix has only changed from 1 to 2 cm in 3 hours of contractions occurring every 5 minutes. The best response by the nurse is:
 
  1. Your cervix has also effaced, or thinned out, and that change in the cervix is also labor progress.
  2. When your perineal body thins out, your cervix will begin to dilate much faster than it is now.
  3. What did you expect? You've only had contractions for a few hours. Labor takes time.
  4. The hormones that cause labor to begin are just getting to be at levels that will change your cervix.

Question 2

The nurse manager is consulting with a certified nurse-midwife about a client. What is the role of the CNM? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
 
  1. Be prepared to manage independently the care of women at low risk for complications during pregnancy and birth.
  2. Give primary care for high-risk clients who are in hospital settings.
  3. Give primary care for healthy newborns.
  4. Obtain a physician consultation for any technical procedures at delivery.
  5. Be educated in two disciplines of nursing.

[chem1s3]

Answer to Question 1

1
Rationale 1: Cervical effacement must be nearly complete before cervical dilation takes place in primips. This is why the labor and birth of a first baby usually take much more time than do subsequent labors and births.
Rationale 2: The perineal body's thinning primarily occurs during the second stage of labor; it is not expected now.
Rationale 3: This reply is not therapeutic. The nurse must always be therapeutic in all communication.
Rationale 4: The hormones that cause labor contractions do not directly cause cervical change; the contractions cause the cervix to change.

Answer to Question 2

1, 3, 5
Explanation: 1. A CNM is prepared to manage independently the care of women at low risk for complications during pregnancy and birth and the care of healthy newborns.
3. A CNM is prepared to manage independently the care of women at low risk for complications during pregnancy and birth and the care of healthy newborns.
5. The CNM is educated in the disciplines of nursing and midwifery.