An 18-year-old pregnant woman, gravida 1, is admitted to the ...

[mcmcdaniel]

An 18-year-old pregnant woman, gravida 1, is admitted to the labor and birth unit with moderate contractions every 5 minutes, lasting 40 seconds. The woman states, My contrac-tions are so strong I don't know what to do.. The nurse should:
 
  1. assess for fetal well-being.
  2. encourage the woman to lie on her side.
  3. disturb the woman as little as possible.
  4. recognize that pain is personalized for each individual.

Question 2

When attempting to diagnose and treat developmental dysplasia of the hip (DDH), the nurse should:
 
  1. be able to perform the Ortolani and the Barlow tests.
  2. teach double- or triple-diapering for added support.
  3. explain to parents the need for serial casting.
  4. carefully monitor infants for DDH at follow-up visits.

[HandsomeMarc]

Answer to Question 1

4
1. Incorrect. There is no information in this scenario that would indicate fetal distress or a logical reason to be overly concerned about the well-being of the fetus.
2. Incorrect. The left lateral position is used to alleviate fetal distress, not maternal stress.
3. Incorrect. The nurse has an obligation to provide physical, emotional, and psychosocial care and support to the laboring woman. This patient clearly needs support.
4. Correct. Each woman's pain during childbirth is unique and is influenced by a variety of physiologic, psychosocial, and environmental factors. A critical issue for the nurse is how support can make a difference in the pain of the woman during labor and birth.

Answer to Question 2

4
1. Incorrect. Ortolani and Barlow tests must be performed by experienced clinicians in order to prevent fracture or other damage to the hip.
2. Incorrect. Double- or triple-diapering is not recommended because it promotes hip exten-sion, thus worsening the problem.
3. Incorrect. Serial casting is done for clubfoot, not DDH.
4. Correct. Because DDH is often not detected at birth, infants should be carefully moni-tored at follow-up visits.