The perinatal nurse is providing care to a multiparous woman in ...

[james9437]

The perinatal nurse is providing care to a multiparous woman in labor. Upon arrival to the birthing suite, the cervix is 5 cm dilated and the patient is experiencing contractions every 1 to 2 minutes that she describes as strong.
 
  The patient states that she labored for 1 hour at home and is feeling some rectal pressure. The patient is most likely experiencing what condition?
  A.
  Hypertonic contractions
  B.
  Hypotonic contractions
  C.
  Precipitous labor
  D.
  Uterine hyperstimulation

Question 2

The perinatal nurse determines by vaginal examination that a patient's cervix is fully dilated and the fetal presenting part is descending rapidly with the patient's pushing efforts.
 
  The most appropriate nursing intervention at this time would be to do which of the following?
  A.
  Assist the patient with breathing patterns to slow down her pushing.
  B.
  Document the patient's progress and coping abilities in labor.
  C.
  Notify the health-care provider to come now for the birth.
  D.
  Provide information to the patient's partner about her stage of labor.

[Chocorrol77]

Answer to Question 1

ANS: C
Precipitous labor contractions produce very rapid, intense contractions. A precipitous labor lasts less than 3 hours from the beginning of contractions to birth. Patients often progress through the first stage of labor with little or no pain and may present to the birth setting already advanced into the second stage.

Answer to Question 2

ANS: A
This woman's labor is progressing precipitously. The nurse should instruct her to breathe through contractions to avoid pushing. Documentation should always be thorough, but further action is needed. The provider should be notified about a possible precipitous birth, but the woman needs assistance to control the bearing-down efforts. The nurse can delegate the notification task to someone else. Patients and their support persons always need information on their progress, but this is not the most important action.

[james9437]

TYSM

[bitingbit]

Excellent