The nurse is caring for a woman, G2 P1001, 40 weeks' gestation, ...

[karen]

The nurse is caring for a woman, G2 P1001, 40 weeks' gestation, in labor.
 
  A 12 P.M. assessment revealed: cervix 4 cm, 80 effaced, 3 station, and fetal heart 124 with moderate variability.
  5 p.m. assessment: cervix 6 cm, 90 effaced, 3 station, and fetal heart 120 with minimal variability.
  10 a.m. assessment: cervix 8 cm, 100 effaced, 3 station, and fetal heart 124 with absent variability.
  Based on the assessments, which of the following should the nurse conclude?
  a. Descent is progressing well.
  b. Woman is carrying a small-for-gestational age fetus.
  c. Baby is potentially acidotic.
  d. Woman should begin to push with the next contraction.

Question 2

After assessing the FHR tracing shown below, which of the following interventions should the nurse perform?
 
  a. Turn the woman on her side.
  b. Administer oxygen by nasal cannula.
  c. Encourage the patient to push with each contraction.
  d. Provide the patient with caring labor support.

[nhea]

Answer to Question 1

ANS: c
Feedback
a. The baby has not descended since admission. The station is still 3.
b. The baby may be macrosomic. Because the baby is not descending, the baby may be too large to traverse through the pelvis.
c. The variability is decreasing. This is an indication that the fetus is in distress.
d. The woman is only 8 cm dilated. She should not begin to push until she has reached 10 cm dilation. Plus, the fetal station is still 3.

Answer to Question 2

ANS: a
Feedback
a. The woman's position should be changed. The side-lying position is the best.
b. If a laboring patient needs oxygen, it should be administered via face mask.
c. There is no indication in the scenario that the patient is fully dilated.
d. The nurse should not wait to intervene. He or she should intervene as quickly as possible in order to reverse the problem.

[karen]

Excellent

[parker125]

TYSM