A nurse is caring for a client in the second stage of labor who does not want any tools used to assist with the vaginal birth. Which of the following interventions should the nurse understand will help prevent an assisted vaginal birth? (Select All that Apply.)

Change client position every 30 min

Upright positions

Supine positions

Lateral positions

Delayed pushing

Answer and Explanation

Correct Answer : A,B,D

A) Change client position every 30 minutes:
Changing positions regularly during the second stage of labor can help facilitate fetal descent and improve the effectiveness of contractions. This strategy also helps relieve pressure on certain areas of the body, such as the perineum and lower back, promoting more effective pushing and reducing the need for assisted delivery. Frequent position changes can help the mother progress in labor without the need for tools or interventions.

B) Upright positions:
Upright positions, such as standing, squatting, or kneeling, can be beneficial in the second stage of labor. These positions allow gravity to assist in the descent of the baby, which can help avoid the need for forceps or vacuum extraction. Upright positions also tend to open up the pelvis and can result in more effective pushing, reducing the likelihood of an assisted vaginal delivery.

C) Supine positions:
Supine positions (lying on the back) are not recommended for avoiding an assisted vaginal birth. Lying on the back can hinder fetal descent and may also lead to increased pressure on the inferior vena cava, which can decrease blood flow and oxygen to the uterus. This position tends to slow down labor and may increase the need for interventions like forceps or vacuum extraction, making it less favorable for a spontaneous vaginal delivery.

D) Lateral positions:
Lateral positions (lying on one side) can also help in the second stage of labor. This position can improve uterine blood flow, relieve pressure on the perineum, and provide more room for the baby to descend. It is a good alternative to supine positions and can aid in achieving a vaginal birth without assistance.

E) Delayed pushing:
Delayed pushing can be helpful for some clients, especially if they are not fully dilated or if they need time to rest. However, delayed pushing is not directly related to preventing an assisted vaginal birth. In fact, if the mother waits too long to push or doesn't push effectively, it could potentially lead to more complications or require assisted interventions. The key is ensuring that pushing is done effectively and at the right time in the second stage, rather than delaying it unnecessarily.

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Correct Answer is ["2"]

Explanation

Given:

Desired dose: Ampicillin 0.5 g PO

Available concentration: Ampicillin capsules 250 mg each

To find:

Number of capsules to administer for a single dose

Step 1: Convert desired dose to milligrams

We know that 1 gram (g) is equal to 1000 milligrams (mg). Therefore, to convert the desired dose from grams to milligrams, we multiply by 1000:

Desired dose (mg) = Desired dose (g) x 1000

Desired dose (mg) = 0.5 g x 1000 = 500 mg

Step 2: Calculate the number of capsules

To find the number of capsules, we divide the desired dose by the strength of each capsule:

Number of capsules = Desired dose / Capsule strength

Number of capsules = 500 mg / 250 mg/capsule = 2 capsules

A. decrease the heart rate of the fetus B. Aid the women while she pushes C. prevent supine hypertension D. prevent the client from falling out of bed

Correct Answer is C

Explanation

A) Decrease the heart rate of the fetus:
Lying on the left side can sometimes help improve fetal oxygenation, especially if there is a concern about reduced blood flow from compression of the inferior vena cava, which can occur when the mother lies on her back. However, the primary rationale for this position is to prevent supine hypotension, not specifically to decrease fetal heart rate. In fact, side-lying can promote better oxygen exchange, which can indirectly benefit the fetal heart rate.

B) Aid the women while she pushes:
While a left-side lying position may offer comfort during labor and can help with uterine positioning, it is not specifically intended to aid in the pushing phase. Positions such as squatting or hands-and-knees are generally more helpful during the pushing phase because they can facilitate effective pushing and help the baby descend into the birth canal. The left-side position is more about circulation and preventing hypotension.

C) Prevent supine hypertension:
Supine hypotension occurs when the pregnant woman lies flat on her back, which can compress the inferior vena cava and reduce blood return to the heart. This leads to a drop in blood pressure and can compromise both maternal and fetal circulation. The left-side position is recommended because it helps to prevent this compression and allows optimal blood flow to both the mother and fetus, improving oxygenation and circulation.

D) Prevent the client from falling out of bed:
While lying on the left side may make the woman feel more stable, the primary reason for this position is to prevent supine hypotension, not to prevent her from falling out of bed. The nurse would ensure safety by using appropriate bed rails and monitoring, but the primary concern is supporting optimal circulation, not preventing falls.

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A nurse is caring for a client in the second stage of labor who does not want any tools used to assist with the vaginal birth. Which of the following interventions should the nurse understand will help prevent an assisted vaginal birth? (Select All that Apply.)

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Naxlex Comprehensive Predictor Exams

A client is ordered ampicillin 0.5 g po every 6 hours. On hand are ampicillin capsules labeled 250mg. How many capsules will the nurse administer for single dose?

Correct Answer is ["2"]

Explanation

The nurse asks a laboring client to lie on her left side. The appropriate rationale for this measure is to:

Correct Answer is C

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