The nurse is caring for a patient in the second stage of Labor. Which statement by the nurse is appropriate?

Semi-Fowler's is the safest position for pushing.

Choose a position you feel most comfortable.

Sitting with your head elevated on two pillows makes pushing easier.

It is normal if you're having a bowel movement.

Answer and Explanation

The Correct Answer is B

Choice A reason: The statement that "Semi-Fowler's is the safest position for pushing" is not necessarily appropriate because the best position for pushing can vary from one woman to another. There is no single safest position universally recommended for all labouring women. The choice of position should be individualized based on the woman's comfort, progress of Labor, and any specific medical considerations. The Semi-Fowler's position involves lying semi-upright, which might be suitable for some but not for everyone.

Choice B reason: Advising the patient to "choose a position you feel most comfortable" is appropriate because it empowers the woman to listen to her body and adopt a position that feels natural and effective for her. Comfort plays a crucial role in the effectiveness of pushing and the overall Labor experience. This approach promotes a sense of control and autonomy for the labouring woman and aligns with best practices in patient-cantered maternity care.

Choice C reason: Suggesting that "sitting with your head elevated on two pillows makes pushing easier" may not be the best advice for every labouring woman. While this position might work for some, it is not universally effective or recommended. Labor positions should be flexible and adaptive to the individual's needs and comfort. Blanket recommendations can overlook the diversity of experiences and preferences among labouring women.

Choice D reason: Telling the patient that "it is normal if you're having a bowel movement" might address a concern some women have during Labor. However, it does not directly guide the woman on effective pushing positions. While it can be reassuring to mention that a bowel movement can occur during pushing, this statement alone is not sufficient as a primary piece of advice for managing the second stage of Labor.

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Correct Answer is A

Explanation

Choice A reason: Walking unaided is a significant gross motor milestone that may be delayed in a child with chronic lung disease due to decreased physical stamina and energy levels. These children may tire easily, making it more challenging to develop the strength and coordination needed to walk independently. The need for supplemental oxygen can further limit the child's mobility and opportunities for practicing walking.

Choice B reason: Holding a crayon is a fine motor skill that may not be as significantly affected by chronic lung disease. While any serious health condition can impact overall development, fine motor skills like holding a crayon can be practiced in less physically demanding ways, even if the child has reduced stamina.

Choice C reason: Copying a circle is a developmental milestone typically expected later, around 3 years old. At 12 months, a child is not expected to perform this task, so it is not relevant in this context for identifying a delay at this age.

Choice D reason: Speaking 15 words is a language milestone that can be affected by various factors. However, chronic lung disease more directly impacts physical stamina and gross motor skills rather than speech development. While any health issue can influence overall development, speech and language milestones might not be as immediately impacted by chronic lung disease.

A. Says two-word sentences. B. Uses pincer grasp to eat Cheerio’s. C. Removes shoes and socks. D. Prefers to use the right hand.

Correct Answer is D

Explanation

Choice A reason: Saying two-word sentences is an expected developmental milestone for an 18-month-old child. At this age, children should begin combining two words to form simple sentences, such as "more juice" or "mama go." This indicates normal language development.

Choice B reason: Using a pincer grasp to eat Cheerio’s is a typical fine motor skill for an 18-month-old child. The ability to pick up small objects between the thumb and forefinger demonstrates proper development of fine motor skills and hand-eye coordination.

Choice C reason: Removing shoes and socks is a common developmental milestone for an 18-month-old child. This task shows growing independence and the ability to perform basic self-care activities, which is a sign of normal development.

Choice D reason: Preferring to use the right hand may suggest a developmental delay because children typically do not show a strong hand preference (left or right) until around the age of 2 to 3 years. Early hand dominance can be a sign of an underlying issue, such as asymmetry in muscle strength or neurological development. It is important to assess further if a child shows a strong preference for one hand at this early age.

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The nurse is caring for a patient in the second stage of Labor. Which statement by the nurse is appropriate?

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