The nursing, intructor is explaining the cardinal movements of labor to the nursing students. The instructor explains that the initial descent of the fetus into the pelvis to zero station is which one of the cardinal movements of labor.
Flexion
Engagement
Extension
Expulsion
The Correct Answer is B
A) Flexion:
Flexion is a movement where the fetal head bends forward during labor, which allows the smallest diameter of the head to pass through the birth canal. It is an important part of the labor process but does not refer to the initial descent of the fetus into the pelvis. Flexion typically occurs once the fetus begins to descend into the pelvis.
B) Engagement:
Engagement refers to the initial descent of the fetal head into the pelvis and the passage of the largest part of the fetal head (the biparietal diameter) into the maternal pelvis. This occurs when the fetal head reaches zero station at the level of the ischial spines and is the first cardinal movement of labor. It marks the point at which the presenting part of the fetus enters the pelvic inlet and begins the process of descent.
C) Extension:
Extension is the movement of the fetal head as it exits the birth canal after engagement and descent. The head moves from a flexed position (chin to chest) to an extended position (chin moving away from the chest) as it passes through the birth canal. This movement occurs after engagement and is a part of the expulsion phase, not the initial descent.
D) Expulsion:
Expulsion is the final phase of labor, which occurs after the fetal head has been delivered. It involves the delivery of the rest of the body (shoulders, torso, and legs) following the birth of the head. This is the final cardinal movement, which takes place after engagement, descent, flexion, internal rotation, extension, and external rotation.
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Related Questions
Correct Answer is ["A","B","D"]
Explanation
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.
Correct Answer is C
Explanation
A) "Have you had any health concerns during your pregnancy?"
While it's important to assess the client's overall health and pregnancy history, this question doesn't directly address the current concern of possible labor and does not immediately help assess the client's status for labor evaluation. The focus should be on signs of labor or complications at this point.
B) "Do you have a support person present?"
Although this is a helpful question to ask in preparation for labor, it doesn't provide the necessary information needed to assess whether the client is in labor. The priority at this stage is determining if the client is in labor or experiencing any complications, such as rupture of membranes.
C) "Have you noticed any fluid leaking from your vagina?"
This is the most important question to ask next. If the client has ruptured membranes (i.e., water breaking), it is important to assess the timing and nature of the fluid leakage, as it would indicate the need for immediate evaluation at the hospital. Rupture of membranes requires monitoring for infection and should prompt the client to come in for assessment regardless of the frequency or intensity of contractions.
D) "When was your last prenatal visit?"
While it is helpful to know when the client had their last prenatal visit, this question does not directly address the issue of possible labor. The priority is to determine if the client is in labor, whether their membranes have ruptured, or if there are any other complications such as bleeding or abnormal fetal movement. The question about fluid leakage is more immediate and relevant to their current condition.
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