Which of the following is not a part of the nurse’s role in genetic counseling?

Choice A rationale:

Bishop score: A tool used to assess the readiness of the cervix for labor induction. It evaluates factors such as cervical dilation, effacement, consistency, position, and station of the fetal presenting part.

Score ranges from 0 to 13: A higher score indicates a more favorable cervix for induction.

Score of 6 or less: Induction is less likely to be successful.

Score of 9 or higher: Induction is more likely to be successful.

Nurses understand: The importance of the Bishop score in predicting the likelihood of successful induction.

Nurses use this information: To counsel patients about the risks and benefits of induction, to prepare for induction, and to monitor progress during induction.

Choice B rationale:

Not always done for medical reasons: Induction can also be elective, meaning it is chosen for non-medical reasons, such as convenience or a desire to avoid a post-term pregnancy.

Examples of medical reasons:

Gestational hypertension or preeclampsia

Fetal growth restriction

Prolonged pregnancy

Chorioamnionitis

Oligohydramnios

Choice C rationale:

Trial of labor (TOL): A term used to describe a vaginal birth attempt after a previous cesarean delivery.

Not synonymous with induction of labor: TOL can occur spontaneously or be induced.

Choice D rationale:

Not always electively done at 37 weeks' gestation: The decision to induce labor at 37 weeks is made on a case-by-case basis.

Factors considered:

Maternal and fetal health

Bishop score

Patient preferences

Rationale for Choice A:

Encouraging the woman to rest between contractions can promote relaxation and help conserve energy, but it does not directly address the mechanisms of pain transmission as explained by the gate-control theory. Rest can have indirect benefits for pain management, but it does not directly interfere with pain signals in the same way that massage does.

Rationale for Choice B:

Administering prescribed medication can effectively block pain signals, but it does not rely on the principles of the gatecontrol theory. Medications typically work through pharmacological mechanisms that target pain receptors or neurotransmitters, rather than by competing with pain signals at the spinal cord level.

Rationale for Choice D:

Changing the woman's position can sometimes alleviate discomfort by shifting pressure or encouraging fetal movement, but it does not directly apply the gate-control theory either. Position changes can offer some physical relief, but they do not directly modulate the transmission of pain signals.

Rationale for Choice C:

Massaging the woman's back directly aligns with the gate-control theory of pain management. This theory proposes that nonpainful sensory input can effectively compete with pain signals, preventing them from reaching the brain. The following mechanisms explain how massage applies this theory:

Stimulation of non-painful nerve fibers: Massage activates large-diameter nerve fibers that transmit touch, pressure, and vibration sensations. These signals travel faster than pain signals and can effectively "close the gate" at the spinal cord, preventing pain signals from ascending to the brain.

Release of endorphins: Massage can stimulate the release of endorphins, the body's natural pain relievers. Endorphins bind to opioid receptors in the brain and spinal cord, reducing the perception of pain.

Reduction of muscle tension: Labor pain often involves muscle tension and spasms. Massage can help relax tense muscles, which can indirectly reduce pain by decreasing muscle ischemia and the release of pain-provoking substances.

Promotion of relaxation and distraction: Massage can induce a state of relaxation and provide a distraction from pain. This psychological effect can further contribute to pain relief by reducing anxiety and focusing attention on pleasant sensations.

Conclusion:

Massage offers a non-pharmacological, evidence-based approach to pain management that directly aligns with the gate-control theory. By stimulating non-painful sensory input, promoting relaxation, and releasing endorphins, massage effectively interrupts pain signals and provides significant relief for women in labor.