Review Nursing Interventions

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Nursing Interventions

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Total Questions : 1

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Question 1:

A client is being assessed for pre-term labor.

The nurse performs a digital examination of the cervix and finds it to be 3 cm dilated, 60% effaced, and at -2 station.

What should the nurse interpret from these findings?

A. The client is in active labor B. The client is not in labor C. The client is experiencing early labor D. The client is at risk for pre-term birth

Answer and Explanation

Choice A:

The patient is not in active labor.Active labor is when the cervix is 6 cm or more dilated, and contractions are stronger and closer together.

Choice B:

The patientis not in labor.Labor is when the cervix begins to open and the baby moves down the birth canal due to regular contractions.

Choice C:

The client is not experiencing early labor.Early labor is when the cervix is up to 6 cm dilated, and contractions are mild and irregular.

Choice D:

The client is at risk for pre-term birth.Pre-term labor occurs when regular contractions begin to open your cervix before 37 weeks of pregnancy.A full-term pregnancy should last about 40 weeks.

The client’s cervix is 3 cm dilated, 60% effaced, and at -2 station, which indicates that the cervix is thinning and opening, and the baby is moving down the birth canal.These are signs of early labor, which can progress to active labor and delivery if not stopped.

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Nursing Interventions

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