1. A laboring client reports feeling the need to have a bowel movement and begin

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1. A laboring client reports feeling the need to have a bowel movement and begins vomiting. The nurse notes that the client’s legs are trembling. What cervical examination finding would the nurse most expect this client to have?
1. 2 cm dilated, 50% effaced, −2 station
2. 6 cm dilated, 70% effaced, −1 station
3. 7 cm dilated, 80% effaced, 0 station
4. 8 cm dilated, 100% effaced, +1 station
ANSWER: (4) 8 cm dilated, 100% effaced, +1 station
The end of the first stage of labor (8-10 cm dilation) is commonly referred to as the “transition phase” of labor. This period is often characterized by perineal/rectal pressure due to fetal descent, which the client may perceive as an urge to have a bowel movement. The maternal ischial spines are designated as the “0 station” landmark. During this period, descent of fetal station below the maternal ischial spines (ie, +1 station or greater) often results in nausea and vomiting and trembling or shivering
A. State your rationale.
B. Describe labor stages and their specifications (include finding during assessment).
2. A nulliparous client asks about being in “real” labor. The nurse should teach that which signs are most indicative of true labor? Select all that apply.
1. Contractions that increase in frequency
2. Contractions that lessen after resting
3. Increased blood-tinged, mucoid vaginal discharge
4. Pain in lower back that moves to lower abdomen
5. Progressive cervical effacement and dilation
ANSWER: (1) Contractions that increase in frequency
(4) Pain in lower back that moves to lower abdomen
(5) Progressive cervical effacement and dilation
A key indicator of true labor is the progressive effacement and dilation of the cervix (Option 5). Contractions in true labor are regular, and increase in frequency, duration, and intensity (Option 1). The pain may initially start in the lower back and radiate to the abdomen (Option 4).
A. State your rationale
B. Make a comparison between “true” labor and “false” labor (include assessment findings,
contractions’ features, cervical changes, etc.)

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