Maternity Nursing Q 74

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The following are common causes of dysfunctional labor. Which of these can a nurse, on her own manage?

  

     A. Pelvic bone contraction

     B. Full bladder

     C. Extension rather than flexion of the head

     D. Cervical rigidity

    

    

Correct Answer: B. Full bladder

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A full bladder can impede the descent of the fetal head. The nurse can readily manage this problem by doing a simple catheterization of the mother.

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Option A: The narrower shape of the android pelvis can make labor difficult because the baby might move more slowly through the birth canal. Some pregnant women with an android pelvis may require a C-section.

Option C: Abnormal labor could also be secondary to the passenger, the size of the infant, and/or the presentation of the infant. In addition to problems caused by the differential in size between the fetal head and the maternal bony pelvis, the fetal presentation may include asynclitism or head extension. Asynclitism is malposition of the fetal head within the pelvis, which compromises the narrowest diameter through the pelvis.

Option D: According to the most recent evidence, arrest of labor in the first stage should be defined as more than or equal to 6cm dilation with ruptured membranes and one of the following: 4 hours or more of adequate contractions (>200 MVU) or 6 hours or more of inadequate contractions and no cervical change.

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