The nurse is preparing to assess a laboring primiparous client who has just arrived in the Labor and Birth unit. Which statement indicates that additional education is needed?
1. "You are going to do a vaginal exam to see how far dilated my cervix is."
2. "The reason for a pelvic exam is to determine how low in the pelvis my baby is."
3. "When you check my cervix, you will find out how thinned out it is."
4. "After you assess my pelvis, you will be able to tell when I will deliver."
4
Rationale:
1. Cervical dilation is one aspect of the pelvic exam assessment.
2. Determining the station of the presenting part is one aspect of the pelvic exam assessment.
3. Cervical effacement, or the thinning of the cervix, is one aspect of the pelvic exam assessment.
4. An experienced Labor and Birth nurse can estimate the time of delivery based on the cervix, fetal position, station, and contraction pattern. However, during a pelvic exam, no information is obtained about the contractions. The nurse will not have enough information following the cervical exam to estimate time of birth.
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