The nurse is caring for laboring clients. Which women are experiencing problems related to a critical factor of labor? Select all that apply
1. Multipara at 3 cm, fetus in longitudinal lie
2. Primipara at 7 cm, fetus in military attitude
3. Multipara at 6 cm, fetus at ?2 station, mild contractions
4. Primipara at 5 cm, fetal presenting part is right shoulder
5. Primipara at 4 cm, fetus with macrocephaly due to hydrocephalus
2, 3, 4, 5
Explanation:
1. Lie refers to the relationship between the cephalocaudal axis of the mother and the cephalocaudal axis of the fetal body; longitudinal lie is normal.
2. Attitude refers to the relationship of the fetal parts to one another. Military attitude is an unflexed neck; normal fetal attitude is flexion of the neck. Military attitude creates a larger diameter of the head fitting through the pelvis. This client is experiencing a problem between the maternal pelvis and the presenting part.
3. Station refers to how low in the pelvis the baby's presenting part is; −2 station is high in the pelvis. Contractions should be strong to cause fetal descent and cervical dilation. Mild contractions will not move the baby down or open the cervix. This client is experiencing a problem between the maternal pelvis and the presenting part.
4. The presenting part is the fetal part coming through the cervix. The occiput or back of the baby's head is the most common and most effective presenting part. A shoulder presentation cannot deliver vaginally and will require a cesarean birth. This client is experiencing a problem between the maternal pelvis and the presenting part.
5. Hydrocephalus can lead to macrocephaly, or an abnormally large head. Macrocephalic babies might not fit through the bony pelvis and could require birth by cesarean section. This client is experiencing a problem between the maternal pelvis and the presenting part.
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