In assisting with the two factors that have an effect on fetal status (i.e., pushing and positioning), nurses should:
a. Encourage the woman's cooperation in avoiding the supine position.
b. Advise the woman to avoid the semi-Fowler position.
c. Encourage the woman to hold her breath and tighten her abdominal muscles to produce a vaginal response.
d. Instruct the woman to open her mouth and close her glottis, letting air escape after the push.
ANS: A
The woman should maintain a side-lying position. The semi-Fowler position is the recommended side-lying position with a lateral tilt to the uterus. The Valsalva maneuver, which encourages the woman to hold her breath and tighten her abdominal muscles, should be avoided. Both the mouth and glottis should be open, letting air escape during the push.
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