The primiparous client has asked the nurse why her cervix has only changed from 1 to 2 cm in three hours of contractions occurring every five minutes. The best response by the nurse is:

Question

1. "Your cervix has also effaced, or thinned out, and that change in the cervix is also labor progress."
2. "When your perineal body thins out, your cervix will begin to dilate much faster than it is now."
3. "What did you expect? You've only had contractions for a few hours. Labor takes time."
4. "The hormones that cause labor to begin are just getting to be at levels that will change your cervix."

Answer 1

1
Rationale:
1. Cervical effacement must be nearly complete before cervical dilation takes place in primips. This is why the labor and birth of a first baby usually take much less time than for subsequent labor and births.
2. The perineal body thinning primarily occurs during the second stage of labor; it is not expected now.
3. This reply is not therapeutic. Although it is true that this client has only been in early labor for a short time, and it is true that labor for a primip averages 12–24 hours, the nurse must always be therapeutic in all communication.
4. The hormones that cause labor contractions do not directly cause cervical change; the contractions cause the cervix to change.