The nurse should assist the laboring woman into a hands-and-knees position when the:
1. occiput of the fetus is in a posterior position.
2. fetus is at or above the ischial spines.
3. fetus is in a vertex presentation.
4. membranes rupture.
1
1. Correct. The hands-and-knees position is an effective position to help rotate the fetus from a posterior to an anterior position.
2. Incorrect. Many women experience the irresistible urge to push when the fetus is at the level of the ischial spines. For some women, this occurs before the woman is fully dilated. The woman should be instructed not to push until complete cervical dilation has occurred.
3. Incorrect. There is no single position for childbirth. The two most common positions as-sumed by women are the sitting and side-lying positions.
4. Incorrect. The woman may be encouraged into a hand-and-knees position if the umbilical cord prolapsed when the membranes ruptured.
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