At what time is the laboring client encouraged to push?
A.
When the health care provider has arrived.
B.
When the fetal head can be seen.
C.
When the nurse wants the client to push.
D.
When the cervix is fully dilated.
The Correct answer and Explanation is:
The correct answer is D. When the cervix is fully dilated.
In labor and delivery, the timing of when to encourage the client to push is crucial for both the safety of the mother and the baby. Pushing too early or too late can lead to complications and affect the progress of labor.
Full Cervical Dilation: The primary guideline for encouraging a laboring client to start pushing is that the cervix must be fully dilated to 10 centimeters. Cervical dilation is a measure of how much the cervix has opened to allow the baby to pass through the birth canal. When the cervix is not yet fully dilated, pushing can be counterproductive. It may cause unnecessary strain and can potentially lead to complications such as cervical swelling or damage. Additionally, pushing before full dilation can lead to fetal distress as the baby may not be able to move through the birth canal properly, increasing the risk of interventions like cesarean delivery.
Health Care Provider’s Role: While it’s important for the health care provider to be present during delivery, the decision to start pushing is based on the progression of cervical dilation rather than the provider’s arrival. In many cases, providers arrive when labor is progressing into the active phase and dilation is nearing completion.
Fetal Head Visibility: Although seeing the fetal head can be a sign of progress, pushing is typically only encouraged when the cervix is fully dilated. Pushing before full dilation, even if the fetal head is visible, can lead to complications and exhaustion for the laboring mother.
Nurse’s Judgment: The nurse’s role includes monitoring the labor progress and assisting the client. However, the decision to push is based on clinical guidelines and the status of cervical dilation rather than the nurse’s preference alone.
In summary, effective and safe labor management requires waiting until the cervix is fully dilated before encouraging the client to push. This approach helps ensure that the baby can move through the birth canal smoothly and reduces the risk of complications for both the mother and the baby.