Which among these is a sign/symptom of impending labor?

Appeared in: KPSC Staff Nurse - 2018

Explanation

Lightening is a classic premonitory (impending) sign of labor.
It describes the descent of the fetal presenting part (usually the head) into the true pelvis.
This typically occurs 2-3 weeks before the onset of labor in a primigravida and may not occur until labor begins in a multipara.
The mother often experiences relief from pressure on the diaphragm, making breathing easier, but notices increased pelvic pressure and urinary frequency.

Option B: Quickening is the mother's first perception of fetal movement.
Option C: Braxton Hicks contractions are irregular, often painless uterine contractions that do not cause cervical change. While they are a sign of the uterus preparing for labor, they are not as definitive a sign of impending labor as lightening, as they can occur for weeks or months before labor begins.
Option D: Tightening is a subjective and non-specific term. It does not describe a defined clinical sign of labor.

Clinical Relevance

Nursing practice connection: Knowing Premonitory signs of impending labor helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses must educate pregnant women on the differences between premonitory signs of labor and the signs of true labor to prevent unnecessary anxiety and hospital visits.
Understanding lightening helps reassure the primigravid patient that her body is preparing for birth, while also counseling her that labor may still be weeks away.
A key nursing intervention is teaching the patient when to contact their healthcare provider or go to the hospital: for regular, painful contractions that increase in frequency and intensity, rupture of membranes, or significant vaginal bleeding.

How to Approach the Question

This is a factual recall question requiring knowledge of obstetrics.
First, read the question carefully to understand what is being asked: a sign of 'impending labor'.
Evaluate each option based on your knowledge of pregnancy and labor.
Recall the definition of 'Lightening': the baby dropping into the pelvis before labor.
Recall the definition of 'Quickening': the first fetal movements felt much earlier in pregnancy.
Recall the definition of 'Braxton Hicks contractions': irregular practice contractions that are not true labor.

Concept Tested & Keywords

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E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur pp. 7-12, 3-8

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