✅ Correct Answer: A) When the maximum diameter of the baby’s head stretches the vulval outlet so much that the head does not go back even after the contraction is over.

👉 Why?

When the baby’s head descends in the second stage of labor, initially the head may appear out for a short while during each uterine contraction and slides back as soon as the contraction is over.

But as soon as the baby’s head descends so much that its widest part (maximum diameter) permanently stretches the vaginal outlet and the head does not go back anymore—even after the contraction is over—this is called Crowning.

📌 Why are the other options incorrect:

B) When the baby’s head and shoulders are visible on the pelvic floor → this only indicates descent, not crowning.

C) When the head comes out completely → this is delivery, not crowning.

D) Torsion of neck → It has no relation with crowning.

💡 Clinical Importance:

Crowning indicates that labour is imminent and delivery is very near.

There is extreme stretch on the perineum at this time, hence nurse/midwife should provide careful perineal support.

This reduces the risk of perineal tear and maternal trauma.

During crowning a controlled delivery technique (e.g., Ritgen’s maneuver) is used so that the head comes out slowly and safely.

👉 In short:

Crowning = permanent exposure of baby’s head (without back movement).

It is an important clinical sign of the second stage of labour and is frequently asked in nursing exams.

✅ Correct Answer: A) Assessing urinary input and output.

👉 Why?

Dehydration involves a loss of water and electrolytes from the body.

The nurse’s primary task is to monitor fluid balance.

Monitoring urinary output and intake is the most direct and effective way to determine a patient’s fluid status.

📌 Why the other options are incorrect:

B) Weighing at different times during the week → This can only indicate fluid status over a long period of time, but is not sufficient to immediately assess dehydration.

C) Monitoring Arterial Blood Gas (ABG) → ABG only shows acid-base and gas exchange status, not a direct indication of dehydration.

D) Keeping IV therapy at a keep-vein-open rate → This is not sufficient; dehydration often requires fluid replacement.

💡 Clinical Importance:

Urine input/output monitoring allows the nurse to identify fluid imbalance early.

Timely intervention can prevent hypovolemia, hypotension and other complications.

This is considered a basic skill in nursing profession and is frequently asked in exams.

👉 In short:

Dehydration = lack of water in the body.

Primary nursing intervention = assessment of urine input and output.