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Maternal Newborn Nursing The Critical

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Chapter 8: Intrapartum Assessment and Interventions

Multiple Choice

1. In caring for a primiparous woman in labor, one of the factors to evaluate is uterine activity.
This is referred to as the __________ of labor.a. Passengerb. Passagec. Powersd. Psyche

ANS: c
Feedback
a. The passenger refers to the fetus.
b. The passage refers to the pelvis and birth canal.
c. Powers refer to the contractions.
d. Psyche refers to the response of a woman to
labor.

KEY: Integrated Process: Clinical Problem Solving | Cognitive Level: Knowledge | Content
Area: Maternity | Client Need: Physiological Adaptation | Difficulty Level: Easy

2. The provision of support during labor has demonstrated that women experience a decrease in
anxiety and a feeling of being in more control. In clinical situations, this has resulted in:a. A
decrease in interventionsb. Increased epidural ratesc. Earlier admission to the hospitald.
Improved gestational age

ANS: a
Feedback
a. Studies have shown that with a support person,
be it a family member, friend, or professional
such as a Doula or nurse, the patient
experiences a decrease in anxiety and has a
feeling of being in more control. This, in turn,
results in a decrease in interventions, a
significantly lower level of pain, and an
enhanced overall maternal satisfaction.
b. There is decreased use of pain medication with
continuous labor support.
c. There is no evidence that continuous labor
support results in earlier admission to the
hospital.
d. There is no evidence that continuous labor
support results in improved gestational age for
the fetus.
KEY: Integrated Process: Clinical Problem Solving | Cognitive Level: Comprehension | Content
Area: Maternity | Client Need: PSI, Psychosocial Integrity | Difficulty Level: Moderate

3. When caring for a primiparous woman being evaluated for admission for labor, a key
distinction between true versus false labor is:a. True labor contractions result in rupture of
membranes, and with false labor, the membranes remain intact.b. True labor contractions result
in increasing anxiety and discomfort, and false labor does not.c. True labor contractions are
accompanied by loss of the mucus plug and bloody show, and with false labor there is no vaginal
discharge. d. True labor contractions bring about changes in cervical effacement and dilation,
and with false labor there are irregular contractions with little or no cervical changes.

ANS: d
Feedback
a. Rupture of membranes can occur prior to labor
or during labor.
b. A woman’s response to labor may not be
reflective of her status in labor but is
influenced by expectations and emotional
status.
c. Loss of the mucus plug can occur prior to the
onset of labor.
d. True labor contractions bring about changes in
cervical effacement and dilation, and with false
labor there are irregular contractions with little
or no cervical changes.

KEY: Integrated Process: Clinical Problem Solving | Cognitive Level: Analysis | Content Area:
Maternity | Client Need: Physiological Adaptation | Difficulty Level: Moderate

4. The mechanism of labor known as cardinal movements of labor are the positional changes
that the fetus goes through to best navigate the birth process. These cardinal movements are:a.
Engagement, Descent, Flexion, Extension, Internal rotation, External rotation, Expulsion b.
Engagement, Descent, Flexion, Internal rotation, Extension, External rotation, Expulsion c.
Engagement, Flexion, Internal rotation, Extension, External rotation, Descent, Expulsion d.
Engagement, Flexion, Internal rotation, Extension, External rotation, Flexion, Expulsion

ANS: b
Feedback
a. The order of the cardinal movements is
incorrect.
b. Engagement occurs when the greatest diameter
of the fetal head passes through the pelvic
inlet. Engagement can occur late in pregnancy
or early in labor. Descent is the movement of
the fetus through the birth canal during the first
and second stages of labor. Flexion is when the
chin of the fetus moves toward the fetal chest.
Flexion occurs when the descending head
meets resistance from maternal tissues. This
movement results in the smallest fetal diameter
to the maternal pelvic dimensions. It typically
occurs early in labor. Internal rotation is the
movement, the rotation of the fetal head, that
aligns the long axis of the fetal head with the
long axis of the maternal pelvis. It occurs
mainly during the second stage of labor.
Extension is the movement facilitated by
resistance of the pelvic floor, causing the
presenting part to pivot beneath the pubic
symphysis and the head to be delivered. This
occurs during the second stage of labor.
External rotation is when the sagittal suture
moves to a transverse diameter and the
shoulders align in the anteroposterior diameter.
The sagittal suture maintains alignment with
the fetal trunk as the trunk navigates through
the pelvis. Expulsion is the movement that
occurs when the shoulders and remainder of
the body are delivered.
c. The order of the cardinal movements is
incorrect.
d. The order of the cardinal movements is
incorrect.

KEY: Integrated Process: Clinical Problem Solving | Cognitive Level: Comprehension | Content
Area: Maternity | Client Need: Physiological Adaptation | Difficulty Level: Moderate

5. A woman is considered in active labor when:a. Cervical dilation progresses from 4 to 7 cm


with effacement of 40% to 80%, contractions become more intense, occurring every 2 to 5
minutes with duration of 45 to 60 seconds.b. Cervical dilation progresses to 3 cm with
effacement of 30, contractions become more intense, occurring every 2 to 5 minutes with
duration of 45 to 60 seconds.c. Cervical dilation progresses to 8 cm with effacement of 80%,
contractions become more intense, occurring every 2 to 5 minutes with duration of 45 to 60
seconds.d. Cervical dilation progresses to 10 cm with effacement of 90%, contractions become
more intense, occurring every 2 to 5 minutes with duration of 45 to 60 seconds.

ANS: a
Feedback
a. Characteristics of this phase are the cervix
dilates, on an average, 1.2 cm/hr for
primiparous women and 1.5 cm/hr for
multiparous women. Cervical dilation
progresses from 4 to 7 cm with effacement of
40% to 80%. Fetal descent continues and
contractions become more intense, occurring
every 2 to 5 minutes with duration of 45 to 60
seconds, and discomfort increases.
b. Cervical dilation progresses to 3 cm with
effacement of 30, indicating the early or latent
phase of labor.
c. Cervical dilation progresses to 8 cm with
effacement of 80%, indicating the transition
phase of labor.
d. Cervical dilation of 10 cm with effacement is
the end of the first stage of labor.

KEY: Integrated Process: Clinical Problem Solving | Cognitive Level: Analysis | Content Area:
Maternity | Client Need: Physiological Adaptation | Difficulty Level: Moderate

6. You are caring for a woman in labor who is 6 cm dilated with a reassuring FHT pattern and
regular strong UCs. The fetal heart rate (FHR) should be:a. Monitored continuouslyb. Monitored
every 15 minutesc. Monitored every 30 minutesd. Monitored every 60 minutes

ANS: c
Feedback
a. Assessment of fetal heart rate (FHR) during the
active phase of labor with a reassuring FHR is
not indicated continuously.
b. Assessment of fetal heart rate (FHR) during the
active phase of labor with a reassuring FHR is
not indicated every 15 minutes.
c. Assessment of fetal heart rate (FHR) during the
active phase of labor with a reassuring FHR is
indicated every 30 minutes.
d. Assessment of fetal heart rate (FHR) during the
active phase of labor with a reassuring FHR is
indicated every 30 minutes, not every 60
minutes.

KEY: Integrated Process: Clinical Problem Solving | Cognitive Level: Application | Content
Area: Maternity | Client Need: Physiological Adaptation | Difficulty Level: Moderate
7. A woman you are caring for in labor requests an epidural for pain relief in labor. Included in
your preparation for epidural placement is a baseline set of vital signs. The most common vital
sign to change after epidural placement:a. Blood pressure, hypotension
b. Blood pressure, hypertension
c. Pulse, tachycardia
d. Pulse, bradycardia

ANS: a
Feedback
a. Blood pressure, hypotension, as up to 40% of
women may experience hypotension.
Hypotension is defined as systolic BP <100
mm Hg or 20% decrease in BP from
preanesthesia levels. Intravenous bolus is
typically given to decrease the incidence of
hypotension.
b. Blood pressure, hypertension is incorrect
because hypotension is the common
complication after epidural placement.
c. Pulse, tachycardia is incorrect because
hypotension is the common complication after
epidural placement.
d. Pulse, bradycardia is incorrect because
hypotension is the common complication after
epidural placement.

KEY: Integrated Process: Clinical Problem Solving | Cognitive Level: Application | Content
Area: Maternity | Client Need: Physiological Adaptation | Difficulty Level: Moderate

8. The labor patient you are caring for is ambulating in the hall. Her vaginal exam 1 hour ago
indicated she was 4/70/–1 station. She tells you she has fluid running down her leg. Your priority
nursing intervention is to:a. Assess the color, odor, and amount of fluid.b. Assist your patient to
the bathroom.c. Assess the fetal heart rate.d. Call the care provider.
ANS: c
Feedback
a. Although assessing the color, odor, and
amount of fluid is appropriate, the priority
nursing action is to assess the FHR because of
the risk of umbilical cord prolapse with rupture
of membranes.
b. The fluid is probably related to rupture of
membranes rather than the patient needing to
go to the bathroom to urinate.
c. Assessing the fetal heart rate is the first priority
because of the risk of umbilical cord prolapse
with rupture of membranes.
d. Although you may call the care provider, the
priority nursing action is to assess the FHR
because of the risk of umbilical cord prolapse
with rupture of membranes.

KEY: Integrated Process: Clinical Problem Solving | Cognitive Level: Application | Content
Area: Maternity | Client Need: Reduction of Risk Potential | Difficulty Level: Moderate

9. You are in the process of admitting a multiparous woman to labor and delivery from the triage
area. One hour ago her vaginal exam was 4/70/0. While completing your review of her prenatal
record and completing the admission questionnaire, she tells you she has an urge to have a bowel
movement and feels like pushing. Your priority nursing intervention is to:a. Reassure the patient
and rapidly complete the admission.b. Assist your patient to the bathroom to have a bowel
movement.c. Assess the fetal heart rate and uterine contractions.d. Perform a vaginal exam.

ANS: d
Feedback
a. Completing the admission paperwork is not a
priority when birth may be imminent.
b. The urge to have a bowel movement is
probably related to fetal descent and complete
dilation rather than the patient needing to have
a bowel movement.
c. Doing a vaginal exam is the first priority as
birth may be imminent.
d. Perform a vaginal exam to assess the progress
of labor. The urge to have a bowel movement
and feeling like pushing indicate that birth may
be imminent.
KEY: Integrated Process: Clinical Problem Solving | Cognitive Level: Analysis | Content Area:
Maternity | Client Need: Physiological Adaptation | Difficulty Level: Moderate

10. The Apgar score consists of a rapid assessment of five physiological signs that indicate the
physiological status of the newborn and includes:a. Apical pulse strength, respiratory rate,
muscle flexion, reflex irritability, and colorb. Heart rate, clarity of lungs, muscle tone, reflexes,
and colorc. Apical pulse strength, respiratory rate, muscle tone, reflex irritability, and color of
extremitiesd. Heart rate, respiratory rate, muscle tone, reflex irritability, and color

ANS: d
Feedback
a. Heart rate, not apical pulse strength, is the
criterion for Apgar scoring; muscle tone, not
flexion, is assessed.
b. Clarity of lungs and reflexes are not assessed
as part of Apgar scoring. Neonatal lungs can be
congested normally at birth, and reflexes are
not assessed. Rather, reflex irritability is
assessed, based on response to tactile
stimulation.
c. Heart rate, not apical pulse strength, is assessed
along with respiratory rate, muscle tone, reflex
irritability, and color of extremities.
d. The Apgar score includes assessment of heart
rate based on auscultation, respiratory rate
based on observed movement of chest, muscle
tone based on degree of flexion and movement
of extremities, reflex irritability based on
response to tactile stimulation, and color based
on observation.

KEY: Integrated Process: Clinical Problem Solving | Cognitive Level: Application | Content
Area: Maternity | Client Need: Physiological Adaptation | Difficulty Level: Moderate

11. The perinatal nurse is assessing a woman in triage who is 34 + 3 weeks’ gestation in her first
pregnancy. She is worried about having her baby “too soon,” and she is experiencing uterine
contractions every 10 to 15 minutes. The fetal heart rate is 136 beats per minute. A vaginal
examination performed by the health-care provider reveals that the cervix is closed, long, and
posterior. The most likely diagnosis would be:
a. Preterm labor
b. Term labor
c. Back labor
d. Braxton-Hicks contractions

ANS: d
Feedback
a. Preterm labor (PTL) is defined as regular
uterine contractions and cervical dilation
before the end of the 36th week of gestation.
Many patients present with preterm
contractions, but only those who demonstrate
changes in the cervix are diagnosed with
preterm labor.
b. Term labor occurs after 37 weeks’ gestation.
c. There is no indication in this scenario that this
is back labor.
d. Braxton-Hicks contractions are regular
contractions occurring after the third month of
pregnancy. They may be mistaken for regular
labor, but unlike true labor, the contractions do
not grow consistently longer, stronger, and
closer together, and the cervix is not dilated.
Some patients present with preterm
contractions, but only those who demonstrate
changes in the cervix are diagnosed with
preterm labor.

KEY: Integrated Process: Clinical Problem Solving | Cognitive Level: Analysis | Content Area:
Maternity | Client Need: Safe and Effective Care Environment | Difficulty Level: Difficult

12. The perinatal nurse knows that the term to describe a woman at 26 weeks’ gestation with a
history of elevated blood pressure who presents with a urine showing 2+ protein (by dipstick) is:
a. Preeclampsia
b. Chronic hypertension
c. Gestational hypertension
d. Chronic hypertension with superimposed preeclampsia

ANS: d
Feedback
a. Preeclampsia is a multisystem, vasopressive
disease process that targets the cardiovascular,
hematologic, hepatic, and renal and central
nervous systems.
b. Chronic hypertension is hypertension that is
present and observable prior to pregnancy or
hypertension that is diagnosed before the 20th
week of gestation.
c. Gestational hypertension is a nonspecific term
used to describe the woman who has a blood
pressure elevation detected for the first time
during pregnancy, without proteinuria.
d. The following criteria are necessary to
establish a diagnosis of superimposed
preeclampsia: hypertension and no proteinuria
early in pregnancy (prior to 20 weeks’
gestation) and new-onset proteinuria, a sudden
increase in protein—urinary excretion of 0.3 g
protein or more in a 24-hour specimen, or two
dipstick test results of 2+ (100 mg/dL), with
the values recorded at least 4 hours apart, with
no evidence of urinary tract infection; a sudden
increase in blood pressure in a woman whose
blood pressure has been well controlled;
thrombocytopenia (platelet count lower than
100,000/mmC); and an increase in the liver
enzymes alanine transaminase (ALT) or
aspartate transaminase (AST) to abnormal
levels.

KEY: Integrated Process: Clinical Problem Solving | Cognitive Level: Application | Content
Area: Peds/Maternity | Client Need: Safe and Effective Care Environment | Difficulty Level:
Moderate

13. A patient is receiving magnesium sulfate for severe preeclampsia. The nurse must notify the
attending physician immediately of which of the following findings?
a. Patellar and biceps reflexes of +4
b. Urinary output of 50 mL/hr
c. Respiratory rate of 10 rpm
d. Serum magnesium level of 5 mg/dL

ANS: c
Feedback
a. Magnesium sulfate has been ordered because
the patient has severe pregnancy-induced
hypertension. Patellar and biceps reflexes of +4
are symptoms of the disease.
b. The urinary output must be above 25 mL/hr.
c. The drop in respiratory rate may indicate that
the patient is suffering from magnesium
toxicity. The nurse should report the finding to
the physician.
d. The therapeutic range of magnesium is 4 to 7
mg/dL.

KEY: Integrated Process: Nursing Process: Analysis; Nursing Process: Implementation |


Cognitive Level: Application | Content Area: Adverse Effects/Contraindications; Antepartum
Care; Potential for Alterations in Body Systems; Reduction of Risk Potential: Diagnostic Tests |
Client Need: Health Promotion and Maintenance; Pharmacological and Parenteral Therapies;
Physiological Integrity: Reduction of Risk Potential | Difficulty Level: Difficult
14. A woman in labor and delivery is being given subcutaneous terbutaline for preterm labor.
Which of the following common medication effects would the nurse expect to see in the mother?
a. Serum potassium level increases
b. Diarrhea
c. Urticaria
d. Complaints of nervousness

ANS: d
Feedback
a. The nurse would not expect to see a rise in the
mother’s serum potassium levels.
b. The beta agonists are not associated with
diarrhea.
c. The beta agonists are not associated with
urticaria.
d. Complaints of nervousness are commonly
made by women receiving subcutaneous beta
agonists.

KEY: Integrated Process: Nursing Process: Analysis | Cognitive Level: Application | Content
Area: Intrapartum Care; Pharmacological and Parenteral Therapies: Adverse
Effects/Contraindications and Side Effects | Client Need: Health Promotion and Maintenance;
Physiological Integrity: Pharmacological and Parenteral Therapies | Difficulty Level: Moderate

15. Which of the following signs or symptoms would the nurse expect to see in a woman with
concealed abruptio placentae?
a. Increasing abdominal girth measurements
b. Profuse vaginal bleeding
c. Bradycardia with an aortic thrill
d. Hypothermia with chills

ANS: a
Feedback
a. The nurse would expect to see increasing
abdominal girth measurements.
b. Profuse vaginal bleeding is rarely seen in
placental abruption and is never seen when the
abruption is concealed.
c. With excessive blood loss, the nurse would
expect to see tachycardia.
d. The nurse would expect to see a stable
temperature.
KEY: Integrated Process: Nursing Process: Assessment | Cognitive Level: Application | Content
Area: Antepartum Care; Reduction of Risk Potential: Potential for Alterations in Body Systems |
Client Need: Health Promotion and Maintenance; Physiological Integrity: Reduction of Risk
Potential | Difficulty Level: Moderate

16. A woman who has had no prenatal care was assessed and found to have hydramnios on
admission to the labor unit and has since delivered a baby weighing 4500 grams. Which of the
following complications of pregnancy likely contributed to these findings?
a. Pyelonephritis
b. Pregnancy-induced hypertension
c. Gestational diabetes
d. Abruptio placentae

ANS: c
Feedback
a. Pyelonephritis does not lead to the
development of hydramnios or macrosomia.
b. Pregnancy-induced hypertension does not lead
to the development of hydramnios or
macrosomia.
c. Untreated gestational diabetics often have
hydramnios and often deliver macrosomic
babies.
d. Abruptio placentae does not lead to the
development of hydramnios or macrosomia.

KEY: Integrated Process: Nursing Process: Analysis | Cognitive Level: Application | Content
Area: Antepartum Care; Physiological Adaptation: Alterations in Body Systems | Client Need:
Health Promotion and Maintenance; Physiological Integrity: Physiological Adaptation |
Difficulty Level: Difficult

17. For the patient with which of the following medical problems should the nurse question a
physician’s order for beta agonist tocolytics?
a. Type 1 diabetes mellitus
b. Cerebral palsy
c. Myelomeningocele
d. Positive group B streptococci culture

ANS: a
Feedback
a. Beta agonists often elevate serum glucose
levels. The nurse should question the order.
b. Beta agonists are not contraindicated for
patients with cerebral palsy.
c. Beta agonists are not contraindicated for
patients with myelomeningocele.
d. Beta agonists are not contraindicated for
patients with group B streptococci.

KEY: Integrated Process: Nursing Process: Analysis; Nursing Process: Implementation |


Cognitive Level: Application | Content Area: Intrapartum Care; Reduction of Risk Potential:
Potential for Alterations in Body Systems | Client Need: Health Promotion and Maintenance;
Physiological Integrity: Reduction of Risk Potential | Difficulty Level: Difficult

18. The nurse is caring for two laboring women. Which of the patients should be monitored most
carefully for signs of placental abruption?
a. The patient with placenta previa
b. The patient whose vagina is colonized with group B streptococci
c. The patient who is hepatitis B surface antigen positive
d. The patient with eclampsia

ANS: d
Feedback
a. Patients with placenta previa are not especially
high risk for placental abruption.
b. Patients colonized with group B streptococci
are not especially high risk for placental
abruption.
c. Patients who are hepatitis B surface antigen
positive are not especially high risk for
placental abruption.
d. Patients with eclampsia are high risk for
placental abruption.

KEY: Integrated Process: Nursing Process: Implementation | Cognitive Level: Application |


Content Area: Intrapartum Care; Reduction of Risk Potential: Potential for Complications |
Client Need: Health Promotion and Maintenance; Physiological Integrity: Reduction of Risk
Potential | Difficulty Level: Difficult

19. The nurse is caring for a woman at 28 weeks’ gestation with a history of preterm delivery.
Which of the following laboratory data should the nurse carefully assess in relation to this
diagnosis?
a. Human relaxin levels
b. Amniotic fluid levels
c. Alpha-fetoprotein levels
d. Fetal fibronectin levels

ANS: d
Feedback
a. Relaxin levels are rarely assessed. In addition,
they are unrelated to the incidence of preterm
labor.
b. Amniotic fluid levels are not directly related to
the incidence of preterm labor.
c. Alpha-fetoprotein levels are not related to the
incidence of preterm labor.
d. A rise in the fetal fibronectin levels in cervical
secretions has been associated with preterm
labor.

KEY: Integrated Process: Nursing Process: Assessment | Cognitive Level: Application | Content
Area: Antepartum Care; Reduction of Risk Potential: Laboratory Values | Client Need: Health
Promotion and Maintenance; Physiological Integrity: Reduction of Risk Potential | Difficulty
Level: Moderate

20. Which of the following statements is most appropriate for the nurse to say to a patient with a
complete placenta previa?
a. “During the second stage of labor you will need to bear down.”
b. “You should ambulate in the halls at least twice each day.”
c. “The doctor will likely induce your labor with oxytocin.”
d. “Please promptly report if you experience any bleeding or feel any back discomfort.”

ANS: d
Feedback
a. This response is inappropriate. This patient
will be delivered by cesarean section.
b. This response is inappropriate. Patients with
placenta previa are usually on bed rest.
c. This response is inappropriate. This patient
will be delivered by cesarean section.
d. Labor often begins with back pain. Labor is
contraindicated for a patient with complete
placenta previa.

KEY: Integrated Process: Nursing Process: Implementation | Cognitive Level: Application |


Content Area: Antepartum Care | Client Need: Health Promotion and Maintenance | Difficulty
Level: Easy
21. A woman at 32 weeks’ gestation is diagnosed with severe preeclampsia with HELLP
syndrome. The nurse will identify which of the following as a positive patient care outcome?
a. Rise in serum creatinine
b. Drop in serum protein
c. Resolution of thrombocytopenia
d. Resolution of polycythemia

ANS: c
Feedback
a. A rise in serum creatinine indicates that the
kidneys are not effectively excreting creatinine.
It is a negative outcome.
b. A drop in serum protein indicates that the
kidneys are allowing protein to be excreted.
This is a negative outcome.
c. Resolution of thrombocytopenia is a positive
sign. It indicates that the platelet count is
returning to normal.
d. Polycythemia is not related to HELLP
syndrome. Rather one sees a drop in red cell
and platelet counts with HELLP. A positive
sign, therefore, would be a rise in the RBC
count.

KEY: Integrated Process: Nursing Process: Evaluation | Cognitive Level: Application | Content
Area: Antepartum Care; Physiological Adaptation: Illness Management | Client Need: Health
Promotion and Maintenance; Physiological Integrity: Physiological Adaptation | Difficulty
Level: Difficult

22. A 16-year-old patient is admitted to the hospital with a diagnosis of severe preeclampsia. The
nurse must closely monitor the woman for which of the following?
a. High leukocyte count
b. Explosive diarrhea
c. Fractured pelvis
d. Low platelet count

ANS: d
Feedback
a. High leukocyte count is not associated with
severe pregnancy-induced hypertension (PIH)
or HELLP (hemolysis, elevated liver enzymes,
and low platelets) syndrome.
b. Explosive diarrhea is not associated with
severe PIH or HELLP syndrome.
c. A fractured pelvis is not associated with severe
PIH or HELLP syndrome.
d. Low platelet count is one of the signs
associated with HELLP (hemolysis, elevated
liver enzymes, and low platelets) syndrome.

KEY: Integrated Process: Nursing Process: Assessment | Cognitive Level: Application | Content
Area: Antepartum Care; Diagnostic Tests; Reduction of Risk Potential: Laboratory Data | Client
Need: Health Promotion and Maintenance; Physiological Integrity: Reduction of Risk Potential |
Difficulty Level: Difficult

23. A woman at 10 weeks’ gestation is diagnosed with gestational trophoblastic disease


(hydatidiform mole). Which of the following findings would the nurse expect to see?
a. Platelet count of 550,000/mm3
b. Dark brown vaginal bleeding
c. White blood cell count 17,000/mm3
d. Macular papular rash

ANS: b
Feedback
a. The nurse would not expect to see an elevated
platelet count.
b. The nurse would expect to see dark brown
vaginal discharge.
c. The nurse would not expect to see an elevated
white blood cell count.
d. The nurse would not expect to see a rash.

KEY: Integrated Process: Nursing Process: Assessment | Cognitive Level: Application | Content
Area: Antepartum Care; Physiological Adaptation: Alterations in Body Systems | Client Need:
Health Promotion and Maintenance; Physiological Integrity: Physiological Adaptation |
Difficulty Level: Difficult

24. After an education class, the nurse overhears an adolescent woman discussing safe sex
practices. Which of the following comments by the young woman indicates that additional
teaching about sexually transmitted infection (STI) control issues is needed?
a. “I could get an STI even if I just have oral sex.”
b. “Girls over 16 are less likely to get STDs than younger girls.”
c. “The best way to prevent an STI is to use a diaphragm.”
d. “Girls get human immunodeficiency virus (HIV) easier than boys do.”
ANS: c
Feedback
a. This statement is true. Organisms that cause
sexually transmitted infections can invade the
respiratory and gastrointestinal tracts.
b. This statement is true. Young women are
especially high risk for becoming infected with
sexually transmitted diseases.
c. This statement is untrue. The young woman
needs further teaching. Condoms protect
against STDs and pregnancy. In addition,
condoms can be kept in readiness for whenever
sex may occur spontaneously. Using condoms
does not require the teen to plan to have sex. A
diaphragm is not an effective infection-control
method. Plus, it would require the teen to plan
for intercourse.
d. This statement is true. Young women are
higher risk for becoming infected with HIV
than are young men.

KEY: Integrated Process: Nursing Process: Evaluation; Teaching and Learning | Cognitive
Level: Application | Content Area: Disease Prevention; High Risk Behaviors; Human Sexuality |
Client Need: Health Promotion and Maintenance: High Risk Behaviors; Human Sexuality |
Difficulty Level: Moderate

25. A woman who is admitted to labor and delivery at 30 weeks’ gestation, is 1 cm dilated, and is
contracting q 5 minutes. She is receiving magnesium sulfate IV piggyback. Which of the
following maternal vital signs is most important for the nurse to assess each hour?
a. Temperature
b. Pulse
c. Respiratory rate
d. Blood pressure

ANS: c
Feedback
a. The temperature should be monitored, but it is
not the most important vital sign.
b. The pulse rate should be monitored, but it is
not the most important vital sign.
c. The respiratory rate is the most important vital
sign. Respiratory depression is a sign of
magnesium toxicity.
d. The blood pressure should be monitored, but it
is not the most important vital sign.

KEY: Integrated Process: Nursing Process: Assessment | Cognitive Level: Application | Content
Area: Intrapartum Care; Potential for Complications from Pharmacological Therapies: Adverse
Effects/Contraindications | Client Need: Health Promotion and Maintenance; Physiological
Integrity: Pharmacological and Parenteral Therapies | Difficulty Level: Moderate

26. A primiparous woman has been admitted at 35 weeks’ gestation and diagnosed with HELLP
syndrome. Which of the following laboratory changes is consistent with this diagnosis?
a. Hematocrit dropped to 28%.
b. Platelets increased to 300,000 cells/mm3.
c. Red blood cells increased to 5.1 million cells/mm3.
d. Sodium dropped to 132 mEq/dL.

ANS: a
Feedback
a. The nurse would expect to see a drop in the
hematocrit: The H in HELLP stands for
hemolysis.
b. The nurse would expect to see low platelets.
c. The nurse would expect to see hemolysis.
d. The sodium is usually unaffected in HELLP
syndrome.

KEY: Integrated Process: Nursing Process: Analysis | Cognitive Level: Application | Content
Area: Intrapartum Care; Physiological Adaptation: Alterations in Body Systems | Client Need:
Health Promotion and Maintenance; Physiological Integrity: Physiological Adaptation |
Difficulty Level: Moderate

27. A labor nurse is caring for a patient, 39 weeks’ gestation, who has been diagnosed with
placenta previa. Which of the following physician orders should the nurse question?
a. Type and cross-match her blood.
b. Insert an internal fetal monitor electrode.
c. Administer an oral stool softener.
d. Assess her complete blood count.

ANS: b
Feedback
a. It would be appropriate to type and cross-
match the patient for a blood transfusion.
b. This action is inappropriate. When a patient
has a placenta previa, nothing should be
inserted into the vagina.
c. To prevent constipation, it is appropriate for a
patient to take a stool softener.
d. It is appropriate to monitor the patient for signs
of anemia.

KEY: Integrated Process: Nursing Process: Implementation | Cognitive Level: Application


Content Area: Antepartum Care; Patient Advocacy; Potential for Alterations in Body Systems |
Client Need: Health Promotion and Maintenance; Physiological Integrity—Reduction of Risk
Potential; Safe and Effective Care Environment—Management of Care | Difficulty Level:
Moderate

28. A type 1 diabetic patient has repeatedly experienced elevated serum glucose levels
throughout her pregnancy. Which of the following complications of pregnancy would the nurse
expect to see?
a. Postpartum hemorrhage
b. Neonatal hyperglycemia
c. Postpartum oliguria
d. Neonatal macrosomia

ANS: d
Feedback
a. The patient is not especially high risk for a
postpartum hemorrhage.
b. The nurse would expect to see neonatal
hypoglycemia, not hyperglycemia.
c. The nurse would expect to see postpartum
polyuria.
d. The nurse would expect to see neonatal
macrosomia.

KEY: Integrated Process: Nursing Process: Analysis | Cognitive Level: Application | Content
Area: Antepartum Care; Physiological Adaptation: Alterations in Body Systems | Client Need:
Health Promotion and Maintenance; Physiological Integrity—Physiological Adaptation |
Difficulty Level: Difficult

29. According to agency policy, the perinatal nurse provides the following intrapartal nursing
care for the patient with preeclampsia:
a. Take the patient’s blood pressure every 6 hours
b. Encourage the patient to rest on her back
c. Notify the physician of urine output greater than 30 mL/hr
d. Administer magnesium sulfate according to agency policy

ANS: d
Feedback
a. The nurse is the manager of care for the
woman with preeclampsia during the
intrapartal period. Careful assessments are
critical. The blood pressure is taken every 1
hour or more frequently according to physician
orders or institutional protocol.
b. The nurse is the manager of care for the
woman with preeclampsia during the
intrapartal period. Careful assessments are
critical. The patient should be encouraged to
assume a side-lying position to enhance uterine
perfusion.
c. The nurse is the manager of care for the
woman with preeclampsia during the
intrapartal period. Careful assessments are
critical. A urine output less than 30 mL/hr is
indicative of oliguria, and the physician must
be notified.
d. The nurse is the manager of care for the
woman with preeclampsia during the
intrapartal period. Careful assessments are
critical. The nurse administers medications as
ordered and should adhere to hospital protocol
for a magnesium sulfate infusion.

KEY: Integrated Process: Clinical Problem Solving | Cognitive Level: Application | Content
Area: Maternity | Client Need: Safe and Effective Care Environment | Difficulty Level: Moderate

30. A woman who is 36 weeks pregnant presents to the labor and delivery unit with a history of
congestive heart disease. Which of the following findings should the nurse report to the primary
health-care practitioner?
a. Presence of chloasma
b. Presence of severe heartburn
c. 10-pound weight gain in a month
d. Patellar reflexes +1

ANS: c
Feedback
a. Chloasma is a normal pregnancy finding.
b. Heartburn is an expected finding during the
third trimester.
c. The weight gain may be due to fluid retention.
Fluid retention may occur in patients with
pregnancy-induced hypertension and in
patients with congestive heart failure. The
physician should be notified.
d. Although slightly hyporeflexic, patellar
reflexes of +1 are within normal limits.

KEY: Integrated Process: Nursing Process: Analysis; Nursing Process: Implementation |


Cognitive Level: Application | Content Area: Antepartum Care; Reduction of Risk Potential:
Potential for Alterations in Body Systems | Client Need: Health Promotion and Maintenance;
Physiological Integrity: Reduction of Risk Potential | Difficulty Level: Difficult

31. Ms. M is 38 weeks’ gestation and is a G1 P0. At 10 pm Ms. M has just been informed by the
nurse that she is 3 to 4 cm dilated, cervix is 100% effaced, and contractions are every 4 to 5
minutes. When the nurse tells her the findings from the SVE, Ms. M states that she had been
contracting since early that morning and she becomes extremely frustrated stating “I should have
had this baby by now.” What is the best response by the nurse?
a. Remind her that length of labor for the first child can be 18 to 24 hours
b. Promote relaxation techniques
c. Discuss various analgesic options
d. Tell Ms. M that the provider will be contacted immediately about the slow progress of labor

ANS: b
Women in the latent phase of labor may be frustrated with lack of progress or slow progress of
labor and desire companionship and encouragement. The other responses are inappropriate. The
nurse should first encourage breathing and relaxation methods as well as provide reassurance,
and then contact the provider.

KEY: Integrated Process: Nursing Process: Implementation | Cognitive Level: Analysis | Content
Area: Intrapartum Care | Client Need: Health Promotion and Maintenance—Intrapartum Care |
Difficulty Level: Difficult

32. Ms. P has delivered her first baby 30 minutes ago and the placenta delivered 15 minutes ago.
She is attempting to breastfeed her newborn daughter for the first time. Which action by the
nurse would NOT be appropriate?
a. The nurse is checking the BP every 15 minutes
b. The nurse is massaging the fundus vigorously
c. The nurse is auscultating the infant’s heart and lungs while on the mother’s chest
d. The nurse is leaving the patient unattended for 30 minutes to bond with her newborn
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Magazine

of

Western History
Illustrated

NO. 1. NOVEMBER 1884


CONTENTS

PAGE.
Portrait of Arthur St. Clair Frontispiece.
Discovery of the Ohio River by La Salle, Col. Charles
1669–70. Whittlesey. 3
Geographical History of Ohio, C. C. Baldwin. 16
A Description of Fort Harmar, 26
Illustration—Fort Harmar in 1788.
Organization of the Ohio Land Company, Alfred Mathews. 32
Illustration—Portrait of Rufus Putnam.
Indian Occupation of Ohio, Alfred Mathews. 41
Arthur St. Clair and the Ordinance of 1787, William W.
Williams. 49
Geo. Washington’s First Experience as
Surveyor, Walter Buell. 62
Illustration—Washington on a Surveying
Expedition.
Editorial Notes, 70
Pioneer Societies, 73
Historical News, 75

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Magazine of Western History.

Vol. I. NOVEMBER, 1884. No. 1


DISCOVERY OF THE OHIO RIVER BY LA
SALLE, 1669–70.

What is designated on the early maps of the United States as the


“Territory Northwest of Ohio” embraced all the country east of the
Mississippi and north of the Ohio River. Great Britain acquired it
from France by the treaty of February, 1762, but, having prior claims
to it, had before that time granted most of the territory to her several
colonies. Probably there were not more than three thousand white
people in the territory when this treaty was signed, and these were
principally wandering French traders; very few of them cultivators of
the soil. In 1778 Virginia conquered the northwest from Great
Britain, and erected the entire territory into a county, by the name of
Illinois. Soon after the close of the War of the Revolution, in the year
1787, the United States established in the same region its first
provincial government, and gave it the above title, which in common
parlance was known as the “Northwestern Territory.” Its fixed
population did not then exceed five thousand. There are now five
States, and the half of a sixth, whose inhabitants number not far
from 10,000,000, among whom the French element is scarcely
perceptible. The people of these States are intelligent, and take a
lively interest in the history of the discoverers of their country,
among whom La Salle holds the first place.
Having spent a life of the length usually allotted to man, on the
waters of the Ohio, the Upper Mississippi, and the lakes, threading
many of the streams on which they floated their canoes, passing over
the same trails, coasting along the same shores, those intrepid
explorers of two centuries since, have often been, in imagination,
vividly near to me.
As early as 1840 I saw evidence of the presence of white men in
northeastern Ohio, of whom we had then no historical proof. This
evidence is in the form of ancient cuts, made by sharp axes on our
oldest forest trees, covered by their subsequent growth. In this
climate the native trees are endogenous, and take on one layer of
growth annually. There are exceptions, but I have tested the accuracy
of this habit, in about forty cases where I have had other proof of the
age of the tree, and find it to be a good general rule.
The Jesuit relations contain no account of establishments on the
south shore of Lake Erie in the seventeenth century. For many years
these wooden records remained an interesting mystery, which I
think may possibly be solved by recent documents brought to light in
France. We know that La Salle in 1680 returned from the Illinois to
Montreal most of the way by land, and it is conjectured that he may
have traversed the south shore of Lake Erie; but the passage of a few
men hastily through a wilderness did not account for the many
marks of axes which we find.
The stump of an oak tree was shown me soon after it had been
felled in 1838, which stood in the northwestern part of Canfield,
Mahoning County, O. It was two feet ten inches in diameter, and,
with the exception of the concealed gashes, was quite sound. When
about fourteen inches in diameter, this tree had been cut nearly half
through; but the scar had healed over so thoroughly that it did not
appear externally. I took a section from the outside to the heart,
showing both the old and the recent axe marks, which may be seen in
the museum of the Western Reserve Historical Society, at Cleveland.
Over the old cuts there had grown one hundred and sixty annual
layers of solid wood, and the tree had died of age some years before.
This would place the cutting between the years 1670 and 1675. The
tree stood a few miles south of the great Indian trail leading from the
waters of the Mahoning, a branch of the Ohio, to the waters of the
Cuyahoga River and Lake Erie. In 1848 or 1849, Mr. S. Lapham, of
Willoughby, Lake County, Ohio, felled a hickory tree, standing a
short distance from the ridge, along which was once the main Indian
trail parallel to the lake. The diameter of the stump was about two
feet. Near the heart there were very distinct cuts of a sharp, broad-
bitted axe. Mr. Lapham preserved a piece of this tree, that is now in
our museum, donated by Professor J. L. Cassells. The annual layers
of growth are very thin, and difficult to count, but are about four
hundred in number, outside the ancient chopping. Another tree was
found in Newburgh, Cuyahoga County, Ohio, more than thirty years
since, with marks of an axe near the centre, represented to have one
hundred and fifty to one hundred and sixty layers of growth over it,
apparently the work of a sharp, broad-bitted axe.
In the cabinet of the Ashtabula Historical Society, at Jefferson,
Ashtabula County, Ohio, there was, some years since, a piece of wood
with ancient axe marks of about the same date. I have heard of two
others in northeastern Ohio, which I have not seen, and which may
have been the work of a dull, narrow-bitted axe in the hands of a
savage, and not the work of white men; but the Indians of northern
Ohio could not have long been in possession of metal tomahawks or
squaw hatchets, in the year 1670. Such cuts, if made by them, could
be only a few years more ancient.
The Lake County stump has about twice the number of layers we
should expect, and which would carry the chopping to a period
before the landing of Columbus. Botanists explain this by the
exceptional cases where there is a double layer in a year. If La Salle
and his party spent two or three years exploring and trading in furs
in the lake country, they might well be the authors of these ancient
cuttings. There must have been several hundreds of them, or we
should not have met with so many at this late period. Any person
examining the pieces in the Western Reserve Historical Society
museum will be convinced they are not the work of Indians.
The honor of the first exploration of Ohio has long been claimed by
the French for their countryman, Robert Cavalier de La Salle, but the
details of this exploration were so meager, its date so doubtful, and
the extent of his travels so uncertain, that some historians were not
inclined to give credence to his claims.
A romantic mystery still envelopes his movements in the country
between Lake Erie and the Ohio River, which it was hoped the papers
of M. Pierre Margry would dissipate, and thus place La Salle on
record in full and clear terms. If this cannot be effected by the zeal
and industry of M. Margry, during a life work in search of
manuscripts relating to La Salle, I fear that we must relinquish the
hope of a satisfactory solution.
DeCourcelles and Talon, who were respectively governor and
intendant in New France, sent out several parties of discovery
between 1665 and 1680. They had two principal objects in view: the
discovery of copper, and a route to China through the Great Southern
Sea.
In a memoir to the king, dated Quebec, October 10, 1670, (New
York Colonial Documents, page 64) Talon writes: “Since my arrival I
have despatched persons of resolution, who promise to penetrate
farther than has ever been done to the west and northwest of
Canada, and others to the southwest and south.” These parties were
instructed to keep journals, reply to instructions, take possession of
the country formally, and were expected to be absent without news
for about two years. After all these precautions, a distressing fatality
overtook most of their letters, field notes, reports and maps. Joliet
was nearly in sight of Montreal on his return in 1674 from the
Mississippi River, when his canoe was capsized in the rapids, he was
nearly drowned, and every paper was lost. Of La Salle’s memoranda,
covering the years 1669 to 1673, nothing has been recovered.
In 1686 Governor DeNonville, writing from Quebec under date of
November 8th, to Seignelay, Minister of Marine, says: “I annex to
this letter a memoir of our right to the whole of that country (Ohio),
of which our registers ought to be full, but no memorials of them are
to be found. I am told that M. Talon has the original of the entries in
his possession of a great many discoveries that were made in this
country, with which our registers ought to be full. Doubtless he has
given them to my late Lord, your father.”—Colonial Documents, vol.
9, page 297.
“The River Ohio, otherwise called the Beautiful River, and its
tributaries, belong indisputably to France, by virtue of its discovery,
by the Sieur de la Salle, and of the trading posts the French have had
there since. * * * It is only within a few years that the English have
undertaken to trade there.”—Instructions to M. DuQuesne, Paris,
1752, (Colonial Documents, N. Y., vol. 10, page 243).
“It is only since the last war that the English have set up claims to
the territory on the Beautiful River, the possession whereof has never
been disputed to the French, who have always resorted to that river
ever since it was discovered by Sieur de la Salle.”—Instructions to
Vaudreuil, Versailles, April, 1755, (Colonial Documents, vol. 10, page
293).
As the Jesuits in Canada were personally hostile to La Salle, they
never mention his name in their relations, or the discoveries made by
him. They were jealous of him as a discoverer and a trader, despised
him as a friend of the Sulpitians, and an apostate from the Society of
Jesus, an order at that time so powerful in Canada that the governor-
general was obliged to compliment them in his open dispatches,
while he spoke severely of them in cypher.
Louis XIV. was not required to expend more money in wars than
other French monarchs, but his civil projects were ample and his
pleasures very expensive. He was habitually straitened for funds, and
required the strictest economy in the expenses of all his officers.
In Canada parsimony in public affairs was even more rigid than in
France. The governor-general was unable to live on his salary.
Intendants, ecclesiastics and local governors were in a still worse
predicament. It was expected that all of them would make up this
deficiency by traffic in furs. Many of the dispatches from Versailles
are laden with warnings against incurring expenses, which amounted
to commands. Many of those sent in reply contain passages
congratulating the king on acquisitions of territory and glory, which
cost him nothing. Three-quarters of a century later, as related above,
in negotiations with England, the Ohio country was claimed by the
French, on the sole ground of the discoveries of La Salle.
The personal interest which public officers had in the Indian trade,
of necessity brought about discord between them. La Salle, having no
fortune, was obliged to sustain himself in the same way, which
brought him in direct antagonism with officers, priests and traders.
This reference is necessary to explain the difficulties under which he
labored.
According to the Abbé Galinée, Governor Courcelles requested
himself and Dollier DeCasson, another Sulpitian, to join La Salle in a
voyage he had long contemplated, toward a great river which he
conceived, from the accounts of the Iroquois, to flow westward,
beyond which, after seven or eight months of travel, in their way of
stating it, the river and country were lost in the sea.
By this river, called by them the Ohio, Olighiny-sipu, or Beautiful
River, and by others, Mescha-zebe, or Mississippi, M. de la Salle
hoped to find the long sought passage to the Red, Vermillion, or
South Sea, and acquire the glory of that enterprise. He also hoped to
find plenty of beavers wherewith to meet the expense of the journey.
We must not forget the nature of the French Government when
contemplating the history of Canada. The king was absolute, not only
in public but in private affairs. When he said: “I am the State,” he
expressed a fact, and not a fiction or a boast. The men and women of
the kingdom were subject to the will of one man, even in their
personal relations and occupations. In Canada nothing escaped the
supervision of his officers, who were equally absolute, which explains
why permission was necessary to engage in any enterprise.
The two parties left Montreal in July, 1669, La Salle having four
canoes and fourteen men, the Sulpitians three canoes and eight men.
They reached Ironduquoit Bay, in New York, on the 10th of August,
making a portage to the Genesee valley and some Indian towns near
Victor Station and Boughton Hill, sixteen miles southeasterly from
Rochester. The savages told La Salle that the Ohio had its rise three
days’ journey from “Sonnontouan,” or the country of the Senecas.
After a month’s travel they would reach the Hon-ni-as-ant-ke-rons,
and the Chouanons (Shawnees); after passing them and a great fall
or chute, there were the Outagamies (Pottawatomies), and the
country of the Is-konsan-gos, with plenty of deer, buffaloes, thick
woods, and an immense population.
The Jesuits had a mission at “Gannegora,” the Indian name of a
town and a fort near Boughton Hill, but were absent when La Salle
and the Sulpitians arrived there. The Indians discouraged them from
taking the Genesee route to the Ohio, representing that it required
six days’ journey of twelve leagues or thirty-six miles each.
Charlevoix affirms that the Genesee is navigable for canoes sixty
leagues or one hundred and eighty miles, and from thence it is only
ten leagues or thirty miles by land to the Allegheny or Ohio, river of
the Iroquois. Mr. Marshall has shown that this portage was in
Allegany County, New York, from near Belvidere to Olean.
By the united efforts of the Jesuits, the Dutch and the Senecas,
they were persuaded to relinquish this route and hasten back to their
canoes, to avoid violence on the part of the savages. They coasted
along the south shore of Lake Ontario, passing the Niagara without
examination, and reached Burlington Bay on the 22d of September.
DeNonville, in 1687, states that La Salle had houses and people at
Niagara in 1668.—(Historical Documents, vol. 1, p. 244). If this is
true, La Salle must have been well acquainted with the portage to
Lake Erie, around the falls. Why he should have selected the more
difficult route by way of Burlington Bay, and a portage of fifteen
miles to Grand River, is nowhere explained.
Not far from the head of the bay was the village of Tenouatouan,
on the path to Grand River. Here the party met Joliet and a few
Indians, on his return from Mackinaw. He had been sent by the
intendant to find the copper mines of Lake Superior, and appears to
have been the first Frenchman to have navigated Lake Erie. He took
that route home at the instigation of the Ottawas, and of an Iroquois
prisoner he was taking home to his people.
According to Galinée, when they were fifty leagues west of Grand
River, this Iroquois became alarmed on account of the
Andasterrionons, Errionons, Eriqueronons, or Eries of the south
shore, with whom the Senecas were at war. They were thus obliged to
leave their canoes and make the journey to Tenouatouan by land.
La Salle’s plan might have been to cross from Lake Ontario to
Grand River, down it to the lake, thence along the north shore of Erie
to the mouth of the Maumee River, on the route referred to by him in
1682; up this stream to the portage at Fort Wayne, and down the
waters of the Wabash into an unknown world.
In a subsequent letter written from Illinois he speaks of this route,
and also in his memorial to Frontenac in 1677, as the best one for
traffic between the Great River and Canada, though it does not
appear that he ever passed over it.—(Western Reserve Historical
Society, Tract 25). Joliet was likewise ambitious of the glory of
discovering the Great River, of which the Jesuit missionaries and the
Indians gave glowing descriptions. He seems to have persuaded
Galinée and DeCasson that this was the better route. La Salle and the
Sulpitians here became alienated, and after attending mass
separated on the 30th of September, they to find Lake Erie and the
Ottawas of Mackinaw; he to pursue his original design. He had been
for some days sick of a fever, which Galinée attributed to the sight of
several rattlesnakes. He declared it to be so late in the season that his
voyageurs, not accustomed to such a rigorous climate, would perish
in the woods during the winter.
From the hour of this separation we are without explicit
information of his journeyings for a term of nearly three years.
During this period the exploration of the Ohio country was effected,
and in the opinion of M. Margry, the Mississippi was discovered by
him, in advance of Joliet and Marquette. These wanderings, of which
after two hundred years we know very little, show more originality of
design, more audacity in execution, and a more pertinacious
resolution under difficulties, than his later achievements on the
Mississippi. No one has set up against him a rival claim to the
discovery of the Ohio. His heirs, his admirers, and his countrymen
should cherish the memory of that discovery as the most wonderful
of his exploits. The historical obscurity which has befallen these
expeditions is a painful fact, but is in some measure compensated by
a glamour of romance, which deepens with the lapse of time. On
seeing his favorite plan of an advance by the north shore of Lake Erie
frustrated, he may have determined to brave all dangers and enter
the lake by way of Niagara. There are many plans which he may have
determined upon, of which we can only form a vague conjecture. He
may have turned his canoes along the north shore, and spent the
winter in hunting in that country. Color is given to this surmise by
the statement of Nicholas Perrot that he met La Salle on the Ottawa
in 1670, but this is not probable. Taken in the order of the
anonymous relation, he was on a river which ran from east to west,
before passing to Onontague (Onondaga), but there is no water route
passable from Lake Ontario to the Ohio which would pass Onondaga.
It is far more probable that the enthusiastic young explorer entered
Niagara River with his Shawnee guide and made the portage to Lake
Erie. He could soon find one of the portages to the waters of the
Ohio, spoken of by the Senecas. One of them was from Lake Erie
near Portland and Westfield, N. Y., of six or seven leagues (eighteen
to twenty-one miles), to Chatauqua Lake. Another, of about the same
length, answers also to their directions, which was afterward the
usual route from Erie to French Creek, at Waterford in Pennsylvania.
By either of these routes he might have been on the Allegheny, with
his goods and canoes, in ten or twelve days, if the weather was good.
He would, however, have here been among the Andasterrionons,
who were probably the Eries or Errieronons, with whom the Senecas
were then at war. These Indians had been represented at
“Gannegora” as sure to kill the Frenchmen if they went among them.
Gravier has a theory that instead of Onontague or “Gannontague,”
mentioned in the memoir of the friend of Galinée, we should read
Ganestogue or “Ganahogue,” the ancient name of the Cuyahoga. It is
not improbable that the guide of La Salle knew of this route, along
which, ascending the Cuyahoga from Cleveland, the party would be
enabled to reach the waters of the Muskingum, by a portage of seven
miles at Akron, and from thence the Ohio, at Marietta. La Salle states
that after he reached the Ohio, according to the anonymous account,
but one very large river was passed on the north shore before
reaching the falls. If he failed to recognize the Scioto as a very large
river, there is only the Great Miami which meets his description.
He may also have concluded to spend the winter in Ohio, where
game was abundant and beavers numerous, an event to which I have
referred in connection with the axe marks. We have no reliable
evidence that he was at Montreal between July, 1669, and August,
1672. The records of Villemarie, quoted by Faillon, contain the first
solid proof of his presence on the St. Lawrence, after he departed
with Galinée and DeCasson. During this period we may be certain he
was not idle. It is far from certain how many men he had, but the
anonymous relation affirms that he was deserted by twenty-three or
twenty-four of them after leaving the Falls of the Ohio. Where did he
get these additional recruits? In the absence of historical proof, it is
reasonable to infer that, when he left the Sulpitians, he moved
southwesterly in accordance with his instructions, and did not turn
back to Montreal. His honor, his interest and his ambition all forced
him in one direction, toward the country where he was directed to go
and to stay, as long as he could subsist.
What the Abbé Faillon states in the third volume of his French
Colonies (page 312) confirms this supposition. According to this
authority, about four months after La Salle’s departure, which would
be in November, 1669, a part of his men returned, having refused to
follow him. He himself could not have returned at this time without
observation and public discredit.
Such a brief and fruitless effort to reach the Great South Sea could
not have escaped the notice of historians. It is not probable that his
foreman, Charles Thoulamion, or his surgeon, Roussilier, (Histoire
Colonie Francais, vol. 3, p. 290) were among those wanting in
courage to follow him. Some soldiers were of the party, furnished by
Talon, who would be likely to remain by force of military discipline.
There are many threads of this tangled skein, which can not yet be
drawn out. In the first volume of the Margry documents (pages 371–
78) may be seen a long recital by a friend of the Abbé Galinée,
already referred to, whose name is a subject of conjecture, but
presumed by Mr. Parkman to have been the second Prince of Conti,
Armand de Bourbon, a friend of La Salle, seventeen or eighteen years
of age, purporting to be the substance of conversations with La Salle,
which must have taken place as late as 1677, when he was in France.
One portion of this paper is styled a “Life of La Salle,” a large part of
which is occupied by his troubles with the Jesuits. “He (La Salle) left
France at twenty-one or twenty-two years of age, in 1665, well
instructed in matters in the new world, with the design of attempting
new discoveries. After having been some time in Canada he acquired
some knowledge of the languages, and traveled northward, where he
found nothing worthy of his attention, and resolved to turn
southward; and having advanced to a village of savages on the
Genesee, where there was a Jesuit, he hoped to find guides,
etc.” * * * * * “M. de la Salle continued his route from ‘Tenouatoua’
upon a river which goes from east to west, and passed to Onondaga
(Onontague), then to six or seven leagues below Lake Erie; and
having reached longitude 280° or 283°, and to latitude 41°, found a
sault, which falls toward the west into a low, marshy country,
covered with dry trees, of which some are still standing. He was
compelled to take the land, and following a height, which led him
very far, he found savages who told him that very far from there the
same river, which was lost in the low, marshy country, reunited in
one bed. He continued his way, but as the fatigue was great, twenty-
three or twenty-four men, whom he had brought thus far, left him all
in one night, regained the river, and saved themselves, some in New
Holland and others in New England. He found himself alone at four
hundred leagues (twelve hundred miles) from his home, where he
failed not to return, reascending the river, and living by hunting,
upon herbs and upon what the savages gave him, whom he met on
the way. After some time he made a second attempt, on the same
river, which he left below Lake Erie, making a portage of six or seven
leagues (eighteen or twenty-one miles), to embark on this lake,
which he traversed toward the north” into lakes Huron and
Michigan, and thence to the Illinois.
Aside from the indefinite phrases of this paper, it is characterized
by so many geographical errors that it would possess little value
without the support of the following statement of La Salle himself:

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