Promoting Client Comfort During Labor and Delivery

Promoting Client Comfort During Labor and Delivery Related

Review Promoting Client Comfort During Labor and Delivery related questions and content

A labor patient, gravida 2, para 1, at term has received meperidine (Demerol) for pain control during labor. Her most recent dose was 15 minutes ago and birth is now imminent. Maternal vital signs have been stable and the EFM tracing has not shown any baseline changes. Which medication does the nurse anticipate would be required in the birth room for administration?

  • A. Oxytocin (Pitocin)
  • B. Naloxone (Narcan)
  • C. Bromocriptine (Parlodel)
  • D. Oxygen
Correct Answer: A

Rationale: Rationale: The correct answer is A: Oxytocin (Pitocin). Oxytocin is commonly given during the third stage of labor to help with uterine contractions and prevent postpartum hemorrhage. Meperidine can cross the placenta and cause respiratory depression in the newborn. Therefore, the nurse should anticipate needing oxytocin to assist with contractions after birth to minimize bleeding.

Summary of other choices:
B: Naloxone (Narcan) - This is an opioid antagonist used to reverse the effects of opioids like meperidine. However, it is not typically needed if the newborn does not show signs of respiratory depression.
C: Bromocriptine (Parlodel) - This medication is not commonly used during labor and birth and is not indicated in this scenario.
D: Oxygen - While oxygen may be needed for the mother or newborn in certain situations, it is not directly related to the administration of meperidine or

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Nausea and vomiting are common discomforts in labor. When treating with promethazine, what must the nurse do when administering this medication?

  • A. Administer subcutaneously.
  • B. Never administer with an opioid.
  • C. Dilute before IV administration.
  • D. Never administer in first stage labor.
Correct Answer: C

Rationale: The correct answer is C: Dilute before IV administration. Promethazine is a vesicant and can cause tissue damage if not properly diluted before IV administration. Diluting the medication helps reduce the risk of phlebitis and tissue irritation. Administering it subcutaneously (A) can cause pain and irritation at the injection site. Administering with an opioid (B) can increase the risk of respiratory depression. Administering promethazine in first stage labor (D) is generally safe, but diluting before IV administration is still necessary to prevent adverse effects.

A multipara's labor plan includes the use of jet hydrotherapy during the active phase of labor. What is the priority patient assessment prior to assisting the patient with this request?

  • A. Maternal pulse
  • B. Maternal temperature
  • C. Maternal blood pressure
  • D. Maternal blood glucose level
Correct Answer: B

Rationale: The correct answer is B: Maternal temperature. The priority assessment before using jet hydrotherapy is to check the maternal temperature to ensure it is within normal limits. Elevated temperature can indicate infection, which could be exacerbated by hydrotherapy. Maternal pulse (A), blood pressure (C), and blood glucose level (D) are important assessments but are not the priority before using hydrotherapy. Pulse and blood pressure can be monitored during hydrotherapy, and blood glucose levels are typically not affected by hydrotherapy.

A patient in early labor is feeling anxious about the labor process. Which intervention would be most effective in reducing her anxiety?

  • A. Explain the stages of labor and what to expect.
  • B. Encourage her to focus on her breathing.
  • C. Administer a sedative as prescribed.
  • D. Limit visitors to reduce external stressors.
Correct Answer: A

Rationale: The correct answer is A. Explanation of the stages of labor and what to expect can help the patient understand the process, reducing uncertainty and anxiety. This empowers the patient and promotes a sense of control. Encouraging breathing techniques (B) can help manage pain but may not address the underlying anxiety. Administering sedatives (C) should be a last resort due to potential side effects. Limiting visitors (D) can help reduce stress, but addressing the patient's anxiety requires more direct intervention.

The nurse detects hypotension in a laboring patient after an epidural. Which actions should the nurse plan to implement? (SeNleUctRaSllIthNatGaTpBpl.y.)C OM

  • A. Encourage the patient to drink fluids.
  • B. Place the patient in a Trendelenburg position.
  • C. Administer a normal saline bolus as prescribe
  • D. Administer oxygen at 8 to 10 L/minute per face mask.
Correct Answer: C

Rationale: The correct answer is C: Administer a normal saline bolus as prescribed. In this scenario, hypotension post-epidural could be due to vasodilation leading to decreased blood pressure. Administering a normal saline bolus can help increase intravascular volume and improve blood pressure. Encouraging the patient to drink fluids (A) may not provide immediate volume resuscitation. Placing the patient in a Trendelenburg position (B) can worsen hypotension by increasing pressure on the vena cava. Administering oxygen (D) may be helpful but addressing the hypotension with a saline bolus is the priority.

What nursing intervention can be performed prior to epidural placement to potentially reduce a blood pressure drop?

  • A. routine use of ephedrine
  • B. IV fluid bolus
  • C. insertion of indwelling urinary catheter
  • D. upright positioning of the laboring person
Correct Answer: B

Rationale: The correct answer is B: IV fluid bolus. Prior to epidural placement, administering an IV fluid bolus can help prevent a drop in blood pressure by increasing preload and maintaining cardiac output. This helps offset the vasodilation effects of the epidural anesthesia. Options A, C, and D are incorrect. Ephedrine (A) is not routinely used before epidural placement due to its potential adverse effects. Insertion of a urinary catheter (C) is not directly related to preventing a blood pressure drop. Upright positioning (D) may actually worsen hypotension by pooling blood in the lower extremities.

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