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A laboring patient requests hot and cold applications be applied to her abdomen for pain control. How will this intervention act to control pain?
- A. By increasing endorphin production
- B. By facilitating effacement and dilation
- C. By producing increasing pain tolerance
- D. By stimulation of large nerve fibers
Correct Answer: D
Rationale: The gate control theory explains how pain impulses reach the brain for interpretation. It supports several nonpharmacological methods of pain control. According to this theory, pain is transmitted through small-diameter nerve fibers. However, the stimulation of large-diameter nerve fibers temporarily interferes with the conduction of impulses through small-diameter fibers. Techniques to stimulate large-diameter fibers and 'close the gate' to painful impulses include massage, palm and fingertip pressure, and heat and cold applications.
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A woman who is 6 cm dilated has the urge to push. What will the nurse instruct the woman to do during the contraction?
- A. Use slow-paced breathing.
- B. Hold her breath and push.
- C. Blow in short breaths.
- D. Use rapid-paced breathing.
Correct Answer: C
Rationale: If a laboring woman feels the urge to push before the cervix is fully dilated, then she is taught to blow in short breaths to avoid bearing down.
An 18-year-old primigravida is 4 cm dilated and her contractions are 5 minutes apart. She received little prenatal care and had no childbirth preparation. She is crying loudly and shouting, 'Please give me something for the pain. I can't take the pain!' What is the priority nursing diagnosis?
- A. Pain related to uterine contractions
- B. Knowledge deficit related to the birth experience
- C. Ineffective coping related to inadequate preparation for labor
- D. Risk for injury related to lack of prenatal care
Correct Answer: A
Rationale: The most important issue for this woman, at this time, is effective pain management.
What breathing techniques would the nurse teach the prenatal patient to help her focus during labor in order to reduce pain? (Select all that apply.)
- A. First-stage breathing
- B. Abdominal breathing
- C. Fourth-stage breathing
- D. Modified paced breathing
- E. Patterned paced breathing
Correct Answer: A,B,D,E
Rationale: First-stage breathing includes the techniques of modified paced breathing and patterned paced breathing, which are types of abdominal breathing techniques. These patterns of breathing will help a woman in labor to focus and reduce pain perception. The fourth stage of labor is the woman's recovery stage and does not require a breathing technique.
A nurse instructs a woman's labor coach to comfort her by firmly pressing on her lower back. What is this technique?
- A. Sacral pressure
- B. Distraction
- C. Effleurage
- D. Conscious relaxation
Correct Answer: A
Rationale: Sacral pressure refers to firm pressure against the lower back to relieve some of the pain of back labor.
A woman requests a pudendal block to manage her labor pain. What statement by the woman indicates a need for further explanation about the pudendal block?
- A. I'm having a contraction. Can I get the pudendal block now?'
- B. I'll get the pudendal block right before I deliver.'
- C. The nurse-midwife will insert the needles into my vagina.'
- D. It takes a few minutes after the medicine is administered to make me feel numb.'
Correct Answer: A
Rationale: The pudendal block does not block pain from contractions and is given just before birth.