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A laboring patient who imagines her body opening to let the baby out is using a mental technique called
- A. imagery.
- B. effleurag
- C. dissociation.
- D. distraction.
Correct Answer: A
Rationale: The correct answer is A: imagery. Imagery involves creating mental pictures or sensations to help focus and relax the mind. In this scenario, the laboring patient visualizes her body opening to facilitate the birthing process, which can help reduce anxiety and pain perception. Effleurage (B) is a massage technique, dissociation (C) is a coping strategy to mentally detach from pain, and distraction (D) involves diverting attention away from pain stimuli. However, in this case, the patient's focus on visualizing the birthing process aligns with the use of imagery.
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The laboring person is in pain and very anxious. They do not want to use traditional pain relief methods. What can the nurse offer the laboring person to help with relaxation and reducing anxiety?
- A. lavender oil
- B. epidural
- C. nalbuphine hydrochloride (Nubain)
- D. cold rag
Correct Answer: A
Rationale: The correct answer is A: lavender oil. Lavender oil is a natural remedy known for its calming and relaxing properties, which can help reduce anxiety and promote relaxation in laboring individuals. It is safe and non-invasive, making it an ideal choice for someone who does not want traditional pain relief methods.
Incorrect choices:
B: Epidural is a commonly used pain relief method that involves injecting anesthesia into the epidural space, providing effective pain relief but not specifically targeting relaxation and anxiety reduction.
C: Nalbuphine hydrochloride (Nubain) is a synthetic opioid analgesic that can help manage pain but may not address the individual's desire for non-traditional methods.
D: Cold rag may provide some temporary relief for discomfort but may not be as effective in promoting relaxation and reducing anxiety compared to the calming effects of lavender oil.
Which patient will most likely have increased anxiety and tension during labor?
- A. Gravida 2 who refused any medication
- B. Gravida 2 who delivered a stillborn baby last year
- C. Gravida 1 who did not attend prepared childbirth classes
- D. Gravida 3 who has two children younger than 3 years
Correct Answer: B
Rationale: The correct answer is B. A patient who delivered a stillborn baby last year is more likely to experience increased anxiety and tension during labor due to previous traumatic experience. This can trigger fear and worry about the current pregnancy outcome, leading to heightened emotional distress.
Incorrect Choices:
A: Refusing medication does not necessarily correlate with increased anxiety during labor.
C: Not attending childbirth classes may result in lack of knowledge but does not directly relate to increased anxiety during labor.
D: Having two children younger than 3 years may cause stress but does not specifically indicate increased anxiety during labor.
A patient is admitted to the labor and birth room in active labor; contractions are 4 to 5 minutes apart and last for 30 seconds. The nurse needs to perform a detailed assessment. When is the best time to ask questions or perform procedures?
- A. After the contraction is over
- B. When it is all right with the coach
- C. During the increment of the next contraction
- D. After administration of analgesic-anesthetic
Correct Answer: C
Rationale: The correct answer is C: During the increment of the next contraction. This is the best time for assessment as the patient is likely to be more focused and cooperative during this phase. Asking questions or performing procedures during the contraction or immediately after may be distracting or uncomfortable for the patient. Waiting until the contraction is over (choice A) may delay necessary assessment. Waiting for the coach's approval (choice B) may not always align with the patient's needs. Waiting until after administration of analgesic-anesthetic (choice D) may not be timely for necessary assessment and may also impact the patient's ability to provide accurate information.
Which fetal position increases the likelihood of a longer and more painful labor?
- A. Left occiput posterior
- B. Left occiput anterior
- C. Right occiput anterior
- D. Right occiput transverse
Correct Answer: A
Rationale: The correct answer is A: Left occiput posterior. In this position, the baby's head is facing the mother's sacrum, making labor longer and more painful due to the baby's position causing more pressure on the mother's back and pelvis. Left occiput anterior (B) and Right occiput anterior (C) are favorable positions for a smoother labor. Right occiput transverse (D) can also lead to a longer and more complicated labor, but not as much as Left occiput posterior.
After insertion of the epidural catheter, what is the nurse's responsibility regarding patient care?
- A. monitoring vital signs every 5 to 15 minutes
- B. intermittent FHR monitoring
- C. providing the laboring person a meal
- D. instructing the laboring person to get out of bed to use the restroom
Correct Answer: A
Rationale: The correct answer is A: monitoring vital signs every 5 to 15 minutes. After inserting the epidural catheter, continuous monitoring of vital signs is crucial to detect any potential complications like hypotension or respiratory depression promptly. Vital signs include blood pressure, heart rate, respiratory rate, and oxygen saturation. Intermittent FHR monitoring (B) may be necessary but is not the primary responsibility after epidural insertion. Providing a meal (C) is contraindicated due to the risk of aspiration. Instructing the laboring person to get out of bed to use the restroom (D) is not recommended as they may be at risk of falls due to decreased sensation and muscle weakness from the epidural.