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A major advantage of nonpharmacologic pain management is
- A. a more rapid labor is likely.
- B. more complete pain relief is possibl
- C. there are no side effects or risks to the fetus
- D. the woman remains fully alert at all times.
Correct Answer: C
Rationale: The correct answer is C because nonpharmacologic pain management methods, such as relaxation techniques or massage, do not involve medications that could potentially harm the fetus. This ensures there are no side effects or risks to the fetus during labor. Option A is incorrect as nonpharmacologic pain management does not necessarily guarantee a more rapid labor. Option B is incorrect because while nonpharmacologic methods can provide pain relief, it may not always be more complete compared to pharmacologic options. Option D is incorrect as some nonpharmacologic methods may alter alertness levels, such as hypnosis.
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While developing an intrapartum care plan for the patient in early labor, it is important that the nurse recognize that psychosocial factors may influence a woman's experience of pain. These include which of the following? (Select all that apply.)
- A. Culture
- B. Anxiety and fear
- C. Support systems
- D. Preparation for childbirth
Correct Answer: A
Rationale: Rationale: Culture can significantly impact a woman's perception and experience of pain during labor due to cultural beliefs, practices, and attitudes towards childbirth. Cultural norms and values can influence pain management preferences, coping mechanisms, and communication styles. Understanding the patient's cultural background is crucial for providing culturally competent care and addressing her psychosocial needs.
Summary of other choices:
B: Anxiety and fear - While anxiety and fear can influence a woman's pain experience, they are not specific to psychosocial factors related to culture.
C: Support systems - Support systems can affect a woman's labor experience, but they do not specifically relate to the influence of psychosocial factors such as culture.
D: Preparation for childbirth - Although preparation for childbirth can impact pain perception, it is not directly related to the influence of psychosocial factors like culture.
For which patient should the oxytocin (Pitocin) infusion be discontinued immediately?
- A. A patient in transition with contractions every 2 minutes lasting 90 seconds each
- B. A patient in early labor with contractions every 5 minutes lasting 40 seconds each
- C. A patient in active labor with contractions every 3 minutes lasting 60 seconds each
- D. A patient in active labor with contractions every 2 to 3 minutes lasting 70 to 80 seconds each
Correct Answer: A
Rationale: The correct answer is A because a patient in transition with contractions every 2 minutes lasting 90 seconds each is experiencing very intense and frequent contractions, indicating high uterine activity. Discontinuing oxytocin infusion is crucial in this scenario to prevent hyperstimulation, which can lead to fetal distress or uterine rupture.
Choice B is incorrect because the patient is in early labor and the contractions are less frequent and less intense compared to the correct answer. Choice C is incorrect as the patient in active labor with contractions every 3 minutes lasting 60 seconds each is not as intense as the patient in transition in the correct answer. Choice D is incorrect because although the contractions are frequent and lasting longer, the intensity described in choice A is more concerning and requires immediate discontinuation of oxytocin infusion.
Which of the following behaviors would be applicable to a nursing diagnosis of "risk for injury" in a patient who is in labor?
- A. Length of second-stage labor is 2 hours.
- B. Patient has received an epidural for pain control during the labor process.
- C. Patient is using breathing techniques during contractions to maximize pain relief.
- D. Patient is receiving parenteral fluids during the course of labor to maintain hydration.
Correct Answer: A
Rationale: The correct answer is A: Length of second-stage labor is 2 hours. This is applicable to the nursing diagnosis of "risk for injury" in a patient in labor because a prolonged second-stage labor can increase the risk of injury to both the mother and the baby. A prolonged second stage can lead to issues such as fetal distress, maternal exhaustion, and increased risk of instrumental delivery or cesarean section.
Explanation for why the other choices are incorrect:
B: Patient has received an epidural for pain control during the labor process - This choice does not directly address the risk for injury in labor.
C: Patient is using breathing techniques during contractions to maximize pain relief - While breathing techniques can help with pain relief, it does not specifically address the risk for injury.
D: Patient is receiving parenteral fluids during the course of labor to maintain hydration - While hydration is important during labor, it does not directly address the risk for injury.
The nurse is reviewing the cardinal maneuvers of labor and birth with a group of nursing students. Which maneuver will immediately follow the birth of the baby's head?
- A. Expulsion
- B. Restitution
- C. Internal rotation
- D. External rotation
Correct Answer: A
Rationale: After the baby's head is born, the immediate next step is the expulsion of the baby's body. This is because the expulsion maneuver refers to the delivery of the rest of the baby's body following the birth of the head. Restitution, internal rotation, and external rotation occur before the birth of the baby's head and are part of the cardinal movements of labor and birth. Restitution involves the realignment of the baby's head with their body after the head is born. Internal rotation refers to the baby's head turning to navigate through the birth canal. External rotation involves the baby's head turning back to its original position after delivery. So, the correct answer is A (Expulsion), as it directly follows the birth of the baby's head.
Which intervention is an essential part of nursing care for a laboring patient?
- A. Helping the woman manage the pain
- B. Eliminating the pain associated with labor
- C. Feeling comfortable with the predictable nature of intrapartal care
- D. Sharing personal experiences regarding labor and birth to decrease her anxiety
Correct Answer: A
Rationale: The correct answer is A because helping the woman manage the pain is essential in nursing care for a laboring patient to ensure her comfort and well-being during labor. This intervention includes providing pain relief measures, such as positioning, massage, breathing techniques, and administering pain medication if needed. The focus is on supporting the woman's coping mechanisms and enhancing her overall birthing experience.
Choice B is incorrect because eliminating pain completely is not always possible or recommended in labor, as some pain is a natural part of the process. Choice C is incorrect as comfort with the predictable nature of care is not as crucial as providing active pain management. Choice D is incorrect because sharing personal experiences may not be relevant or helpful to the laboring patient and may not address her specific needs during labor.