Nokea
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.
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Which are nonpharmacological forms of pain relief? (Select all that apply.)
- A. Skin stimulation
- B. Diversion and distraction
- C. Breathing techniques
- D. Exercise
- E. Yoga
Correct Answer: A,B,C
Rationale: Skin stimulation, diversion and distraction, and breathing techniques are the bases of nonpharmacological pain control. Although exercise and practices such as yoga and Pilates are beneficial, they are not means of pain control.
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.
What nursing assessment should be reported immediately after an amniotomy?
- A. Fetal heart rate is regular at 154 beats/minute.
- B. Amniotic fluid is clear with flecks of vernix.
- C. Amniotic fluid is watery and pale green.
- D. Maternal temperature is 37.8?°C.
Correct Answer: C
Rationale: Amniotic fluid should be clear. Green fluid indicates the fetus has passed meconium, which is associated with fetal compromise.
When a pregnant woman arrives at the labor suite, she tells the nurse that she wants to have an epidural for delivery. What is a contraindication to an epidural block?
- A. Abnormal clotting
- B. Previous cesarean delivery
- C. History of migraine headaches
- D. History of diabetes mellitus
Correct Answer: A
Rationale: An epidural block is not used if a woman has abnormal blood clotting.
The physician has ordered Fentanyl (Sublimaze) for a woman in labor and has asked the nurse to provide patient education. What will the nurse include in the educational plan? (Select all that apply.)
- A. Onset is slow.
- B. Duration is short.
- C. Administration is by mouth.
- D. No known side effects.
- E. It is not the same drug as sufentanil.
Correct Answer: B,E
Rationale: Fentanyl has a rapid onset and short duration of action. Fentanyl, sufentanil, and alfentanil are not the same drugs. Fentanyl can cause respiratory depression but less than meperidine. It is not administered by mouth.