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A nurse is assisting a laboring patient with breathing techniques to reduce labor pain. Which technique involves exhaling slowly while concentrating on relaxing each muscle group?
- A. Cleansing breaths
- B. Slow-paced breathing
- C. Modified-paced breathing
- D. Effleurage
Correct Answer: B
Rationale: The correct answer is B: Slow-paced breathing. This technique involves exhaling slowly while focusing on relaxing each muscle group, which helps reduce labor pain. Slow-paced breathing promotes relaxation and reduces stress, making it an effective pain management technique during labor. Cleansing breaths (A) focus on deep breathing to clear the mind, not necessarily on muscle relaxation. Modified-paced breathing (C) involves breathing in a controlled pattern but may not specifically target muscle relaxation. Effleurage (D) is a massage technique involving light stroking movements, not breathing techniques for pain management.
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What does the nurse explain to the laboring person and partner about nitrous oxide?
- A. It makes the newborn have respiratory depression.
- B. It causes the laboring person to have decreased respirations.
- C. It does not affect respiration as an opiate would.
- D. The mask is held to the person's face by the partner.
Correct Answer: C
Rationale: The correct answer is C because nitrous oxide does not affect respiration like an opiate would. Nitrous oxide is a safe option for pain relief during labor because it does not depress the respiratory system. It is self-administered by the laboring person and does not require assistance from the partner. Choices A and B are incorrect because nitrous oxide does not cause respiratory depression in the newborn or the laboring person. Choice D is incorrect because the laboring person holds the mask to their face themselves.
The best time to teach nonpharmacologic pain control methods to an unprepared laboring patient is during which stage?
- A. Latent phase
- B. Active phase
- C. Second stage
- D. Transition phase
Correct Answer: A
Rationale: The correct answer is A: Latent phase. This stage is ideal for teaching nonpharmacologic pain control methods as the patient is usually more receptive, relaxed, and able to focus. During the latent phase, contractions are typically mild and irregular, allowing the patient to learn and practice techniques effectively. In contrast, the active phase (choice B) is characterized by increased intensity and frequency of contractions, making it challenging for the patient to concentrate on learning. The second stage (choice C) is the pushing stage, where the focus shifts to pushing efforts rather than learning new techniques. The transition phase (choice D) is the most intense stage of labor, making it difficult for the patient to absorb and apply nonpharmacologic pain control methods effectively.
When caring for a patient in labor who is considered to be at low risk, which assessments should be included in the plan of care? (Select all that apply.)
- A. Check the DTR each shift.
- B. Monitor and record vital signs frequently during the course of labor.
- C. Document the FHR pattern, noting baseline and response to contraction patterns.
- D. Indicate on the EFM tracing when maternal position changes are don
Correct Answer: B
Rationale: The correct answer is B: Monitor and record vital signs frequently during the course of labor. This is essential to ensure the patient's physiological stability and detect any deviations that may indicate complications. Checking the DTR (Choice A) is not relevant for low-risk patients in labor. Documenting the FHR pattern (Choice C) is important, but not as crucial as monitoring vital signs. Indicating maternal position changes on the EFM tracing (Choice D) is beneficial but not a priority assessment for low-risk patients. Vital sign monitoring is the most critical assessment for ensuring the well-being of the patient in labor.
Which fetal position may cause the laboring patient increased back discomfort?
- A. Left occiput anterior
- B. Left occiput posterior
- C. Right occiput anterior
- D. Right occiput transverse
Correct Answer: B
Rationale: The correct answer is B: Left occiput posterior. In this position, the baby's occiput is towards the mother's back, leading to increased back discomfort during labor. The baby's position can put pressure on the mother's sacrum and lower back, causing more pain. Choices A, C, and D do not involve the baby's occiput being posterior, so they would not result in the same level of back discomfort.
Which of the following factors would affect pain perception or tolerance for the laboring patient?
- A. Right occiput posterior fetal position during labor
- B. Bishop score of 10 prior to the induction of labor
- C. Gynecoid pelvis
- D. Absence of Ferguson's reflex
Correct Answer: A
Rationale: The correct answer is A: Right occiput posterior fetal position during labor. This position can lead to intense back pain and prolonged labor, affecting pain perception. A posterior position can put pressure on the sacrum and cause increased discomfort. In contrast, choices B, C, and D do not directly impact pain perception during labor. Choice B, Bishop score of 10, indicates favorable conditions for labor progress but does not necessarily affect pain perception. Choice C, Gynecoid pelvis, refers to a common pelvis shape that may facilitate labor but does not directly influence pain tolerance. Choice D, Absence of Ferguson's reflex, is related to the ability to push effectively but is not directly linked to pain perception.