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A patient in active labor asks about using a birth ball. What is the primary benefit of using a birth ball during labor?
- A. Provides a distraction from labor pain.
- B. Helps maintain proper fetal alignment.
- C. Increases the rate of cervical dilation.
- D. Reduces the likelihood of epidural anesthesia use.
Correct Answer: B
Rationale: The correct answer is B: Helps maintain proper fetal alignment. Using a birth ball during labor helps the mother maintain an upright position, which can aid in proper alignment of the fetus for an optimal birthing position. This can facilitate the progress of labor and potentially reduce the risk of complications.
A: Provides a distraction from labor pain - While using a birth ball may offer some distraction, the primary benefit is not pain management.
C: Increases the rate of cervical dilation - While movement and positioning can support the body's natural labor process, the birth ball itself does not directly increase cervical dilation rate.
D: Reduces the likelihood of epidural anesthesia use - While movement and positioning can sometimes help manage pain and reduce the need for epidural anesthesia, the primary benefit of the birth ball is more related to fetal alignment than pain management.
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A patient who is receiving oxytocin (Pitocin) infusion for the augmentation of labor is
- A. Which intervention would be a priority?
- B. Increase rate of Pitocin infusion to help spread out contraction pattern.
- C. Place oxygen on patient at 8 to 10 L/minute via face mask and turn patient to left
- D. Stop Pitocin infusion.
Correct Answer: A
Rationale: The correct answer is A because the priority intervention for a patient receiving oxytocin infusion for labor augmentation is to monitor fetal heart rate and uterine contractions. This is essential to ensure the safety of both the mother and the baby. Increasing the rate of Pitocin infusion (B) can lead to hyperstimulation and fetal distress. Providing oxygen and changing position (C) may be helpful in some situations but are not the priority. Stopping the Pitocin infusion (D) should only be done if there are signs of fetal distress or other complications.
During a vaginal exam, the nurse identifies that the fetal station is at +2. What does this finding indicate?
- A. The fetus is high in the pelvis.
- B. The presenting part is at the ischial spines.
- C. The presenting part is below the ischial spines.
- D. The presenting part is crowning.
Correct Answer: C
Rationale: The correct answer is C because when the fetal station is at +2, it indicates that the presenting part is below the ischial spines. This means the baby's head is 2 cm below the ischial spines, which is a significant milestone in the descent of the fetus through the birth canal. The other choices are incorrect because: A) +2 station indicates descent, not that the fetus is high in the pelvis; B) Ischial spines are at 0 station, not +2; D) Crowning is at +5 station, not +2.
A patient presents to the labor and birth area for emergent birth. Vaginal exam reveals that the patient is fully dilated, vertex, +2 station, with ruptured membranes. The patient is extremely apprehensive because this is her first childbirth experience and asks for an epidural to be administered now. What is the priority nursing response based on this patient assessment?
- A. Use contact anesthesia for an epidural and prepare the patient per protocol.
- B. Tell the patient that she will not need any pain medication because the birth will be over in a matter of minutes and the pain will stop.
- C. Assist the patient with nonpharmacologic methods of pain distraction during this time as you prepare for vaginal birth.
- D. Call the physician for admitting orders.
Correct Answer: C
Rationale: The correct answer is C. In this scenario, the patient is fully dilated and at +2 station, indicating imminent birth. The priority nursing response should focus on assisting the patient with nonpharmacologic pain distraction methods as the birth is likely to occur soon. Nonpharmacologic pain management techniques such as breathing exercises, positioning changes, massage, and emotional support can help alleviate the patient's anxiety and provide comfort during this intense stage of labor. Administering an epidural at this late stage may not be feasible or effective due to the advanced stage of labor and imminent birth. Options A and D are not appropriate as they do not address the immediate needs of the patient in active labor. Option B is incorrect as it dismisses the patient's request for pain relief and fails to address her emotional and physical needs during labor.
A labor patient has brought in a photograph of her two children and asks the nurse to place it on the wall so that she can look at it during labor contractions. This is an example of
- A. focal point.
- B. distraction.
- C. effleurag
- D. relaxation
Correct Answer: A
Rationale: The correct answer is A: focal point. Placing the photograph on the wall serves as a focal point for the laboring patient, helping her to concentrate and stay focused during contractions. By having a specific point of visual focus, the patient can channel her energy and emotions towards the photo, providing a sense of comfort and motivation. It can also serve as a source of inspiration and reminder of the joy of motherhood, which can help in managing the pain and anxiety of labor.
Summary of other choices:
B: Distraction - While the photograph may provide a distraction, the primary purpose is to serve as a focal point for the patient.
C: Effleurage - Effleurage is a massage technique used in labor, not related to placing a photograph on the wall.
D: Relaxation - While the photograph may help in relaxation indirectly by providing comfort and focus, the primary purpose is not relaxation but rather concentration and emotional support.
The nurse receives orders for pharmacologic pain relief. What does the nurse explain to the laboring person after administering fentanyl?
- A. "I will need to monitor your oxygen saturation."
- B. "It's important for me to insert a Foley catheter."
- C. "I will need to monitor for vaginal bleeding."
- D. "It's important for me to check your cervix after I administer this medication."
Correct Answer: A
Rationale: Rationale: After administering fentanyl, the nurse explains the need to monitor oxygen saturation due to the potential respiratory depression as a side effect of the medication. This is crucial for early detection and intervention. Monitoring for vaginal bleeding (C) is unrelated to fentanyl administration. Inserting a Foley catheter (B) and checking the cervix (D) are not necessary post-fentanyl administration. Oxygen saturation monitoring is the priority for patient safety.