Promoting patient comfort during labor and birth questions quizlet

Promoting patient comfort during labor and birth questions quizlet Related

Review Promoting patient comfort during labor and birth questions quizlet related questions and content

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.

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A laboring patient is 10 cm dilated; however, she does not feel the urge to push. The nurse understands that according to laboring down, the advantages of waiting until an urge to push are which of the following? (Select all that apply.)

  • A. Less maternal fatigue
  • B. Less birth canal injuries
  • C. Decreased pushing time
  • D. Faster descent of the fetus
Correct Answer: A

Rationale: The correct answer is A: Less maternal fatigue. Waiting for the urge to push during laboring down helps conserve the mother's energy and prevents exhaustion. Pushing without the urge can lead to ineffective pushing efforts, increasing maternal fatigue.

Incorrect choices:
B: Less birth canal injuries - Pushing without the urge may increase the risk of birth canal injuries due to ineffective pushing efforts.
C: Decreased pushing time - Pushing without the urge may actually prolong pushing time as the efforts may be less effective.
D: Faster descent of the fetus - Pushing without the urge may not necessarily result in faster descent of the fetus and can lead to prolonged labor.

The nurse provides counter pressure to relieve pain and open the pelvis to help with fetal descent. What type of counter pressure is the nurse providing?

  • A. hip squeeze
  • B. perineal pressure
  • C. shoulder pressure
  • D. knee press
Correct Answer: A

Rationale: The correct answer is A: hip squeeze. The nurse uses hip squeeze to provide counter pressure during labor. This technique helps relieve pain, open the pelvis, and facilitate fetal descent. By applying pressure on the hips, the nurse can help alleviate discomfort and create more space for the baby to move down the birth canal. Perineal pressure (B) focuses on the perineum, shoulder pressure (C) is not typically used in this context, and knee press (D) is not a common technique for labor pain management.

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.

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.

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.

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