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How does the pain of childbirth differ from other types of pain? (Select all that apply.)
- A. Childbirth pain is part of a normal process.
- B. Childbirth pain seldom needs narcotic relief.
- C. Position changes relieve pain and facilitate delivery.
- D. Childbirth pain declines following birth.
- E. Childbirth pain is self-limited.
Correct Answer: A,C,D,E
Rationale: Childbirth pain differs from other types of pain, because it is part of a normal, natural, and expected process, can be relieved by change of position, declines immediately following birth, and is self-limiting. Childbirth pain requires pharmacological management with narcotics in many cases.
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The nurse who encourages the gate control theory of pain control would advise a woman in labor and her partner to use which nonpharmacological method of pain management?
- A. Slow abdominal breathing
- B. Guided relaxation
- C. Listening to music
- D. Massage
Correct Answer: D
Rationale: According to the gate control theory, stimulating large-diameter nerve fibers temporarily interferes with conduction of impulses through small-diameter fibers. Massage is a technique that stimulates large-diameter fibers and 'closes the gate.'
A woman in labor will receive general anesthesia prior to cesarean section. The nurse reminds the patient that food and fluids need to be restricted for several hours prior to delivery. What will this prevent?
- A. Nausea and vomiting
- B. Vomiting and aspiration
- C. Abdominal cramping
- D. Intestinal obstruction
Correct Answer: B
Rationale: The major adverse effect of general anesthesia is aspiration of stomach contents.
What breathing techniques would the nurse teach the prenatal patient to help her focus during labor in order to reduce pain? (Select all that apply.)
- A. First-stage breathing
- B. Abdominal breathing
- C. Fourth-stage breathing
- D. Modified paced breathing
- E. Patterned paced breathing
Correct Answer: A,B,D,E
Rationale: First-stage breathing includes the techniques of modified paced breathing and patterned paced breathing, which are types of abdominal breathing techniques. These patterns of breathing will help a woman in labor to focus and reduce pain perception. The fourth stage of labor is the woman's recovery stage and does not require a breathing technique.
What assessment should be taken immediately after the anesthesiologist administers an epidural block to a laboring woman?
- A. Bladder for distention
- B. Blood pressure
- C. Sensation in the lower extremities
- D. Intravenous fluid flow rate
Correct Answer: B
Rationale: Blood pressure is checked every 5 minutes when the epidural block is first begun. Bladder assessment is also important but not an initial assessment.
An 18-year-old primigravida is 4 cm dilated and her contractions are 5 minutes apart. She received little prenatal care and had no childbirth preparation. She is crying loudly and shouting, 'Please give me something for the pain. I can't take the pain!' What is the priority nursing diagnosis?
- A. Pain related to uterine contractions
- B. Knowledge deficit related to the birth experience
- C. Ineffective coping related to inadequate preparation for labor
- D. Risk for injury related to lack of prenatal care
Correct Answer: A
Rationale: The most important issue for this woman, at this time, is effective pain management.