Nokea
The fetus is in an occiput posterior position. What position can the nurse assist the laboring person into that may encourage the fetus to find the occiput anterior position?
- A. squatting
- B. shower
- C. hands and knees
- D. semi-Fowler
Correct Answer: C
Rationale: The correct answer is C: hands and knees. This position can help rotate the fetus from occiput posterior to occiput anterior by allowing gravity to assist in the rotation. Placing the laboring person on hands and knees can help the baby's head shift towards the front, facilitating a more optimal birthing position. Squatting and shower may provide comfort but may not directly encourage the fetus to rotate. Semi-Fowler position may not be as effective in promoting the desired fetal positioning compared to hands and knees.
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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.
A laboring patient has asked the nurse to assist her in utilizing a cutaneous stimulation strategy for pain management. The nurse would
- A. assist her into the shower.
- B. apply a heat pack to lower back.
- C. help her to create a relaxing mental scen
- D. encourage cleansing breaths and slow-paced breathing.
Correct Answer: B
Rationale: The correct answer is B because applying a heat pack to the lower back can help alleviate labor pain through cutaneous stimulation. Heat therapy can increase blood flow, relax muscles, and reduce pain perception. Choice A is not specific to cutaneous stimulation and may not provide effective pain relief. Choice C focuses on mental imagery, not cutaneous stimulation. Choice D, while helpful for pain management, does not involve cutaneous stimulation.
Which patient presentation is an acceptable indication for serial oxytocin induction of labor?
- A. Multiple fetuses
- B. Polyhydramnios
- C. History of long labors
- D. Past 42 weeks of gestation
Correct Answer: D
Rationale: Rationale:
1. Past 42 weeks of gestation increases the risk of stillbirth.
2. Oxytocin can help initiate labor to reduce the risk.
3. Induction at this stage is considered safe and beneficial.
4. Other choices are not direct indications for oxytocin induction and may have different management strategies.
Summary:
- A: Multiple fetuses and polyhydramnios may require different approaches.
- B: History of long labors may not necessarily indicate the need for oxytocin induction.
A major advantage of nonpharmacologic pain management is
- A. a more rapid labor is likely.
- B. more complete pain relief is possibl
- C. there are no side effects or risks to the fetus
- D. the woman remains fully alert at all times.
Correct Answer: C
Rationale: The correct answer is C because nonpharmacologic pain management methods, such as relaxation techniques or massage, do not involve medications that could potentially harm the fetus. This ensures there are no side effects or risks to the fetus during labor. Option A is incorrect as nonpharmacologic pain management does not necessarily guarantee a more rapid labor. Option B is incorrect because while nonpharmacologic methods can provide pain relief, it may not always be more complete compared to pharmacologic options. Option D is incorrect as some nonpharmacologic methods may alter alertness levels, such as hypnosis.
A laboring patient experiences a sudden rupture of membranes and the nurse observes a prolapsed cord. What is the nurse's priority action?
- A. Reposition the patient to relieve pressure on the cord.
- B. Immediately prepare the patient for a cesarean delivery.
- C. Administer oxygen at 10 L/min.
- D. Monitor the fetal heart rate continuously.
Correct Answer: A
Rationale: The correct answer is A: Reposition the patient to relieve pressure on the cord. This is the priority action because a prolapsed cord can lead to fetal compromise due to decreased blood flow. By repositioning the patient to a knee-chest or Trendelenburg position, gravity helps alleviate pressure on the cord. This action is crucial to prevent further compromise to the fetus.
Incorrect Choices:
B: Immediately prepare the patient for a cesarean delivery - While this may be necessary eventually, the immediate priority is to relieve pressure on the cord.
C: Administer oxygen at 10 L/min - Oxygen may be needed, but it is not the priority action in this emergency situation.
D: Monitor the fetal heart rate continuously - Monitoring is important, but repositioning the patient to relieve cord compression takes precedence.