Nokea
The laboring person is using hypnosis for comfort measures. How can the nurse support the person?
- A. Talk them through the contractions.
- B. Keep the lights on so that everyone can see.
- C. Keep the room quiet and dimly lit.
- D. During the contraction, ask them to rate the pain.
Correct Answer: C
Rationale: The correct answer is C because keeping the room quiet and dimly lit promotes relaxation and helps the person stay focused during hypnosis. Bright lights and noise can be distracting and increase stress levels. Talking them through contractions (Choice A) may disrupt their concentration on hypnosis. Asking them to rate pain during contractions (Choice D) can also be disruptive and may increase anxiety.
You may also like to solve these questions
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.
A patient in early labor is feeling anxious about the labor process. Which intervention would be most effective in reducing her anxiety?
- A. Explain the stages of labor and what to expect.
- B. Encourage her to focus on her breathing.
- C. Administer a sedative as prescribed.
- D. Limit visitors to reduce external stressors.
Correct Answer: A
Rationale: The correct answer is A. Explanation of the stages of labor and what to expect can help the patient understand the process, reducing uncertainty and anxiety. This empowers the patient and promotes a sense of control. Encouraging breathing techniques (B) can help manage pain but may not address the underlying anxiety. Administering sedatives (C) should be a last resort due to potential side effects. Limiting visitors (D) can help reduce stress, but addressing the patient's anxiety requires more direct intervention.
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: A
Rationale: The correct answer is A because the patient is fully dilated and at +2 station, indicating imminent birth. Administering an epidural at this stage can be risky due to the potential for rapid progression of labor, making it difficult to safely place the epidural. Contact anesthesia is often used in emergent situations for epidural placement. Additionally, preparing the patient per protocol ensures that all necessary steps are followed for the safety and well-being of the patient and the baby.
Choices B and C are incorrect because telling the patient she won't need pain medication is dismissive of her valid request and could lead to unnecessary distress. Assisting with nonpharmacologic methods may not be effective at this point given the patient's extreme apprehension and the advanced stage of labor.
Choice D is incorrect as calling the physician for admitting orders is not the priority in this situation. The immediate focus should be on addressing the patient's request for pain management and ensuring her safety during the birth process.
A labor patient, gravida 2, para 1, at term has received meperidine (Demerol) for pain control during labor. Her most recent dose was 15 minutes ago and birth is now imminent. Maternal vital signs have been stable and the EFM tracing has not shown any baseline changes. Which medication does the nurse anticipate would be required in the birth room for administration?
- A. Oxytocin (Pitocin)
- B. Naloxone (Narcan)
- C. Bromocriptine (Parlodel)
- D. Oxygen
Correct Answer: B
Rationale: The correct answer is B: Naloxone (Narcan). Meperidine is an opioid analgesic that can cross the placenta and potentially cause respiratory depression in the newborn if given close to delivery. Naloxone is a specific opioid antagonist that can reverse the effects of opioids like meperidine quickly and effectively. Administering naloxone in this scenario can help prevent or reverse neonatal respiratory depression.
Choice A: Oxytocin (Pitocin) is not required in this scenario as it is used to induce or augment labor, not to counter the effects of meperidine.
Choice C: Bromocriptine (Parlodel) is a medication used to suppress lactation and is not indicated in this situation.
Choice D: Oxygen may be needed during delivery for maternal or fetal distress, but it is not the specific medication needed to counter the effects of meperidine in the newborn.
What nursing intervention can be performed prior to epidural placement to potentially reduce a blood pressure drop?
- A. routine use of ephedrine
- B. IV fluid bolus
- C. insertion of indwelling urinary catheter
- D. upright positioning of the laboring person
Correct Answer: B
Rationale: The correct answer is B: IV fluid bolus. Prior to epidural placement, administering an IV fluid bolus can help prevent a drop in blood pressure by increasing preload and maintaining cardiac output. This helps offset the vasodilation effects of the epidural anesthesia. Options A, C, and D are incorrect. Ephedrine (A) is not routinely used before epidural placement due to its potential adverse effects. Insertion of a urinary catheter (C) is not directly related to preventing a blood pressure drop. Upright positioning (D) may actually worsen hypotension by pooling blood in the lower extremities.