Nokea
The nurse is instructing a Lamaze class on abdominal breathing and tells a patient that her baseline respiratory rate is 22 breaths per minute. What should be the patient's rate while performing slow breathing?
- A. 9
- B. 11
- C. 15
- D. 20
Correct Answer: B
Rationale: The range of respirations should be no lower than half of the base rate and no more rapid than double the base rate.
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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.
The nurse coaches the primigravida not to bear down until the cervix is completely dilated. What may premature bearing down cause?
- A. Increased use of oxygen
- B. Cervical laceration
- C. Uterine rupture
- D. Compression of the cord
Correct Answer: B
Rationale: Bearing down against a cervix that is not dilated can cause edema and laceration to the cervix.
Which position(s) and exercise(s) will the nurse teach as beneficial in combating discomfort in the later stages of pregnancy? (Select all that apply.)
- A. Leg lifts
- B. Pelvic rock
- C. Tailor sitting
- D. Sit-ups
- E. Shoulder curling
Correct Answer: B,C,E
Rationale: Pelvic rock, tailor sitting, and shoulder curling are beneficial to the muscles that will have to adapt to the extra weight and changed posture of later pregnancy. Leg lifts and sit-ups are not beneficial, because they both increase intra-abdominal pressure.
When a pregnant woman arrives at the labor suite, she tells the nurse that she wants to have an epidural for delivery. What is a contraindication to an epidural block?
- A. Abnormal clotting
- B. Previous cesarean delivery
- C. History of migraine headaches
- D. History of diabetes mellitus
Correct Answer: A
Rationale: An epidural block is not used if a woman has abnormal blood clotting.
What would the nurse explain regarding giving a narcotic analgesic medication at this stage of labor?
- A. It can cause medication given at later stages to be ineffective.
- B. It will have no complications for the mother or infant.
- C. It may result in respiratory depression to the newborn.
- D. It will speed up labor and increase pain.
Correct Answer: C
Rationale: The risk of narcotic analgesics is that they cross the placenta and can cause fetal respiratory depression.