Promoting Client Comfort During Labor and Delivery

Promoting Client Comfort During Labor and Delivery Related

Review Promoting Client Comfort During Labor and Delivery related questions and content

The nurse is preparing a patient for a cesarean birth scheduled to be performed under general anesthesia. Which should the nurse plan to administer, if ordered by the health care provider, to prevent aspiration of gastric contents?

  • A. Citric acid (Bicitra)
  • B. Ranitidine (Zantac)
  • C. Hydroxyzine (Vistaril)
  • D. Glycopyrrolate (Robinul)
Correct Answer: C

Rationale: The correct answer is C: Hydroxyzine (Vistaril). Hydroxyzine is a first-generation antihistamine with antiemetic properties that can help reduce the risk of aspiration of gastric contents during general anesthesia. It works by decreasing nausea and vomiting, which in turn decreases the likelihood of aspiration. Citric acid (Bicitra) can actually increase gastric acidity and promote aspiration. Ranitidine (Zantac) is a histamine-2 receptor antagonist used to reduce gastric acid secretion but does not directly prevent aspiration. Glycopyrrolate (Robinul) is an anticholinergic medication used to reduce secretions but does not specifically target prevention of aspiration. Therefore, hydroxyzine is the most appropriate choice in this scenario.

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Following an external cephalic version, which assessment finding indicates a complication?

  • A. Onset of irregular contractions
  • B. Maternal blood pressure of 110/70 mm Hg
  • C. Deceleration of FHR to 88 bpm
  • D. Maternal pulse rate of 100 bpm
Correct Answer: C

Rationale: The correct answer is C: Deceleration of FHR to 88 bpm. This finding indicates fetal distress, a complication post external cephalic version. Deceleration of FHR suggests reduced oxygenation to the fetus. A: Onset of irregular contractions is a common post-procedure finding and not necessarily indicative of a complication. B: Maternal blood pressure of 110/70 mm Hg is within normal range and not directly related to a complication. D: Maternal pulse rate of 100 bpm is slightly elevated but not a specific indicator of a complication post external cephalic version.

During labor a vaginal examination should be performed only when necessary because of the risk of

  • A. infection.
  • B. fetal injury.
  • C. discomfort.
  • D. perineal traum
Correct Answer: A

Rationale: Step 1: Vaginal examination during labor can introduce bacteria, leading to infection.
Step 2: Infections can be harmful to both the mother and the baby.
Step 3: Minimizing unnecessary vaginal exams reduces the risk of infection.
Summary: Choice A is correct because infection poses serious risks. Choices B, C, and D are incorrect as they do not directly address the primary risk associated with vaginal examinations during labor.

The nurse is teaching a childbirth education class. Which information regarding excessive pain in labor should the nurse include in the session?

  • A. It usually results in a more rapid labor.
  • B. It has no effect on the outcome of labor.
  • C. It is considered to be a normal occurrenc
  • D. It may result in decreased placental perfusion.
Correct Answer: D

Rationale: The correct answer is D because excessive pain in labor can lead to increased maternal stress, which may result in decreased placental perfusion, compromising oxygen and nutrient delivery to the fetus. This can have serious implications for the baby's well-being. Choices A, B, and C are incorrect because excessive pain in labor does not necessarily lead to a more rapid labor, has an effect on the labor outcome by potentially impacting placental perfusion, and is not considered a normal occurrence that should be disregarded.

A nursing priority during admission of a laboring patient who has not had prenatal care is

  • A. obtaining admission labs.
  • B. identifying labor risk factors.
  • C. discussing her birth plan choices.
  • D. explaining importance of prenatal car
Correct Answer: B

Rationale: The correct answer is B: identifying labor risk factors. This is a priority because it helps in assessing potential complications and planning appropriate care. Obtaining admission labs (A) can be important but not the top priority. Discussing birth plan choices (C) can wait until after assessing risk factors. Explaining the importance of prenatal care (D) is not the immediate concern during labor admission. Identifying labor risk factors is crucial for ensuring the safety and well-being of both the mother and the baby.

Which assessment finding is an indication of hemorrhage in the recently delivered postpartum patient?

  • A. Elevated pulse rate
  • B. Elevated blood pressure
  • C. Firm fundus at the midline
  • D. Saturation of two perineal pads in 4 hours
Correct Answer: D

Rationale: The correct answer is D. Saturation of two perineal pads in 4 hours is an indication of hemorrhage postpartum. This is because excessive bleeding after delivery can lead to soaking through pads quickly. A: Elevated pulse rate can be a sign of shock but not specific to hemorrhage. B: Elevated blood pressure is not a typical sign of hemorrhage. C: A firm fundus at the midline is a normal finding postpartum and not indicative of hemorrhage.

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