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What is a side effect of general anesthesia that usually limits its use to cases of emergency?
- A. hyperactive newborns
- B. newborn respiratory depression
- C. increase in uterine contractions
- D. decrease in cervical dilation
Correct Answer: B
Rationale: The correct answer is B: newborn respiratory depression. General anesthesia can cross the placental barrier and affect the newborn's respiratory system, leading to potential complications such as respiratory depression. This side effect is a major concern, especially in non-emergency situations, as it can pose risks to the newborn's health. Hyperactive newborns (A), increase in uterine contractions (C), and decrease in cervical dilation (D) are not typical side effects of general anesthesia that limit its use in emergency cases. These options are unrelated to the primary concern of newborn respiratory depression in the context of administering general anesthesia during childbirth.
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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.
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.
A woman who is gravida 3, para 2 enters the intrapartum unit. The most important nursing assessments include
- A. contraction pattern, amount of discomfort, and pregnancy history.
- B. fetal heart rate, maternal vital signs, and the woman's nearness to birth.
- C. last food intake, when labor began, and cultural practices the couple desires.
- D. identification of ruptured membranes, the woman's gravida and para, and access to a support person.
Correct Answer: B
Rationale: The correct answer is B because fetal heart rate, maternal vital signs, and the woman's nearness to birth are crucial assessments in the intrapartum period. Fetal heart rate indicates fetal well-being, maternal vital signs reflect maternal status, and assessing the nearness to birth helps in determining the stage of labor and necessary interventions.
A is incorrect because while contraction pattern and discomfort are important, pregnancy history is not as immediate a concern in the intrapartum period.
C is incorrect as last food intake and cultural practices are not the most critical assessments during labor.
D is incorrect because while identification of ruptured membranes is important, the woman's gravida and para are less immediate concerns compared to fetal heart rate and maternal vital signs.
The laboring person is anxious and hurting. What can the nurse do to help the laboring person?
- A. Offer her an epidural.
- B. Encourage frequent position changes.
- C. Explain that she has to care for two other persons.
- D. Tell them to call someone to come sit with them.
Correct Answer: B
Rationale: The correct answer is B because encouraging frequent position changes can help alleviate discomfort during labor by reducing pressure on certain areas and promoting better circulation. This also helps with the progression of labor. Choice A (Offer her an epidural) may be a valid option, but it should not be the first line of intervention for all laboring individuals. Choice C (Explain that she has to care for two other persons) is irrelevant and may increase anxiety. Choice D (Tell them to call someone to come sit with them) does not address the physical discomfort and is not a direct intervention to support the laboring person.
Which method of pain management would be safest for a gravida 3, para 2, admitted at 8 cm cervical dilation?
- A. Narcotics
- B. Spinal block
- C. Epidural anesthesia
- D. Breathing and relaxation techniques
Correct Answer: C
Rationale: The correct answer is C: Epidural anesthesia. At 8 cm cervical dilation, the patient is in active labor and close to delivery. Epidural anesthesia is the safest method as it provides effective pain relief without affecting the baby's central nervous system. Narcotics can pass through the placenta and affect the baby's breathing. Spinal block may cause a sudden drop in blood pressure. Breathing and relaxation techniques may not be sufficient at 8 cm dilation. Epidural anesthesia is the most appropriate for pain management in this scenario.