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What is the most appropriate pain-relief intervention for a woman in precipitate labor?
- A. Get an order for an intravenous narcotic.
- B. Notify the anesthesiologist for an epidural block.
- C. Stay and breathe with her during contractions.
- D. Tell her to bear with it because she is close to delivery.
Correct Answer: C
Rationale: The nurse would stay with the woman experiencing precipitate labor and breathe with her during contractions to help the woman focus and cope with each contraction.
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What position will the nurse promote to encourage fetal rotation and pain relief?
- A. Prone with legs supported and give her a back massage
- B. Supine with legs bent at the knee
- C. Standing with support
- D. Sitting up and leaning forward on the overbed table
Correct Answer: D
Rationale: A position that favors fetal rotation and descent and is helpful for the woman with back labor is to sit or kneel leaning forward on a support.
What action by the physician will the nurse anticipate?
- A. Perform an amniotomy.
- B. Initiate tocolytic drugs.
- C. Order a sedative for the patient.
- D. Plan to do an emergency cesarean section.
Correct Answer: A
Rationale: Medical treatment for hypotonic labor dysfunction includes an amniotomy as the first remedy if the membranes are intact.
Which laboring patient should the nurse attend to first?
- A. 18-year-old primigravida with a fetal breech presentation
- B. 25-year-old multigravida with history of previous cesarean section
- C. 35-year-old multigravida with history of precipitate birth
- D. 16-year-old primigravida with a twin pregnancy
Correct Answer: C
Rationale: A precipitate birth is completed in less than 3 hours and can lead to complications like uterine rupture or cervical lacerations, requiring immediate attention.
What complication should the nurse closely assess for with this patient?
- A. Chorioamnionitis
- B. Hemorrhage
- C. Hypotension
- D. Amniotic fluid embolism
Correct Answer: A
Rationale: Infection of the amniotic sac, called chorioamnionitis, may cause prematurely ruptured membranes, or it may be a consequence of rupture, because the barrier to the uterine cavity is broken.
What will the nurse expect when caring for this patient?
- A. Elevated uterine resting tone
- B. Painful and poorly coordinated contractions
- C. Implementation of fluid restriction
- D. Use of frequent position changes
Correct Answer: D
Rationale: A woman with hypotonic labor dysfunction will be encouraged to change position frequently to enhance contractions.