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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.
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When caring for the laboring patient, the nurse determines that the fetus is located in the right occiput posterior (ROA). What will the nurse anticipate?
- A. Urinary retention
- B. Severe lower back pain
- C. A shorter labor process
- D. Nausea
Correct Answer: B
Rationale: If the fetal occiput is in a posterior pelvic quadrant, each contraction pushes it against the mother's sacrum, resulting in persistent and poorly relieved back pain (back labor). Labor is often longer with this fetal position.
The nurse is caring for a woman with epidural anesthesia for pain control during a vaginal delivery. A risk for injury related to epidural anesthesia has been identified by the nursing staff. What interventions are appropriate for the nurse to implement related to this diagnosis? (Select all that apply.)
- A. Assess leg movement and sensation before ambulating.
- B. Administer antibiotic as ordered.
- C. Observe for signs of impending birth.
- D. Provide sacral pressure as needed.
- E. Assess fetal position frequently.
Correct Answer: A,C
Rationale: To prevent the risk for injury related to epidural anesthesia, the nurse should assess for movement, sensation, and leg strength before ambulating, ambulate cautiously with an assistant, assist the woman to change positions regularly, and observe for signs that birth may be near: increase in bloody show, perineal bulging, and/or crowning.
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.
How does the pain of childbirth differ from other types of pain? (Select all that apply.)
- A. Childbirth pain is part of a normal process.
- B. Childbirth pain seldom needs narcotic relief.
- C. Position changes relieve pain and facilitate delivery.
- D. Childbirth pain declines following birth.
- E. Childbirth pain is self-limited.
Correct Answer: A,C,D,E
Rationale: Childbirth pain differs from other types of pain, because it is part of a normal, natural, and expected process, can be relieved by change of position, declines immediately following birth, and is self-limiting. Childbirth pain requires pharmacological management with narcotics in many cases.
What is the Dick-Read method of childbirth preparation based on?
- A. Mild sedation throughout labor
- B. Relaxation techniques
- C. Skin stimulation
- D. Deep massage
Correct Answer: B
Rationale: The Dick-Read method depends on the use of relaxation techniques to reduce the discomforts of labor.