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What would the nurse guide a labor coach to do to comfort a woman tensing her muscles with contractions?
- A. Offer warm liquids to the patient.
- B. Encourage the patient to pant.
- C. Engage the patient in conversation.
- D. Assist the patient to the knee-chest position.
Correct Answer: B
Rationale: Panting relaxes the abdominal wall and distracts the patient. It would not be helpful to offer fluids or to attempt conversation during contractions.
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A nurse instructs a woman's labor coach to comfort her by firmly pressing on her lower back. What is this technique?
- A. Sacral pressure
- B. Distraction
- C. Effleurage
- D. Conscious relaxation
Correct Answer: A
Rationale: Sacral pressure refers to firm pressure against the lower back to relieve some of the pain of back labor.
A laboring patient requests hot and cold applications be applied to her abdomen for pain control. How will this intervention act to control pain?
- A. By increasing endorphin production
- B. By facilitating effacement and dilation
- C. By producing increasing pain tolerance
- D. By stimulation of large nerve fibers
Correct Answer: D
Rationale: The gate control theory explains how pain impulses reach the brain for interpretation. It supports several nonpharmacological methods of pain control. According to this theory, pain is transmitted through small-diameter nerve fibers. However, the stimulation of large-diameter nerve fibers temporarily interferes with the conduction of impulses through small-diameter fibers. Techniques to stimulate large-diameter fibers and 'close the gate' to painful impulses include massage, palm and fingertip pressure, and heat and cold applications.
A woman in labor has had an epidural block for pain relief. The nurse will be assessing carefully for what associated side effect of this type of regional anesthesia?
- A. Reduced fetal heart rate
- B. Long, intense contractions
- C. Sudden leg cramps
- D. Bladder distention
Correct Answer: D
Rationale: A side effect of an epidural block is urine retention, because the anesthesia interferes with the woman's ability to have an urge to void. The patient may have to be catheterized.
The physician has ordered Fentanyl (Sublimaze) for a woman in labor and has asked the nurse to provide patient education. What will the nurse include in the educational plan? (Select all that apply.)
- A. Onset is slow.
- B. Duration is short.
- C. Administration is by mouth.
- D. No known side effects.
- E. It is not the same drug as sufentanil.
Correct Answer: B,E
Rationale: Fentanyl has a rapid onset and short duration of action. Fentanyl, sufentanil, and alfentanil are not the same drugs. Fentanyl can cause respiratory depression but less than meperidine. It is not administered by mouth.
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.