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Exam 17: Maximizing Comfort for the Laboring Woman

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Question 1

Multiple Choice

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What is the correct terminology for the nerve block that provides anesthesia to the lower vagina and perineum?

A) Epidural
B) Pudendal
C) Local
D) Spinal block

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verified

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Question 2

Multiple Choice

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According to professional standards which action cannot be performed by the non-anesthetist registered nurse who is caring for a woman with epidural anesthesia?

A) Monitoring the status of the woman and fetus
B) Initiating epidural anesthesia
C) Replacing empty infusion bags with the same medication and concentrate
D) Stopping the infusion,and initiating emergency measures

Correct Answer

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B

Question 3

Multiple Choice

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Maternity nurses often must answer questions about the many,sometimes unusual,ways people have tried to make the birthing experience more comfortable.Which information regarding nonpharmacologic pain relief is accurate?

The class of drugs known as opioid analgesics (butorphanol,nalbuphine) is not suitable for administration to women with known opioid dependence.The antagonistic activity could precipitate withdrawal symptoms (abstinence syndrome) in both mothers and newborns.Which signs would indicate opioid withdrawal in the mother? (Select all that apply. )

The nurse should be aware of which physiologic effect of labor pain?

The obstetric nurse is preparing the client for an emergency cesarean birth,with no time to administer spinal anesthesia,general anesthesia will be used.What is the greatest risk of administering general anesthesia to the client.?

Nurses with an understanding of cultural differences regarding likely reactions to pain may be better able to help their clients.Which clients may initially appear very stoic but then become quite vocal as labor progresses until late in labor,when they become more vocal and request pain relief?

A first-time mother is concerned about the type of medications she will receive during labor.The client is in a fair amount of pain and is nauseated.In addition,she appears to be very anxious.The nurse explains that opioid analgesics are often used along with sedatives.How should the nurse phrase the rationale for this medication combination?

What is the rationale for the use of a blood patch after spinal anesthesia?

A woman in labor has just received an epidural block.What is the most important nursing intervention at this time?

Which statement correctly describes the effects of various pain factors?

An 18-year-old pregnant woman,gravida 1,para 0,is admitted to the labor and birth unit with moderate contractions every 5 minutes that last 40 seconds.The client states,"My contractions are so strong,I don't know what to do." What should the nurse's first action be?

A woman has requested an epidural block for her pain.She is 5 cm dilated and 100% effaced.The baby is in a vertex position and is engaged.The nurse increases the woman's IV fluid for a preprocedural bolus.Before the initiation of the epidural,the woman should be informed regarding the disadvantages of an epidural block.Which concerns should the nurse share with this client? (Select all that apply. )

Which breathing pattern should the nurse support for the woman and her coach during the latent phase of the first stage of labor if the couple has attended childbirth preparation classes?

Which alternative approaches to relaxation have proven successful when working with the client in labor? (Select all that apply. )

Maternal hypotension is a potential side effect of regional anesthesia and analgesia.What nursing interventions could the nurse use to increase the client's blood pressure? (Select all that apply. )

Anxiety is commonly associated with pain during labor.Which statement regarding anxiety is correct?

A woman in the active phase of the first stage of labor is using a shallow pattern of breathing,which is approximately twice the normal adult breathing rate.She starts to report feeling lightheaded and dizzy and states that her fingers are tingling.Which intervention should the nurse immediately initiate?

Nursing care measures are commonly offered to women in labor.Which nursing measure reflects the application of the gate-control theory?

A woman has requested an epidural for her pain.She is 5 cm dilated and 100% effaced.The baby is in a vertex position and is engaged.The nurse increases the woman's IV fluid for a preprocedural bolus.The nurse reviews her laboratory values and notes that the woman's hemoglobin is 12 g/dl,hematocrit is 38%,platelets are 67,000,and white blood cells (WBCs) are 12,000/mm³.Which factor would contraindicate an epidural for this woman?