Maternal Child Chapter 9

During labor, a client who has been receiving epidural anesthesia has a sudden episode of severe nausea, and her skin becomes pale and clammy. What is the nurse's immediate reaction?

Turn the client on her side

A client arrives in the birthing room with fetal caput emerging. What should the nurse tell the client to do during a contraction?

Use the panting-breathing pattern

A laboring client reports low back pain. What should a nurse recommend to the client's coach that will promote comfort?

Apply pressure to her back during contractions

A client in active labor becomes very uncomfortable and asks the nurse for pain medication. Nalbuphine is prescribed. How does this medication relieve pain?

Acts on opioid receptors to reduce pain

A client with an inflamed sciatic nerve is to have a conventional transcutaneous electrical nerve stimulation (TENS) device applied to the painful nerve pathway. When operating the TENS unit, which nursing action is appropriate?

Adjust the dial on the unit until the client states the pain is relieved

Which birthing technique should the nurse instruct the client to use as the head of the fetus is crowning?

Blowing

In childbirth classes, the nurse is teaching paced-breathing techniques to use during labor. In which order should the breathing techniques be used as labor progresses?

Cleansing breathes ----> Slow, deep breathes ----> Modified-paced breathing -----> Pant-blow breathing ----> Slow, exhalation pushing

A pregnant client is now in the third trimester. The client tells the nurse, "I want to be knocked out for the birth." How should the nurse respond?

You don't want to be awake during the birth

A client and her partner are working together during the woman's labor. The client's cervix is now dilated 7 cm, and the presenting part is low in the midpelvis. What should the nurse instruct the partner to do that would alleviate the client's discomfort during contractions?

Deep-breathe slowly

A nurse is caring for an obese client in early labor. The anesthesiologist discussed several types of analgesia/anesthesia with the client and recommended one. The client requests clarification before signing the consent form. Which type did the anesthesiologist recommend?

Epidural anesthesia

A nurse has just finished reviewing how anesthesia will be used during a vaginal birth for a client with class I heart disease. What type of anesthesia does the client discuss that indicates to the nurse that the teaching was effective?

Epidural regional

Why should a nurse teach pregnant women the importance of conserving the "spurt of energy" before labor?

Fatigue may influence the need for pain medication

How should a nurse direct care for a client in the transition phase of the first stage of labor?

Help the client to maintain control

A nurse is caring for a client who is having a prolonged birth. The client is annoyed and very concerned because her labor is deviating from what she perceives as normal. After the nurse has acknowledged the client's feelings, What is the next best intervention?

I'll rub your back, and you tell me if it helps

A nurse applies an ice pack to a client's back for 20 minutes. What clinical indicator helps the nurse determine the effectiveness of the treatment?

Local anesthesia

A nurse is caring for a primigravida during labor. At 7 cm dilation a prescribed pain medication is administered. Which medication requires monitoring of the newborn for the side effect of respiratory depression?

Meperidine hydrochloride

A nurse is caring for an adolescent in labor an hour after she was admitted to the birthing unit. The adolescent is anxious and tense. She cries during contractions and asks the nurse for epidural anesthesia. The nurse obtains the adolescent's current vital signs and reviews her history and admission information. What nursing interventions are essential before epidural anesthesia is administered?

Perform a baseline vaginal examination Tell the adolescent what to expect with each procedure Identify risk factors that contraindicate epidural anesthesia

What does a nurse consider the most significant influence on many clients' perception of pain when interrupting findings from a pain assessment?

Previous experience and cultural values

A primigravida who is at 40 weeks' gestation arrives at the birthing center with abdominal cramping and a bloody show. Her membranes ruptured 30 minutes before arrival. A vaginal examination reveals 1 cm dilation and the presenting part at - 1 station. After obtaining the fetal heart rate (FHR) and maternal vital signs, what should the nurse do next?

Provide the client with comfort measure used for women in labor

What position should a nurse teach a client to avoid when the client is experiencing back pain during labor?

Supine