Mother Baby Ricci ch 14
A woman refuses to have an epidural block because she does not want to have a spinal headache after birth. What would be the nurse's best response?
"Spinal headache is not a usual complication of epidural blocks."
A client in labor has received a spinal epidural block. Which nursing intervention should the nurse prioritize after assessing maternal hypotension and changes in the fetal heart rate (FHR)?
Administer supplemental oxygen.
The nurse is working with a client approaching her due date. Arrange the sequence of typical labor pain that the client may experience from onset to birth of the fetus. Use all options.
Cramping in the lower abdomen Pain noted in the lower back, buttocks and thighs Intense contractions resulting in fetal movement Burning in the perineum
A nurse is assigned to conduct an admission assessment on the phone for a pregnant client. Which information should the nurse obtain from the client?
Estimated due date Characteristics of contractions Appearance of vaginal blood
At which time does the nurse anticipate that the woman will need the most pain relief measures?
In the active phase of the first stage of labor
baseline variability
Irregular fluctuations in the baseline FHR, measured as the amplitude of the peak to trough in bpm. Because variability is in essence the combined result of autonomic nervous system branch function, its presence implies that the both branches are working and receiving adequate oxygen
Fetal Distress Vaginal Bleeding Cervical dilation greater than 6cm Contraindications for what?
Magnesium Sulfate
UTI Multifetal Pregnancy Oligohydramnios DM Uterine Abnormalities Risks for what?
Pre term labor
baseline fetal heart rate
Refers to the average FHR that occurs during a 10-minute segment that excludes periodic or episodic rate changes, such as tachycardia or bradycardia. It is assessed when the woman has no contractions and the fetus is not experiencing episodic FHR changes. The normal baseline FHR ranges between 110 and 160 beats per minute (bpm)-can be obtained by auscultation, ultrasound, or Doppler, or by a continuous internal direct fetal electrode
neuraxial analgesia/anesthesia
The administration of analgesic (opioids) or anesthetic (capable of producing a loss of sensation in an area of the body) agents, either continuously or intermittently, into the epidural or intrathecal space to relieve pain.
artifact
The term artifact is used to describe irregular variations or absence of the FHR on the fetal monitor record that result from mechanical limitations of the monitor or electrical interference
The nurse is caring for a client who has been in labor for the past 8 hours. The nurse determines that the client has transitioned into the second stage of labor based on which sign?
The urge to push occurs.
deceleration
a transient fall in FHR caused by stimulation of the parasympathetic nervous system. Decelerations are described by their shape and association to a uterine contraction. They are classified as early, late, and variable only
Leopold maneuvers
method for determining the presentation, position, and lie of the fetus through the use of four specific steps
accelerations
transitory abrupt increases in the FHR above the baseline that last <30 seconds from onset to peak. Duration is >15 seconds, but less than 2 minutes. generally considered reassuring
