Chapter 9
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? select all that apply.
1. Perform a baseline vaginal examination, 2. tell the adolescent what to expect with each procedure, 3. identify risk factors that contraindicate epidural anesthesia.
A client and her partner are working together during the woman's labor. The client cervix is now dilated 7cm, 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 client arrives in the birthing room with the fetal caput emerging. what should the nurse tell the client to do during a contraction?
use the panting-breathing pattern
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
What does a nurse consider the most significant influence on many clients' perception of pain when interpreting findings from a pain assessment?
previous experience and cultural values.
A pregnant clients 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."
what position should a nurse teach a client to avoid when the client is experiencing back pain during labor?
supine
A client in active labor becomes very uncomfortable and asks a nurse for pain medication. Nalbuphine is prescribed. How does this medication relieve pain?
Acts on opioid receptors to reduce pain.
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 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.
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 nurse is caring for a client who is having a prolonged labor. 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 client with an inflamed sciatic nerve is to have a conventional trans cutaneous electrical nerve stimulation (TENS) unit, which nursing action is appropriate?
Adjust the dial on the unit until the client states the pain is relieved.
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.
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?
1.cleansing breaths, 2.slow deep breaths, 5. Modified-paced breathing,3. pant-blow breathing,4. slow exhalation pushing.
which breathing technique should the nurse instruct the client to use as the head of the fetus is crowning?
Blowing
A nurse is caring for an obese client in early labor. The anesthesiologist discussed several types of analgesia/anesthesia with the client and recommend one. The client requests clarification before signing the consent form. which type did the anesthesiologist recommend?
Epidural anesthesia
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 measures used for women in labor.
