Maternity Ch. 14

Front 1

an 18 year old pregnant woman, gravida 1, is admitted to the labor and birth unit with moderate contractions every 5 minutes that last 40 seconds. the woman states, " my contractions are so strong that i dont know what to do with myself." the nurse should

Back 1

recognize that pain is personalized for each individual

Front 2

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

Back 2

massaging the woman's back

Front 3

a woman in active labor receives an analgesic opioid agonist. which medication relieves severe, persistent, or recurrent pain; creates a sense of well-being; overcomes inhibitory factors; and may even relax the cervix but should be used cautiously in women with cardiac disease

Back 3

meperidine (demerol)

Front 4

a laboring woman received an opioid agonist (meperidine) intravenously 90 minutes before she gave birth. which medication should be available to reduce the postnatal effects Demerol on the neonate

Back 4

naloxone (narcan)

Front 5

a woman in labor has just receive an epidural block . the most important nursing intervention is to*

Back 5

monitor the maternal blood pressure for possible hypotension

Front 6

the nurse should be aware that an effective plan to achieve adequate pain relief without maternal risk is most effective if

Back 6

the mother and family's priorities and preferences are incorporated into the plan

Front 7

a woman in the active phase of the first stage of labor is using a shallow pattern of breathing, which is about twice the normal adult breathing rate. she starts to complain about feeling lightheaded and dizzy and states that her fingers are tingling. the nurse should

Back 7

help her breathe into a paper bag

Front 8

a woman is experiencing back labor and complains of intense pain in her lower back. an effective relief measure would be to use

Back 8

counterpressure against the sacrum

Front 9

if an opioid antagonist is administered to a laboring woman, she should be told that

Back 9

her pain will return

Front 10

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 intravenous fluid for a preprocedural bolus. she reviews her laboratory values and notes that the woman's hemoglobin is 12g/dl, hematocrit is 38%, platelets are 67,000, and WBC are 12,000. which factor would contraindicate an epidural for the woman*

Back 10

she has thrombocytopenia

Front 11

the role of the nurse with regard to informed consent is to

Back 11

act as a client advocate and help clarify the procedure and the options

Front 12

a first time mother is concerned about the type of medications she will receive during labor. she is in a fair amount of pain and is nauseous. in addition, she appears to be very anxious. you explain that opioid analgesics often are used with sedatives because

Back 12

sedatives help the opioid work better, an they also will assist you to relax and relieve your nausea

Front 13

to help clients manage discomfort and pain during labor, nurses should be aware that

Back 13

the predominant pain of the first stage of labor is the visceral pain located in the lower portion of the abdomen

Front 14

which statement correctly describes the effects of various pain factors

Back 14

levels of pain-mitigating B-endorphins are higher during a spontaneous, natural childbirth

Front 15

nurses with an understanding of cultural differences regarding likely reactions to pain may be better able to help clients. nurses should know that ____ women may be stoic until late in labor, when they may become vocal and request pain relief

Back 15

hispanic

Front 16

with regard to a pregnant woman's anxiety and pain experience, nurses should be aware that

Back 16

severe anxiety increases tension, which increases pain, which in turn increases fear and anxiety and so on.

Front 17

nurses should be aware of the differences experience can make in labor pain such as

Back 17

sensory pain for nulliparous women often is greater than for multiparous women during early labor

Front 18

in the current practice of childbirth preparation, emphasis is placed on

Back 18

having expectant parents attend childbirth preparation in any or no specific method

Front 19

with regard to breathing techniques during labor, maternity nurses should understand that

Back 19

breathing techniques in the first stage of labor are designed to increase the size of the abdominal cavity to reduce friction

Front 20

maternity nurses often have to answer questions about the many, sometimes unusual ways people have tried to make the birthing experience more comfortable. for instance, nurses should be aware that

Back 20

electrodes attached to either side of the spine to provide high-intensity electrical impulses facilitate the release of endorphins

Front 21

with regard to systemic analgesics administered during labor, nurses should be aware that

Back 21

effects on the fetus and newborn can include decreased alertness and delayed sucking

Front 22

with regard to nerve block analgesia and anesthesia, nurses should be aware that

Back 22

most local agents are related chemically to cocaine and end in the suffix -caine

Front 23

with regard to spinal and epidural (block) anesthesia, nurses, should know that

Back 23

a high incidence of after-birth headache is seen with spinal block

Front 24

a woman in labor is breathing into a mouthpiece just before that start of her regular contractions. as she inhales, a valve opens, and gas is released. she continues to inhale the gas slowly and deeply until the contraction starts to subside. when the inhalation stops, the valve closes. this procedure is

Back 24

an application of nitrous oxide

Front 25

in assessing a woman for pain and discomfort management during labor, a nurse most likely would

Back 25

have the woman use a visual analog scale (VAS) to determine her level of pain

Front 26

after change of shift report the nurse assumes care of a mltiparous client in labor. the woman is complaining of pain that radiates to her abdominal wall, lower back, and buttocks and down her thighs. before implementing a plan of care, the nurse should understand that this type of pain is

Back 26

referred

Front 27

it is important for the nurse to develop a realistic birth plan with the pregnant woman in her care. the nurse can explain that a major advantage of nonpharmacologic pain management is

Back 27

no side effects or risk to the fetus are involved

Front 28

the nurse providing newborn stabilization must be aware that the primary side effect of maternal narcotic analgesia in the newborn is

Back 28

respiratory depression

Front 29

the nerve block used in labor that provides anesthesia to the lower vagina and perineum is called

Back 29

a pudendal

Front 30

which method of pain management is safest for a gravida 3 para 2 admitted at 8 cm cervical dilation

Back 30

breathing and relaxation techniues

Front 31

the laboring woman who imagines her body opening to let the baby out is using a mental technique called

Back 31

imagery

Front 32

the obstetric nurse is preparing the patient for an emergency cesearean birth, with no time to administer spinal anesthesia. the nurse is aware and prepared for the greatest risk of administering general anesthesia to the patient. this risk is

Back 32

aspiration of stomach contents

Front 33

to assist the woman after delivery of the infant, the nurse knows that the blood patch is used after spinal anesthesia to relieve

Back 33

headache

Front 34

maternal hypotension is a potential side effect of regional anesthesia and analgesia. what nursing interventions could you use to raise the client's blood pressure (select all that apply)

Back 34

place the woman in a lateral position

increase IV fluids

administer oxygen

Front 35

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. signs of opioid/narcartic withdrawal in the mother would include (select all that apply)

Back 35

yawning, runny nose

chills and hot flashes

irritability, restlessness

Front 36

while developing an intrapartum care plan for the patient in early labor, it is important that the nurse recognize that psychosocial factors may influence a woman's experience of pain. these include (select all that apply)

Back 36

culture

anxiety and fear

previous experiences with pain

support systems

Front 37

a. yoga d. water immersion

b. massage e. aromatherapy

c. accupunture

less pain intensity, decreased use of analgesia, fewer instrumental births

significantly decreased use of analgesia, shorter labor

no difference when compared with placebo

less pain and anxiety during the first stage of labor

reduced length of labor, increased satisfaction of pain relief

Back 37

less pain intensity, decreased use of analgesia, fewer instrumental births (C)

significantly decreased use of analgesia, shorter labor (D)

no difference when compared with placebo (E)

less pain and anxiety during the first stage of labor (B)

reduced length of labor, increased satisfaction of pain relief (A)