Pain Management During Labor > Maternal & Newborn
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Summary
Total Questions : 15
Showing 15 questions, Sign in for moreA nurse is reviewing nonpharmacologic methods of pain relief with a pregnant client who is in early labor.
The client states that she wants to try aromatherapy during labor but does not know which essential oils are safe to use.
Which of the following oils should the nurse recommend?
Explanation
Lavender is a safe and effective essential oil to use during labor for pain relief and relaxation.According to Evidence Based Birth, lavender may also help reduce anxiety, nausea and the length of labor.
A nurse is assisting a client who is in active labor and plans to use hypnosis as a nonpharmacologic method of pain relief.
Which of the following actions should the nurse take to facilitate this method?
Explanation
hypnosis for pain relief during labor involves entering into a state of self-hypnosis that alters the perception of potentially painful sensations.By focusing on a pleasant image or memory, the client can enhance the effect of hypnosis and reduce the need for pharmacological analgesia.
A nurse is caring for a client who is in transition phase of labor and reports feeling nauseated and lightheaded.
The nurse suspects that the client is hyperventilating due to rapid breathing.
Which of the following findings supports this suspicion?
Explanation
are common symptoms of hyperventilation.Hyperventilation is rapid or deep breathing that reduces the amount of carbon dioxide in the blood.This causes the blood vessels that supply the brain to narrow, leading to lightheadedness and tingling sensations.
A nurse is teaching a childbirth education class about nonpharmacological measures for pain management during labor.
Which of the following techniques should the nurse include as an example of gate control theory?
Explanation
Acupressure is an example of gate control theory of pain, which describes how non-painful sensations can override and reduce painful sensations.Acupressure involves applying pressure to specific points on the body to stimulate large-diameter nerve fibers that can block the transmission of pain signals from smaller-diameter nerve fibers.
A nurse is caring for a client who is receiving pudendal block anesthesia for a vaginal delivery.
Which of the following outcomes should the nurse expect?
Explanation
a pudendal nerve block is a form of local anesthesia that blocks the pudendal nerve, which innervates the perineum, vulva, and vagina.A pudendal nerve block is commonly used to relieve pain during the delivery of baby by forceps, vaginal repairs, and anorectal surgeries.
A nurse is administering nitrous oxide to a client who is in labor.
Which of the following actions should the nurse take?
Explanation
The nurse should take all of the following actions when administering nitrous oxide to a client who is in labor:
Instruct the client to hold the mask over her mouth and nose during contractions.This allows the client to self-administer the gas and control the amount and timing of inhalation.
Monitor the client’s oxygen saturation level continuously.Nitrous oxide can cause hypoxia and respiratory depression if used in high concentrations or for prolonged periods.
Ensure that there is adequate ventilation in the room.Nitrous oxide is a greenhouse gas and can have negative environmental and occupational effects if not properly scavenged.
A nurse is caring for a client who is in labor and has received epidural anesthesia for pain relief.
Which of the following interventions should the nurse perform to prevent hypotension?
Explanation
epidural anesthesia can cause vasodilation and decrease venous return, leading to hypotension.IV fluids can help maintain blood volume and prevent hypotension.
A nurse is caring for a client who is in labor and has received spinal anesthesia for pain relief.
The client reports a severe headache that worsens when sitting up.
Which of the following actions should the nurse take?
Explanation
the client has a spinal headache, which is caused by leakage of cerebrospinal fluid (CSF) through the dural hole created by the needle.Lying flat can reduce the pressure gradient between the brain and the spinal cord and decrease the headache pain.
A nurse is caring for a client who is in labor and has received nitrous oxide for pain relief.
Which of the following are potential adverse effects of this method? (Select all that apply.).
Explanation
Dizziness and headache are potential adverse effects of nitrous oxide for pain relief during labor.Nitrous oxide can also cause nausea, vomiting, drowsiness, reduced awareness, and mask phobia.
A nurse is caring for a child who is receiving morphine via a patient-controlled analgesia (PCA) pump after abdominal surgery.
Which of the following actions should the nurse take? (Select all that apply.)
Explanation
The nurse should assess the child’s pain level using a numeric rating scale and check the PCA pump settings with another nurse.
These actions ensure that the child is receiving adequate pain relief and that the PCA pump is functioning properly and safely.
A nurse is caring for a client who is in active labor and requests pain medication.
Which of the following factors should the nurse consider when choosing a pharmacological pain management method? (Select all that apply.)
Explanation
These are the factors that the nurse should consider when choosing a pharmacological pain management method for a client who is in active labor.
- the client’s preference and birth plan should be respected and supported by the nurse.The client may have specific wishes or expectations about the type and timing of pain medication, and the nurse should discuss these with the client and provide information and education as needed.
- the stage and duration of labor affect the type and effectiveness of pharmacological pain management methods.For example, parenteral opioids provide pain relief that is superior to nitrous oxide but inferior to regional anesthesia.However, opioids may cause adverse effects such as nausea, vomiting, sedation and respiratory depression in both the mother and the fetus.Therefore, opioids are usually given in early labor and avoided in late labor or close to delivery.Regional anesthesia, such as epidural or spinal anesthesia, provides the most effective pain relief but may also have some drawbacks such as hypotension, pruritus, urinary retention and prolonged second stage of labor.Therefore, regional anesthesia may not be suitable for clients who have contraindications or who are in advanced labor.
- the fetal heart rate and position may influence the choice of pharmacological pain management method.For example, regional anesthesia may cause maternal hypotension, which can reduce uteroplacental blood flow and cause fetal bradycardia.Therefore, regional anesthesia should be used with caution in clients who have fetal distress or nonreassuring fetal heart rate patterns.Additionally, some fetal positions, such as occiput posterior or transverse lie, may cause more severe back pain that may not be relieved by regional anesthesia alone.In such cases, other methods such as sterile water injections or pudendal block may be helpful.
A nurse is reviewing informed consent with a client who is scheduled for a cesarean delivery with spinal anesthesia.
Which of the following statements by the client indicates a need for further teaching?
Explanation
Spinal anesthesia does not affect blood loss or blood pressure during a cesarean delivery.It only blocks pain sensations from the lower part of the body by injecting medication into the cerebrospinal fluid.
A nurse is caring for a client who is in active labor and requests pain medication.
Which of the following factors should the nurse consider when choosing a systemic analgesic? (Select all that apply.).
Explanation
The stage and phase of labor and the fetal heart rate and pattern are important factors that the nurse should consider when choosing a systemic analgesic for a client who is in active labor.Systemic analgesics can cross the placenta and affect the fetus, so the nurse should monitor the fetal heart rate and pattern for any signs of distress or changes.The stage and phase of labor can influence the timing and effectiveness of systemic analgesics, as well as the risk of adverse effects on the mother and the fetus.For example, systemic analgesics given too early in labor may prolong labor, whereas systemic analgesics given too late in labor may cause respiratory depression in the newborn.
Normal ranges for maternal vital signs are: blood pressure 110/60 to 140/90 mm Hg, pulse 60 to 100 beats per minute, respiratory rate 12 to 20 breaths per minute, and temperature 36.5 to 37.5°C (97.7 to 99.5°F).
Normal ranges for fetal heart
A nurse is caring for a client who is receiving intrathecal opioid analgesia during labor.
Which of the following medications should the nurse have available as an antidote in case of respiratory depression?
Explanation
Naloxone is an opioid antagonist that can reverse the respiratory depression caused by intrathecal opioid analgesia.Flumazenil is an antidote for benzodiazepine overdose, not opioid overdose.Protamine sulfate is an antidote for heparin overdose, not opioid overdose.Vitamin K is an antidote for warfarin overdose, not opioid overdose.
A nurse is caring for a client who is receiving nitrous oxide for pain relief during labor.
Which of the following are advantages of this method? (Select all that apply.).
Explanation
Nitrous oxide hasrapid onset and offsetand it allows the client tocontrol the dosageby self-administering the gas through a mask or mouthpiece.
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