Question 1

An 18-year-old primigravida is 4 cm dilated and her contractions are 5 minutes apart.She received little prenatal care and had no childbirth preparation.She is crying loudly and shouting,"Please give me something for the pain.I can't take the pain!" What is the priority nursing diagnosis?

Accepted Answer

The most important issue for this woman,at this time,is effective pain management.

Question 2

A woman requests a pudendal block to manage her labor pain.What statement by the woman indicates a need for further explanation about the pudendal block?

Accepted Answer

The pudendal block does not block pain from contractions and is given just before birth.

Question 3

A nurse is teaching a childbirth preparation class.The group is discussing individual expression of labor pain.What statement is accurate about a patient's expression of pain?

Accepted Answer

Culture influences how women feel about birth and what is an acceptable response to pain.

Question 4

What is the most appropriate nursing action to take when a laboring woman hyperventilates?

Accepted Answer

Measures to combat hyperventilation include breathing into cupped hands or a paper bag or holding breath for a few seconds.All of these techniques decrease PCO?.

Question 5

When a pregnant woman arrives at the labor suite,she tells the nurse that she wants to have an epidural for delivery.What is a contraindication to an epidural block?

Accepted Answer

An epidural block is not used if a woman has abnormal blood clotting.

Question 6

What assessment should be taken immediately after the anesthesiologist administers an epidural block to a laboring woman?

Accepted Answer

Blood pressure is checked every 5 minutes when the epidural block is first begun.Bladder assessment is also important but not an initial assessment.

Question 7

The nurse is preparing a teaching plan for a woman receiving a subarachnoid block before delivery.What nursing action will be included in this plan to prevent the associated side effect of this type of anesthesia?

Accepted Answer

The woman would be advised to remain flat for several hours after the block to decrease the chance of postspinal headache.

Question 8

A nurse instructs a woman's labor coach to comfort her by firmly pressing on her lower back.What is this technique?

Accepted Answer

Sacral pressure refers to firm pressure against the lower back to relieve some of the pain of back labor.

Question 9

What is the Dick-Read method of childbirth preparation based on?

Accepted Answer

The Dick-Read method depends on the use of relaxation techniques to reduce the discomforts of labor.

Question 10

The nurse is instructing a Lamaze class on abdominal breathing and tells a patient that her baseline respiratory rate is 22 breaths per minute.What should be the patient's rate while performing slow breathing?

Accepted Answer

The range of respirations should be no lower than half of the base rate and no more rapid than double the base rate.

Question 11

What chemical substance(s)produced in the body acts as a natural pain reliever?

Accepted Answer

Endorphins are natural body substances that are similar to morphine and may explain why laboring women need smaller doses of analgesia.

Question 12

A woman in labor will receive general anesthesia prior to cesarean section.The nurse reminds the patient that food and fluids need to be restricted for several hours prior to delivery.What will this prevent?

Accepted Answer

The major adverse effect of general anesthesia is aspiration of stomach contents.

Question 13

What would the nurse guide a labor coach to do to comfort a woman tensing her muscles with contractions?

Accepted Answer

Panting relaxes the abdominal wall and distracts the patient.It would not be helpful to offer fluids or to attempt conversation during contractions.Walking intensifies contractions.

Question 14

The nurse who encourages the gate control theory of pain control would advise a woman in labor and her partner to use which nonpharmacological method of pain management?

Accepted Answer

According to the gate control theory,stimulating large-diameter nerve fibers temporarily interferes with conduction of impulses through small-diameter fibers.Massage is a technique that stimulates large-diameter fibers and "closes the gate."

Question 15

Which narcotic antagonist is used to reverse narcotic-induced respiratory depression?

Accepted Answer

Naloxone (Narcan)is used to reverse respiratory depression caused by narcotics.

Question 16

A woman in labor has had an epidural block for pain relief.The nurse will be assessing carefully for what associated side effect of this type of regional anesthesia?

Accepted Answer

A side effect of an epidural block is urine retention,because the anesthesia interferes with the woman's ability to have an urge to void.The patient may have to be catheterized.

Question 17

The nurse coaches the primigravida not to bear down until the cervix is completely dilated.What may premature bearing down cause?

Accepted Answer

Bearing down against a cervix that is not dilated can cause edema and laceration to the cervix.

Question 18

A woman in the transition phase of labor requests a narcotic analgesic medication for pain relief.What should the nurse explain regarding giving a narcotic analgesic medication at this stage of labor?

Accepted Answer

The risk of narcotic analgesics is that they cross the placenta and can cause fetal respiratory depression.

Question 19

A woman who is 6 cm dilated has the urge to push.What will the nurse instruct the woman to do during the contraction?

Accepted Answer

If a laboring woman feels the urge to push before the cervix is fully dilated,then she is taught to blow in short breaths to avoid bearing down.

Question 20

Several hours into labor,a woman complains of dizziness,numbness,and tingling of her hands and mouth.What does the nurse recognize these symptoms signify?

Accepted Answer

Hyperventilation is sometimes a problem if a woman is breathing rapidly.

Quiz 7: Nursing Management of Pain During Labor and Birth