A client whose labor is being augmented with an oxytocin infusion requests an epidural for pain control.
Findings of the last vaginal exam, performed one hour ago, were 3 cm cervical dilation, 60% effacement, and a -2 station.
Which action should the nurse implement first?

Request placement of the epidural.

Determine current cervical dilation.

Decrease the oxytocin infusion rate.

Give a bolus of intravenous fluids.

Answer and Explanation

The Correct Answer is B

Choice A rationale

Requesting placement of the epidural should be based on the current cervical dilation and labor progress. Administering an epidural too early may lead to prolonged labor and increased risk of interventions.

Choice B rationale

Determining current cervical dilation is essential to assess the progress of labor and to make informed decisions about pain management and the use of epidurals. This ensures appropriate timing for interventions.

Choice C rationale

Decreasing the oxytocin infusion rate would not be the first action without assessing the current cervical dilation and labor progress. Oxytocin adjustments should be based on specific clinical indications and findings.

Choice D rationale

Giving a bolus of intravenous fluids is typically done before administering an epidural to prevent hypotension. However, this should be preceded by assessing cervical dilation to determine the timing and need for an epidural.

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Correct Answer is B

Explanation

Choice B rationale

Providing multidisciplinary resources and ongoing support is crucial for newborns exposed to methadone. This approach helps in managing withdrawal symptoms and ensures the child receives comprehensive care.

Choice A rationale

Keeping the newborn in the nursery may be beneficial initially but does not address the long-term needs of the child and the family.

Choice C rationale

Administering methadone to the newborn is not typically done unless specifically indicated by the healthcare provider.

Choice D rationale

Calling social services for foster care placement may be necessary in some cases, but providing support and resources to the mother and child is the primary intervention.

A. Client's hourly blood pressure. B. Preparation for emergency cesarean birth. C. Checking the perineum for bulging. D. Intensity, interval, and length of contractions.

Correct Answer is D

Explanation

Choice A rationale

Monitoring hourly blood pressure is essential, but it is not the most crucial data in this scenario. Blood pressure monitoring can help identify maternal hypotension or hypertension, which can affect uteroplacental blood flow. However, hypotonic dystocia requires monitoring contractions to assess labor progression and effectiveness of oxytocin.

Choice B rationale

Preparing for an emergency cesarean birth is a potential intervention if labor does not progress or if fetal distress occurs. However, it is not the primary data to monitor initially. The decision for a cesarean is based on a comprehensive assessment, including fetal heart rate patterns and contraction quality.

Choice C rationale

Checking the perineum for bulging may indicate imminent delivery or fetal descent. However, in the context of hypotonic dystocia, the primary concern is evaluating contraction patterns to ensure the effectiveness of oxytocin in augmenting labor.

Choice D rationale

Monitoring the intensity, interval, and length of contractions is the most critical data in this case. Hypotonic dystocia involves weak, infrequent, or irregular contractions. Oxytocin is administered to strengthen and regularize contractions, so assessing their characteristics is crucial to determine the response to treatment and guide further interventions.

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A client whose labor is being augmented with an oxytocin infusion requests an epidural for pain control.Findings of the last vaginal exam, performed one hour ago, were 3 cm cervical dilation, 60% effacement, and a -2 station.Which action should the nurse implement first?

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a newborn with suspected neonatal abstinence syndrome.The mother is currently taking methadone and is in a treatment program.Which intervention should the nurse implement prior to discharge?

Correct Answer is B

Explanation

Correct Answer is D

Explanation

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A client whose labor is being augmented with an oxytocin infusion requests an epidural for pain control.
Findings of the last vaginal exam, performed one hour ago, were 3 cm cervical dilation, 60% effacement, and a -2 station.
Which action should the nurse implement first?