A nurse is caring for a client who is a primigravida, at term, and having contractions but is stating that she is "not really sure if she is in labor or not.”. Which of the following should the nurse recognize as a sign of true labor?

The question is about a client who has been in the latent phase of labor for 12 hours and wants some medication to help her rest. The nurse has to predict which medication the healthcare provider will prescribe. The choices are:. • A. Fentanyl: a synthetic opioid that is used for pain relief and sedation. It is fast-acting and potent, but can cause respiratory depression and nausea. • B. Meperidine: a synthetic opioid that is used for pain relief and sedation. It is less potent than fentanyl, but can cause seizures and serotonin syndrome. • C. Morphine: a natural opioid that is used for pain relief and sedation. It is less potent than fentanyl, but can cause respiratory depression and itching. • D. Secobarbital: a barbiturate that is used for sedation and anesthesia. It is not an opioid, but can cause respiratory depression and addiction.

Choice A reason:

Basal metabolic rate reduction. This is incorrect because a newborn under a radiant heat warmer will have an increased basal metabolic rate, not a reduced one. The basal metabolic rate is the amount of energy the body uses at rest, and it is influenced by temperature. A warmer environment will stimulate the newborn's metabolism and increase the energy expenditure. • Choice B reason:

Brown fat production. This is incorrect because a newborn under a radiant heat warmer will have less need for brown fat production, not more. Brown fat is a type of fat tissue that generates heat by burning calories. It is found in newborns and helps them maintain their body temperature in cold environments. A warmer environment will reduce the need for brown fat activation. • Choice C reason:

Shivering. This is incorrect because a newborn under a radiant heat warmer will not shiver, but shivering is not the main mechanism of heat production in newborns. Shivering is an involuntary contraction of muscles that generates heat by increasing metabolism. Newborns have limited ability to shiver because of their immature nervous system and low muscle mass. They rely more on brown fat and increased metabolic rate to produce heat. • Choice D reason:

Cold stress. This is correct because a newborn under a radiant heat warmer will prevent cold stress, which is a condition where the newborn's body temperature drops below normal and causes adverse effects. Cold stress can impair oxygen delivery, increase acidosis, decrease blood glucose, and increase the risk of infection and bleeding. A radiant heat warmer provides a neutral thermal environment for the newborn and prevents heat loss by radiation.

: 1 : 2 : 3 : 4.