A nurse is caring for a client who is in the latent phase of the first stage of labor and is in pain.
Which of the following nursing interventions are appropriate to reduce pain? (Select all that apply.)
Perform Leopold maneuvers.
Apply counterpressure to the sacral area
Ambulate the client in the hallway
Administer 70-90% nitrous oxide mixed with oxygen
Correct Answer : B,C,D,E
Applying counterpressure to the sacral area can help alleviate back pain during labor.
Ambulating the client in the hallway can help with pain management and facilitate labor progress.
Administering nitrous oxide mixed with oxygen can provide pain relief during labor.
Having the client sit upright can help with pain management and facilitate labor progress.
Choice A is incorrect because performing Leopold maneuvers is a technique used to assess fetal position and presentation and is not a pain management technique.
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Related Questions
Correct Answer is B
Explanation
A client who is 80% effaced and 8 cm dilated is in active labor and at risk for postpartum hemorrhage.
Choice A is not an answer because ectopic pregnancy occurs when a fertilized egg implants outside of the uterus and is not a risk for a client who is in active labor.
Choice C is not an answer because an incompetent cervix refers to a cervix that dilates prematurely during pregnancy and is not a risk for a client who is in active labor.
Choice D is not an answer because hyperemesis gravidarum refers to severe nausea and vomiting during pregnancy and is not a risk for a client who is in active labor.
Correct Answer is D
Explanation
Answer: D
Rationale:
(A) "Your partner will apply continuous, firm pressure between your thumb and index finger": This statement is not appropriate for describing counterpressure during labor. Counterpressure typically involves applying pressure to areas such as the lower back or sacrum, not between the thumb and index finger.
(B) "Your partner will apply pressure to the top of your uterus during contractions": This statement is not appropriate. Applying pressure to the top of the uterus during contractions could be harmful and is not recommended as a counterpressure technique during labor. Counterpressure is generally applied to the lower back or hips to alleviate pain.
(C) "Your partner will apply steady pressure with a tennis ball to your finger": This statement is not correct. Counterpressure during labor involves applying pressure to the lower back or hips, not to the fingers. A tennis ball may be used, but it is applied to the lower back or sacral area, not the fingers.
(D) "Your partner will apply upward pressure on you": This statement is appropriate. During labor, counterpressure is often applied by the partner to the lower back or hips, pressing upward or in a direction that helps alleviate the pain caused by contractions, particularly in cases of back labor. This technique can help relieve discomfort by counteracting the pressure from the baby's head against the mother's spine.
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