A nurse is caring for a primigravida whose cervix is 2 cm dilated, 75% effaced, and the fetal presenting part is at +2 station.
The patient says to the nurse, “I want an epidural now.Why won’t someone give me an epidural?” Which response is most appropriate for the nurse to make?
“Your labor may slow down if you receive an epidural now.”.
“You need to be at least eight centimeters dilated prior to receiving an epidural.”.
“You will need to be catheterized prior to receiving an epidural.”.
“Your baby needs to be at zero station before you can have an epidural.”.
The Correct Answer is A
The correct answer is choice A. “Your labor may slow down if you receive an epidural now.” An epidural is a type of regional anesthesia that blocks pain in a specific area of the body.
It can be used to reduce pain during labor and delivery.
However, an epidural can also have some side effects, such as lowering blood pressure, causing fever, and slowing down labor progress.
Therefore, it is usually recommended to wait until the cervix is at least 4 to 5 cm dilated and the contractions are strong and regular before receiving an epidural.
Choice B is wrong because there is no fixed rule about how dilated the cervix needs to be before receiving an epidural.
Some women may receive an epidural earlier or later than others, depending on their pain level, medical history, and preferences.
Choice C is wrong because catheterization is not a prerequisite for receiving an epidural.
Catheterization is the insertion of a tube into the bladder to drain urine.
It may be done after receiving an epidural because the anesthesia can affect the ability to urinate.
However, it is not required before receiving an epidural.
Choice D is wrong because the station of the baby does not determine when a woman can have an epidural.
The station of the baby refers to how far the baby has descended into the pelvis.
It is measured in relation to the ischial spines, which are bony landmarks in the pelvis.
A positive station means that the baby is below the spines, while a negative station means that the baby is above the spines.
Zero station means that the baby is at the level of the spines.
The station of the baby does not affect the administration of an epidural, as long as there are no other complications or contraindications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A rubella titer of 1:33 indicates a low level of immunity to rubella, which can be dangerous for a pregnant woman and her fetus.
Rubella is a viral infection that can cause birth defects or miscarriage if contracted during pregnancy.A rubella titer of 1:10 or higher is considered protective.
Choice B is wrong because a non-reactive serologic test for syphilis (STS) means that the patient does not have syphilis, which is a bacterial infection that can also harm the fetus if untreated.
Choice C is wrong because blood type A-negative does not require further assessment unless the patient has antibodies to the Rh factor, which can cause hemolytic disease of the newborn if the fetus is Rh-positive.
This can be prevented by giving the patient Rh immunoglobulin injections during pregnancy and after delivery.
Choice D is wrong because hemoglobin 12.2 gm/dL is within the normal range for a pregnant woman, which is 11 to 14 gm/dL.
Hemoglobin is the protein in red blood cells that carries oxygen.
A low hemoglobin level can indicate anemia, which can affect the oxygen delivery to the fetus and increase the risk of preterm labor or low birth weight.
Correct Answer is B
Explanation
The correct answer is choice B: The risk of transplacental transmission of chlamydia between mother and baby is low.This means that the infection is unlikely to pass from the mother’s blood to the baby’s blood through the placenta.However, this does not mean that the infection is harmless for the baby.
Choice A is wrong because transmission of chlamydia usually occurs when the baby passes through the vagina.This can cause eye infections or pneumonia in the newborn.
Choice C is wrong because the baby has probably not developed antibodies to the chlamydia in utero.Antibodies are proteins that help fight infections, and they are usually passed from the mother to the baby through the placenta.However, chlamydia does not stimulate a strong antibody response in the mother, so there is little protection for the baby.
Choice D is wrong because the baby will not receive systemic treatment at birth to prevent a chlamydia infection.Systemic treatment means medication that affects the whole body, such as oral or intravenous antibiotics.The baby will only receive topical treatment, such as eye drops or ointment, to prevent eye infections.Normal ranges: Chlamydia infection is common among pregnant women, especially those under 25 years old or with risk factors such as multiple or new sexual partners.The prevalence of chlamydia among pregnant women in the United States ranges from 1% to 40%, depending on the population and screening methods.Chlamydia infection can be diagnosed by urine or swab tests, and treated with antibiotics such as azithromycin or doxycycline.Chlamydia screening is recommended for all pregnant women at their first prenatal visit and again in the third trimester if they are at high risk.
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