A term multigravida, who is receiving oxytocin IV for labor augmentation, is requesting pain medication. Review of the client's record indicates that she was medicated 30 minutes ago with butorphanol 2 mg and promethazine 25 mg IV push. Vaginal examination reveals that the client's cervical dilation is 3 cm, 10% effaced, and at a 0 station. Which action should the practical nurse (PN) implement?
Coach the client to take slow, deep breaths during each contraction.
Report to the nurse that the client needs another dose of butorphanol.
Notify the healthcare provider.
Discontinue the oxytocin infusion.
The Correct Answer is A
In this situation, the practical nurse (PN) should coach the client to take slow, deep breaths during each contraction. The client has already been medicated with butorphanol and promethazine for pain relief and it may not be appropriate to administer another dose at this time. Instead, the PN can provide non- pharmacological pain relief measures such as coaching the client to use breathing techniques to help manage the pain during contractions. The other actions listed may also be appropriate in some situations, but coaching the client to use breathing techniques is the most appropriate action in this situation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Guided imagery is a technique that can help the client to relax and reduce anxiety by imagining a peaceful and calming scene. This technique can be helpful for clients waiting for surgery to reduce stress and promote relaxation.
Option A (mindfulness) may also be helpful, but it may require more practice and preparation than guided imagery.
Option C (biofeedback) may not be feasible in the preoperative holding area, and
Option D (cognitive reframing) may not be helpful in the immediate preoperative period.
Therefore, options A, C, and D are not answers because they may not be the most effective technique to help the client in the preoperative holding area.
Correct Answer is D
Explanation
Acute glomerulonephritis is a type of kidney disease that can develop after an infection such as strep throat. A sore throat is a common symptom of strep throat and could have been the sign that motivated the parents to seek medical care for their child.
Hematuria (A) is the presence of blood in the urine and can be a symptom of acute glomerulonephritis, but it is not the most likely sign that originally motivated the parents to seek medical care. Weight loss (B) and polydipsia (C), which is excessive thirst, are not typically associated with acute glomerulonephritis or strep throat.
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