The pregnant client term has in presented in the early phase of labor. She is experiencing abdominal pain and shows signs of growing anxiety about pain. What is the best pain management technique the nurse can suggest at this stage?

Practicing effleurage on the abdomen

Beginning epidural anesthesia

using on opioid antagonist, such aS Butorphanol

Immersing the client in hot water in a pool of Jacuzzi

Answer and Explanation

The Correct Answer is A

A) Practicing effleurage on the abdomen:
It is an excellent non-pharmacological pain management technique that can help distract the mother, reduce anxiety, and alleviate some of the discomfort associated with early labor. It also promotes relaxation and can help manage early labor pain effectively without the need for medications. This technique is easy to perform and can be done by the nurse or the partner, providing emotional support along with pain relief.

B) Beginning epidural anesthesia:
Epidural anesthesia is typically not initiated in the early phase of labor unless there is a specific indication or a desire for significant pain relief early in the process. An epidural is more commonly offered in the later stages of labor, when the pain is more intense and the cervix is further dilated. Starting an epidural too early could expose the mother to unnecessary risks and is generally not recommended unless it's requested or deemed medically necessary.

C) Using an opioid antagonist, such as Butorphanol:
Opioids, including Butorphanol, can have side effects such as drowsiness, nausea, and respiratory depression in both the mother and fetus. These medications are more commonly used in later stages of labor or when more potent pain relief is required. Additionally, opioid antagonists like Butorphanol may not be the best choice for a client who is experiencing anxiety and mild to moderate pain in the early phase, as they may not provide the relaxation and coping support that non-pharmacological methods like effleurage offer.

D) Immersing the client in hot water in a pool or Jacuzzi:
While immersion in water can be a helpful method of pain relief, especially during labor, it is generally recommended in the later stages of labor or when the cervix is dilated enough for water immersion to be safely utilized. Immersion in hot water may not be appropriate for all patients and could potentially lead to risks like overheating or changes in blood pressure. Additionally, the early phase of labor often involves less intense pain, and less invasive methods like effleurage are usually preferred first to manage discomfort and reduce anxiety.

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Correct Answer is C

Explanation

A) The client will progress one station every 2 hours:
This statement is inaccurate. The progress of labor in terms of fetal station does not follow a predictable or uniform rate. While some progression might occur every hour or two, it varies greatly depending on factors such as the position of the fetus, maternal anatomy, and strength of contractions. Labor can progress at different rates, and not all clients will experience consistent progression every 2 hours.

B) The client should feel the urge to push at -2 station:
This statement is incorrect. The urge to push generally occurs once the fetal head has descended to +1 or +2 station, which is closer to the perineum. At -2 station, the fetal head is still relatively high in the pelvis, and the client typically will not feel the urge to push until the head is lower. The urge to push is often experienced when the fetal head is well engaged in the pelvis and ready for delivery.

C) The client's temperature will need to be checked every hour when the membranes have ruptured:
This statement is correct. Once the membranes have ruptured, there is an increased risk of infection, as the protective barrier of the amniotic sac is no longer intact. Checking the maternal temperature every hour is an essential practice to monitor for signs of infection, such as chorioamnionitis, especially since the longer the rupture lasts, the greater the risk of infection. A rise in temperature is a key indicator of infection in the postpartum period.

D) The client's cervix will need to be checked every 30 minutes:
This is not correct practice. Cervical checks should be performed only when clinically indicated, not routinely every 30 minutes. Frequent cervical checks can increase the risk of infection, especially after the membranes have ruptured. The cervix should be assessed when there is a clinical reason to do so, such as checking for progress in labor or when considering interventions like an epidural or pushing.

Correct Answer is ["5"]

Explanation

Given:

Desired dose: Digoxin 0.25 mg PO daily

Available concentration: Digoxin 500 mcg/10 mL

To find:

Volume to administer (in mL)

Step 1: Convert desired dose to micrograms

We know that 1 milligram (mg) is equal to 1000 micrograms (mcg). Therefore, to convert the desired dose from mg to mcg, we multiply by 1000:

Desired dose (mcg) = Desired dose (mg)x 1000

Desired dose (mcg) = 0.25 mg x 1000 = 250 mcg

Step 2: Set up the proportion

We can use the following proportion to solve the problem:

(Desired dose) / (Available concentration) = Volume to administer

Step 3: Substitute the values

Plugging in the given values, we get:

(250 mcg) / (500 mcg/10 mL) = Volume to administer

Step 4: Simplify

To simplify, we can invert the denominator and multiply:

(250 mcg) x (10 mL / 500 mcg) = Volume to administer

The "mcg" units cancel out, leaving us with:

(250 x 10 mL) / 500 = Volume to administer

Step 5: Calculate

Performing the multiplication and division, we get:

2500/ 500 = Volume to administer

5 mL = Volume to administer

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The pregnant client term has in presented in the early phase of labor. She is experiencing abdominal pain and shows signs of growing anxiety about pain. What is the best pain management technique the nurse can suggest at this stage?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a student nurse about the anticipated care of a maternal client with ruptured membranes during the second stage of labor. Which of the following statements by the student indicates an understanding of the teaching?

Correct Answer is C

Explanation

A client is ordered digoxin 0.25mg po. daily. On hand is a liquid in a dropper bottle labeled 500mcg/10mL. How many milliliters will be administered?

Correct Answer is ["5"]

Explanation

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