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 ["A","B","D"]

Explanation

A) Change client position every 30 minutes:
Changing positions regularly during the second stage of labor can help facilitate fetal descent and improve the effectiveness of contractions. This strategy also helps relieve pressure on certain areas of the body, such as the perineum and lower back, promoting more effective pushing and reducing the need for assisted delivery. Frequent position changes can help the mother progress in labor without the need for tools or interventions.

B) Upright positions:
Upright positions, such as standing, squatting, or kneeling, can be beneficial in the second stage of labor. These positions allow gravity to assist in the descent of the baby, which can help avoid the need for forceps or vacuum extraction. Upright positions also tend to open up the pelvis and can result in more effective pushing, reducing the likelihood of an assisted vaginal delivery.

C) Supine positions:
Supine positions (lying on the back) are not recommended for avoiding an assisted vaginal birth. Lying on the back can hinder fetal descent and may also lead to increased pressure on the inferior vena cava, which can decrease blood flow and oxygen to the uterus. This position tends to slow down labor and may increase the need for interventions like forceps or vacuum extraction, making it less favorable for a spontaneous vaginal delivery.

D) Lateral positions:
Lateral positions (lying on one side) can also help in the second stage of labor. This position can improve uterine blood flow, relieve pressure on the perineum, and provide more room for the baby to descend. It is a good alternative to supine positions and can aid in achieving a vaginal birth without assistance.

E) Delayed pushing:
Delayed pushing can be helpful for some clients, especially if they are not fully dilated or if they need time to rest. However, delayed pushing is not directly related to preventing an assisted vaginal birth. In fact, if the mother waits too long to push or doesn't push effectively, it could potentially lead to more complications or require assisted interventions. The key is ensuring that pushing is done effectively and at the right time in the second stage, rather than delaying it unnecessarily.

Correct Answer is ["33"]

Explanation

Given:

Total volume to infuse: 100 mL

Infusion time: 60 minutes

Drop factor of tubing: 20 gtt/mL

To find:

Drip rate (gtt/min)

Step 1: Calculate the total number of drops

Total drops = Total volume x Drop factor

Total drops = 100 mL x 20 gtt/mL = 2000 gtt

Step 2: Calculate the drip rate

Drip rate = Total drops / Infusion time in minutes

Drip rate = 2000 gtt / 60 minutes = 33.33 gtt/min

Step 3: Round to the nearest whole number

33 gtt/min.

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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 caring for a client in the second stage of labor who does not want any tools used to assist with the vaginal birth. Which of the following interventions should the nurse understand will help prevent an assisted vaginal birth? (Select All that Apply.)

Correct Answer is ["A","B","D"]

Explanation

Calculate the gravity rate for gentamycin 100 mg/100ml with secondary tubing (20gtts/mL) over 60 minutes.

Correct Answer is ["33"]

Explanation

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