Which nursing care measure, commonly offered to women in labor, reflects the application of the gate-control theory?
Encourage the woman to rest between contractions.
Administer the prescribed medication.
Massage the woman’s back.
Change the woman’s position.
The Correct Answer is C
Rationale for Choice A:
Encouraging the woman to rest between contractions can promote relaxation and help conserve energy, but it does not directly address the mechanisms of pain transmission as explained by the gate-control theory. Rest can have indirect benefits for pain management, but it does not directly interfere with pain signals in the same way that massage does.
Rationale for Choice B:
Administering prescribed medication can effectively block pain signals, but it does not rely on the principles of the gatecontrol theory. Medications typically work through pharmacological mechanisms that target pain receptors or neurotransmitters, rather than by competing with pain signals at the spinal cord level.
Rationale for Choice D:
Changing the woman's position can sometimes alleviate discomfort by shifting pressure or encouraging fetal movement, but it does not directly apply the gate-control theory either. Position changes can offer some physical relief, but they do not directly modulate the transmission of pain signals.
Rationale for Choice C:
Massaging the woman's back directly aligns with the gate-control theory of pain management. This theory proposes that nonpainful sensory input can effectively compete with pain signals, preventing them from reaching the brain. The following mechanisms explain how massage applies this theory:
Stimulation of non-painful nerve fibers: Massage activates large-diameter nerve fibers that transmit touch, pressure, and vibration sensations. These signals travel faster than pain signals and can effectively "close the gate" at the spinal cord, preventing pain signals from ascending to the brain.
Release of endorphins: Massage can stimulate the release of endorphins, the body's natural pain relievers. Endorphins bind to opioid receptors in the brain and spinal cord, reducing the perception of pain.
Reduction of muscle tension: Labor pain often involves muscle tension and spasms. Massage can help relax tense muscles, which can indirectly reduce pain by decreasing muscle ischemia and the release of pain-provoking substances.
Promotion of relaxation and distraction: Massage can induce a state of relaxation and provide a distraction from pain. This psychological effect can further contribute to pain relief by reducing anxiety and focusing attention on pleasant sensations.
Conclusion:
Massage offers a non-pharmacological, evidence-based approach to pain management that directly aligns with the gate-control theory. By stimulating non-painful sensory input, promoting relaxation, and releasing endorphins, massage effectively interrupts pain signals and provides significant relief for women in labor.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Answer and explanation
The correct answer is B. Aspiration of stomach contents.
Choice A rationale:
Respiratory depression is a potential risk of general anesthesia, but it is not the greatest risk in this scenario.
It is usually well-managed by the anesthesiologist during surgery.
They will closely monitor the patient's respiratory status and adjust the level of anesthesia as needed to maintain adequate breathing.
If respiratory depression does occur, it can be quickly reversed with medications.
Choice B rationale:
Aspiration of stomach contents is the most serious risk of general anesthesia in pregnant women.
This is because pregnancy causes a number of changes in the gastrointestinal system that increase the risk of aspiration:
The growing uterus puts pressure on the stomach, which can cause stomach contents to reflux into the esophagus.
Pregnancy hormones can relax the esophageal sphincter, which is the muscle that normally prevents food and stomach acid from coming back up the esophagus.
Labor can further delay gastric emptying, leading to a higher volume of stomach contents.
If stomach contents are aspirated into the lungs, it can cause a serious and potentially fatal condition called aspiration pneumonia.
It is important to note that aspiration can occur even if a woman has been fasting before surgery.
This is because the stomach never completely empties, and there is always some risk of reflux.
Choice C rationale:
Uterine relaxation is a potential side effect of some general anesthetic agents, but it is not a major risk in this scenario.
The anesthesiologist will choose an anesthetic agent that is less likely to cause uterine relaxation.
Additionally, they will closely monitor the patient's uterine tone and can administer medications to stimulate the uterus if necessary.
Choice D rationale:
Inadequate muscle relaxation is not a major risk of general anesthesia in this scenario.
The anesthesiologist will ensure that the patient's muscles are adequately relaxed to facilitate surgery.
Correct Answer is D
Explanation
Choice A rationale:
Incorrect. The quad screen test does not examine fetal DNA to determine gender. That is the role of other tests, such as amniocentesis or chorionic villus sampling (CVS).
Gender determination is not a primary objective of the quad screen test.
Focusing on gender unnecessarily narrows the scope of the test's potential findings.
Choice B rationale:
Incorrect. The quad screen test does not use fetal tissue. It is a non-invasive blood test that measures levels of four substances in the mother's blood: alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), unconjugated estriol (uE3), and inhibin A.
Fetal tissue sampling is more invasive and carries risks, while the quad screen is a safer alternative.
Clarifying the non-invasive nature of the test is crucial for informed consent and patient understanding.
Choice C rationale:
Incorrect. While AFP levels can be affected by maternal liver function, that is not the primary focus of the quad screen test.
Liver function tests are specifically designed to assess liver health, and they are not part of the quad screen panel.
Distinguishing between liver function assessment and AFP's role in screening for fetal anomalies is essential for accurate interpretation.
Choice D rationale:
Correct. The quad screen test measures levels of AFP, hCG, uE3, and inhibin A in the mother's blood. These substances can provide information about the risk of certain fetal chromosomal abnormalities and neural tube defects.
Elevated AFP levels can indicate an increased risk for neural tube defects such as spina bifida or anencephaly.
Low AFP levels can be associated with Down syndrome or other chromosomal abnormalities.
Understanding the specific disorders that can be indicated by AFP levels is crucial for patient counseling and further testing decisions.
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