With regard to systemic analgesics administered during labor, nurses should be aware that:

Systemic analgesics cross the maternal blood-brain barrier as easily as they do the fetal blood-brain barrier.

Effects on the fetus and newborn can include decreased alertness and delayed sucking

Intravenous (IV) patient-controlled analgesia (PCA) results in increased use of an analgesic

Intramuscular (M) administration is preferred over IV administration

Answer and Explanation

The Correct Answer is B

A. Systemic analgesics cross the maternal blood-brain barrier as easily as they do the fetal blood-brain barrier. While systemic analgesics do cross the placenta, they actually affect the fetus more readily than the mother because the fetal liver and kidneys are immature, making drug metabolism and excretion slower. This leads to prolonged effects on the newborn.

B. Effects on the fetus and newborn can include decreased alertness and delayed sucking. Opioid analgesics, such as fentanyl, meperidine, or morphine, can cause neonatal respiratory depression, reduced alertness, and difficulty initiating breastfeeding due to delayed sucking reflex. If administered too close to delivery, the newborn may require respiratory support or naloxone to reverse opioid effects.

C. Intravenous (IV) patient-controlled analgesia (PCA) results in increased use of an analgesic. PCA allows controlled dosing of pain medication, often leading to less total medication use because the patient receives smaller, more frequent doses rather than large, single doses. This helps maintain stable pain control without excessive sedation.

D. Intramuscular (IM) administration is preferred over IV administration. IV administration is preferred over IM because it provides faster pain relief and better dose control. IM injections have delayed absorption and an unpredictable effect, making IV the preferred route for labor analgesia.

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Correct Answer is ["A","C"]

Explanation

A. Pitocin. Pitocin (oxytocin) is the primary medication used for labor induction. It stimulates uterine contractions to initiate or augment labor. It is given intravenously (IV) and carefully titrated to avoid complications like uterine tachysystole and fetal distress.

B. Methergine. Methergine (methylergonovine) is not used for labor induction. It is a uterotonic medication used postpartum to prevent or treat postpartum hemorrhage by causing sustained uterine contractions. It is contraindicated in pregnancy due to the risk of excessive uterine contractions and hypertension.

C. Misoprostol. Misoprostol (Cytotec) is a prostaglandin used for cervical ripening and labor induction. It is administered vaginally or orally to soften the cervix and stimulate contractions before starting Pitocin. It is commonly used in women with an unfavorable cervix.

D. Magnesium Sulfate. Magnesium sulfate is not used for labor induction. It is primarily used for seizure prevention in preeclampsia/eclampsia and to stop preterm labor (tocolysis). It actually relaxes the uterus, which is the opposite of what is needed for induction.

E. Betamethasone. Betamethasone is a corticosteroid used to accelerate fetal lung maturity in preterm labor (before 34 weeks). It has no role in labor induction.

A. True B. False

Correct Answer is A

Explanation

True.

When supporting a woman who has just experienced a fetal demise, it is appropriate and compassionate to:

Offer supportive care.
Allow and encourage space and time to grieve.
Offer the services of a chaplain, especially if the patient expresses a desire for spiritual or emotional support.

Chaplains are typically trained to be non-denominational and sensitive to a wide range of beliefs, and they can provide comforting words and presence regardless of the patient’s faith or lack thereof. This approach aligns with holistic and patient-centered care.

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With regard to systemic analgesics administered during labor, nurses should be aware that:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

To assist with an induction of labor which of these medications can be used? Select all that apply

Correct Answer is ["A","C"]

Explanation

When working with a woman who has just experienced a fetal demise you should offer supportive care, give her the opportunity to grieve, and provide for a chaplain to come in if the patient wants one. You know that the Chaplain is non-denominational and can also provide comforting words.

Correct Answer is A

Explanation

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With regard to systemic analgesics administered during labor, nurses should be aware that:

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