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

Explanation

Professor Proctor emphasizes safety as the highest priority while traveling, including when coming to class. Ensuring that students arrive safely is considered more important than strict punctuality.

A. Oligohydramnios B. Congenital fetal anomalies. C. Intrauterine fetal seizures D. Polyhydramnios.

Correct Answer is B

Explanation

A. Oligohydramnios. Oligohydramnios, or low amniotic fluid levels, is not a primary complication of pregestational diabetes. It is more commonly associated with conditions such as fetal growth restriction, post-term pregnancy, and rupture of membranes rather than maternal hyperglycemia.

B. Congenital fetal anomalies. Poor glycemic control during preconception and early pregnancy increases the risk of congenital anomalies, particularly affecting the heart, spine, and central nervous system. Hyperglycemia during organogenesis (first 8 weeks of gestation) can lead to defects such as neural tube defects and cardiac malformations.

C. Intrauterine fetal seizures. Fetal seizures in utero are extremely rare and are not a common complication of maternal diabetes. While neonatal hypoglycemia after birth can lead to seizures, maternal hyperglycemia does not directly cause seizures in the fetus.

D. Polyhydramnios. While polyhydramnios (excess amniotic fluid) can occur in pregnancies complicated by diabetes due to fetal polyuria, it is more associated with later pregnancy. The question specifically asks about preconception and early pregnancy risks, making congenital anomalies the best answer.

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

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Professor Proctor: Always wants us to be safe while traveling anywhere- especially when coming to class. This is prioritized even over being on time.

Correct Answer is A

Explanation

Preconception counseling is critical to the outcome of a pregnancy for a patient with diabetes because poor glycemic control before and during early pregnancy is associated with:

Correct Answer is B

Explanation

The nurse would include which of the following statements when describing the pathophysiology of gestational diabetes?

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