NUR1213 semester 3 unit 2 Questions With Complete Updated Solutions.
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Course
NUR 192
Institution
NUR 192
An 18-year-old pregnant woman, gravida 1, is admitted to the labor and birth unit with moderate contractions every 5 minutes that last 40 seconds. The woman states, My contractions are so strong that I dont know what to do with myself. The nurse should:
a. Assess for fetal well-being.
b. Encour...
NUR1213 semester 3 unit 2 Questions
With Complete Updated Solutions.
An 18-year-old pregnant woman, gravida 1, is admitted to the labor and birth unit with moderate
contractions every 5 minutes that last 40 seconds. The woman states, My contractions are so strong that
I dont know what to do with myself. The nurse should:
a. Assess for fetal well-being.
b. Encourage the woman to lie on her side.
c. Disturb the woman as little as possible.
d. Recognize that pain is personalized for each individual. - Answer d. Recognize that pain is
personalized for each individual.
Each womans pain during childbirth is unique and is influenced by a variety of physiologic, psychosocial,
and
environmental factors. A critical issue for the nurse is how support can make a difference in the pain of
the
woman during labor and birth.
Assessing for fetal well-being includes no information that would indicate fetal distress or a logical
reason to
be overly concerned about the well-being of the fetus. The left lateral position is used to alleviate fetal
distress,
not maternal stress. The nurse has an obligation to provide physical, emotional, and psychosocial care
and
support to the laboring woman. This client clearly needs support.
Nursing care measures are commonly offered to women in labor. Which nursing measure reflects
application of the gate-control theory?
a. Massaging the womans back
b. Changing the womans position
,c. Giving the prescribed medication
d. Encouraging the woman to rest between contractions - Answer a. Massaging the womans back
According to the gate-control theory, pain sensations travel along sensory nerve pathways to the brain,
but only
a limited number of sensations, or messages, can travel through these nerve pathways at one time.
Distraction
techniques such as massage or stroking, music, focal points, and imagery reduce or completely block the
capacity of nerve pathways to transmit pain. These distractions are thought to work by closing down a
hypothetic gate in the spinal cord and thus preventing pain signals from reaching the brain. The
perception of
pain is thereby diminished. Changing the womans position, giving prescribed medication, and
encouraging rest
do not reduce or block the capacity of nerve pathways to transmit pain using the gate-control theory.
A woman in active labor receives an analgesic opioid agonist. Which medication relieves severe,
persistent, or recurrent pain; creates a sense of well-being; overcomes inhibitory factors; and may even
relax the cervix
but should be used cautiously in women with cardiac disease?
a. Meperidine (Demerol)
b. Promethazine (Phenergan)
c. Butorphanol tartrate (Stadol)
d. Nalbuphine (Nubain) - Answer c. Butorphanol tartrate (Stadol)
Meperidine is the most commonly used opioid agonist analgesic for women in labor throughout the
world. It
overcomes inhibitory factors in labor and may even relax the cervix. Because tachycardia is a possible
adverse
reaction, meperidine is used cautiously in women with cardiac disease. Phenergan is an ataractic
(tranquilizer)
,that may be used to augment the desirable effects of the opioid analgesics but has few of the
undesirable
effects of those drugs. Stadol and Nubain are opioid agonist-antagonist analgesics.
A laboring woman received an opioid agonist (meperidine) intravenously 90 minutes before she gave
birth. Which medication should be available to reduce the postnatal effects of Demerol on the neonate?
a. Fentanyl (Sublimaze)
b. Promethazine (Phenergan)
c. Naloxone (Narcan)
d. Nalbuphine (Nubain) - Answer c. Naloxone (Narcan)
An opioid antagonist can be given to the newborn as one part of the treatment for neonatal narcosis,
which is a
state of central nervous system (CNS) depression in the newborn produced by an opioid. Opioid
antagonists
such as naloxone (Narcan) can promptly reverse the CNS depressant effects, especially respiratory
depression.
Fentanyl, promethazine, and nalbuphine do not act as opioid antagonists to reduce the postnatal effects
of
Demerol on the neonate. Although meperidine (Demerol) is a low-cost medication and readily available,
the
use of Demerol in labor has been controversial because of its effects on the neonate.
A woman in labor has just received an epidural block. The most important nursing intervention is to:
a. Limit parenteral fluids.
b. Monitor the fetus for possible tachycardia.
c. Monitor the maternal blood pressure for possible hypotension.
d. Monitor the maternal pulse for possible bradycardia. - Answer c. Monitor the maternal blood
pressure for possible hypotension.
, The most important nursing intervention for a woman who has received an epidural block is to monitor
the
maternal blood pressure frequently for signs of hypotension. Intravenous fluids are increased for a
woman
receiving an epidural, to prevent hypotension. The nurse observes for signs of fetal bradycardia. The
nurse
monitors for signs of maternal tachycardia secondary to hypotension.
The nurse should be aware that an effective plan to achieve adequate pain relief without maternal risk is
most effective if:
a. The mother gives birth without any analgesic or anesthetic.
b. The mother and familys priorities and preferences are incorporated into the plan.
c. The primary health care provider decides the best pain relief for the mother and family.
d. The nurse informs the family of all alternative methods of pain relief available in the hospital
setting. - Answer b. The mother and familys priorities and preferences are incorporated into the plan.
The assessment of the woman, her fetus, and her labor is a joint effort of the nurse and the primary
health care
providers, who consult with the woman about their findings and recommendations. The needs of each
woman
are different, and many factors must be considered before a decision is made whether pharmacologic
methods,
nonpharmacologic methods, or a combination of the two will be used to manage labor pain.
A woman in the active phase of the first stage of labor is using a shallow pattern of breathing, which is
about twice the normal adult breathing rate. She starts to complain about feeling lightheaded and dizzy
and states that
her fingers are tingling. The nurse should:
a. Notify the womans physician.
b. Tell the woman to slow the pace of her breathing.
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