OB Pharmacology & Dosage Quiz 2 WITH 100% correct answers

A woman in active labor receives an opioid agonist analgesic. 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? Meperidine (Demerol) Regarding systemic analgesics administered during labor, nurses should be aware that: Effects on the fetus and newborn can include decreased alertness and delayed sucking Regarding spinal and epidural (block) anesthesia, nurses should know that: A high incidence of post birth headache is seen with spinal blocks 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? Naloxone (Narcan) A woman in labor has just received an epidural block. The most important nursing intervention is to: Monitor the maternal blood pressure for possible hypotension If an opioid antagonist is administered to a laboring woman, she should be told that: Her pain will return. A woman has requested an epidural for her pain. She is 5 cm dilated and 100% effaced. The baby is in a vertex position and is engaged. The nurse increases the woman's intravenous fluid for a preprocedural bolus. She reviews her laboratory values and notes that the woman's hemoglobin is 12 g/dL, hematocrit is 38%, platelets are 67,000, and white blood cells (WBCs) are 12,000/mm3. Which factor would contraindicate an epidural for the woman? She has thrombocytopenia A first-time mother is concerned about the type of medications she will receive during labor. She is in a fair amount of pain and is nauseous. In addition, she appears to be very anxious. You explain that opioid analgesics often are used with sedatives because: "Sedatives help the opioid work better, and they also will assist you to relax and relieve your nausea." Regarding nerve block analgesia and anesthesia, nurses should be aware that: Most local agents are related chemically to cocaine and end in the suffix -Caine. Regarding spinal and epidural (block) anesthesia, nurses should know that: A high incidence of after-birth headache is seen with spinal blocks. The nurse providing newborn stabilization must be aware that the primary side effect of maternal narcotic analgesia in the newborn is: Respiratory depression. The nerve block used in labor that provides anesthesia to the lower vagina and perineum is called: Pudendal To assist the woman after delivery of the infant, the nurse knows that the blood patch is used after spinal anesthesia to relieve: Headache Maternal hypotension is a potential side effect of regional anesthesia and analgesia. What nursing interventions could you use to raise the client's blood pressure? a. Place the woman in a lateral position. b. Increase intravenous (IV) fluids. c. Administer oxygen. The class of drugs known as opioid analgesics butorphanol, nalbuphine is not suitable for administration to women with known opioid dependence. The antagonistic activity could precipitate withdrawal symptoms abstinence syndrome in both mothers and newborns. Signs of opioid/narcotic withdrawal in the mother would include: a. Yawning, runny nose. b. Chills and hot flashes. c. Irritability, restlessness A woman in latent labor who is positive for opiates on the urine drug screen is complaining of severe pain. Maternal vital signs are stable, and the fetal heart monitor displays a reassuring pattern. The nurse's MOST appropriate analgesic for pain control is: Fentanyl (Sublimaze) When monitoring a woman in labor who has just received spinal analgesia, the nurse should report which assessment findings to the health care provider? (Select all that apply.) a. FHR of 100bpm b. Minimal variability on a fetal heart monitor After delivering a healthy baby boy with epidural anesthesia, a woman on the postpartum unit complains of a severe headache. The nurse should anticipate which actions in the patient's plan of care? (Select all that apply.) a. Administration of oral analgesics b. Assisting with a blood patch procedure c. Frequent monitoring of vital signs A client is in early labor, and her nurse is discussing the pain relief options she is considering. The client states that she wants an epidural "no matter what!" What is the nurse's best response? "The type of analgesia or anesthesia used is determined, in part, by the stage of your labor and the method of birth." Which action cannot be performed by the non-anesthetist registered nurse who is caring for a woman with epidural anesthesia? Initiating epidural anesthesia Which alterations in the perception of pain by a laboring client should the nurse understand? Sensory pain for nulliparous women is often greater than for multiparous women during early labor. The obstetric nurse is preparing the client for an emergency cesarean birth, with no time to administer spinal anesthesia. The nurse is aware of and prepared for the greatest risk of administering general anesthesia to the client. What is this risk? Aspiration of stomach contents What is the rationale for the use of a blood patch after spinal anesthesia? Headache A woman has requested an epidural block for her pain. She is 5 cm dilated and 100% effaced. The baby is in a vertex position and is engaged. The nurse increases the woman's IV fluid for a preprocedural bolus. Before the initiation of the epidural, the woman should be informed regarding the disadvantages of an epidural block. Which concerns should the nurse share with this client? (Select all that apply.) a. Ability to move freely is limited. b. Orthostatic hypotension and dizziness may occur. c. Higher body temperature may occur.