1. A laboring woman be- he woman is exhibiting signs of hyperventilation.
comes anxious during the This leads to a decreased carbon dioxide level
transition phase of the and respiratory alkalosis. Rebreathing her air
first stage of labor and would increase the carbon dioxide level. Turning
develops a rapid and her on her side will not solve this problem.
deep respiratory pattern.
She complains of feel-
ing dizzy and light-headed.
The nurse's immediate re-
sponse would be to:
encourage the woman to
breathe more slowly.
help the woman breathe
into a paper bag. Correct
turn the woman on her
side.
administer a sedative.
2. A woman is in the sec- Turning the woman to her left side is the best
ond stage of labor and action to take in this situation since this will
has a spinal block in place increase placental perfusion to the infant while
for pain management. The waiting for the doctor's or nurse midwife's in-
nurse obtains the woman's struction. Hypotension indicated by a 20% drop
blood pressure and notes from preblock level is an emergency situation
that it is 20% lower than and action must be taken.
the baseline level. Which
action should the nurse
take?
Encourage her to empty
her bladder.
Decrease her intravenous
(IV) rate to a keep
vein-open rate.
Turn the woman to the left
lateral position or place a
pillow under her hip. Cor-
rect
No action is necessary
since a decrease in the
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, Ch 14 OB NCLEX Quiz Questions with Verified Answers Graded A+
woman's blood pressure is
expected.
3. A woman in latent labor Fentanyl is a commonly used opioid agonist
who is positive for opi- analgesic for women in labor. It is fast and
ates on the urine drug short acting. This patient may require higher
screen is complaining of than normal doses to achieve pain relief due to
severe pain. Maternal vi- her opiate use. Phenergan is not an analgesic.
tal signs are stable, and Phenergan is an ataractic (tranquilizer) that may
the fetal heart monitor dis- be used to augment the desirable effects of the
plays a reassuring pattern. opioid analgesics but has few of those drugs'
The nurse's MOST appro- undesirable effects. Stadol is an opioid ago-
priate analgesic for pain nist-antagonist analgesic. Its use may precipi-
control is: tate withdrawals in a patient with a history of opi-
fentanyl (Sublimaze). Cor- ate use. Nubain is an opioid agonist-antagonist
rect analgesic. Its use may precipitate withdrawals in
promethazine (Phener- a patient with a history of opiate use.
gan).
butorphanol tartrate (Sta-
dol).
nalbuphine (Nubain).
4. A woman is experiencing Counterpressure is steady pressure applied by
back labor and complains a support person to the sacral area with the
of constant, intense pain fist or heel of the hand. This technique helps
in her lower back. An ef- the woman cope with the sensations of internal
fective relief measure is to pressure and pain in the lower back. Pant-blow
use: breathing techniques are usually helpful dur-
counterpressure against ing contractions per the gate-control theory. Ef-
the sacrum. Correct fleurage is light stroking, usually of the ab-
pant-blow (breaths and domen, in rhythm with breathing during contrac-
puffs) breathing tech- tions. It is used as a distraction from contrac-
niques. tion pain; however, it is unlikely to be effective
effleurage. for back labor. Biofeedback-assisted relaxation
biofeedback. techniques are not always successful in reduc-
ing labor pain. Using this technique effectively
requires strong caregiver support.
5.
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