A laboring client is inhaling gas through a mouthpiece just before the onset of her regular contractions.
As they inhale, a valve opens and gas is released.
They continue to inhale the gas slowly and deeply until the contraction starts to subside.
When the inhalation stops, the valve closes.
What is this procedure?
“Likely to be used in the second stage of labor but not in the first stage.”
“A prelude to cesarean birth.”
“Not used much anymore.”
“An application of nitrous Oxide.”
The Correct Answer is D
A rationale:
Incorrect. Nitrous oxide can be used during any stage of labor, not just the second stage. It is often used during the first stage to help manage early labor pain.
Evidence: Studies have shown that nitrous oxide is effective for pain relief during both the first and second stages of labor.
Additional information: The timing of nitrous oxide administration is typically based on the individual's preferences and needs. Some people prefer to use it as soon as labor begins, while others wait until contractions become more intense.
Choice B rationale:
Incorrect. Nitrous oxide is not a prelude to cesarean birth. It is a method of pain relief that can be used during vaginal or cesarean birth.
Evidence: Cesarean birth is a major surgical procedure that is typically performed under regional or general anesthesia. Nitrous oxide is not a type of anesthesia that would be used for this purpose.
Additional information: Cesarean birth is usually only performed when there is a medical reason why a vaginal birth is not possible or safe.
Choice C rationale:
Incorrect. Nitrous oxide is still a commonly used method of pain relief during labor. It is safe and effective, and it has a good safety profile.
Evidence: Nitrous oxide is one of the most widely used methods of pain relief during labor in many countries around the world.
Additional information: The use of nitrous oxide during labor has been increasing in recent years, as more people have become aware of its benefits.
Choice D rationale:
Correct. The procedure described in the question is an application of nitrous oxide. Nitrous oxide is a colorless, odorless gas that has analgesic and anxiolytic properties. It is often used during labor to help manage pain and anxiety.
Evidence: Nitrous oxide is a well-established method of pain relief during labor. It has been used for this purpose for over a century.
Additional information: Nitrous oxide is a safe and effective option for pain relief during labor. It is easy to administer and has few side effects.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","E","F"]
Explanation
The correct answers are B, C, E, and F.
Rationale for each choice:
- Albuterol
Mechanism of action: Albuterol is a beta-2 agonist that stimulates beta-2 receptors in the cell membranes of skeletal muscle, liver, and adipose tissue. This stimulation causes an increase in intracellular cyclic AMP (cAMP), which activates protein kinase A (PKA). PKA then phosphorylates a number of proteins, including the sodium-potassium ATPase pump. This pump is responsible for transporting potassium ions into cells and out of the bloodstream. By increasing the activity of this pump, albuterol can help to lower serum potassium levels.
Onset of action: Albuterol has a rapid onset of action, typically within 30 minutes.
Duration of action: The duration of action of albuterol is relatively short, usually 4-6 hours.
Dosage: The dosage of albuterol for hyperkalemia is typically 10-20 mg nebulized every 4-6 hours.
Additional considerations: Albuterol can cause tachycardia and tremors. It should be used cautiously in patients with heart disease or hyperthyroidism.
- Kayexalate
Mechanism of action: Kayexalate is a cation exchange resin that binds to potassium ions in the gastrointestinal tract. This prevents the potassium from being absorbed into the bloodstream.
Onset of action: Kayexalate has a relatively slow onset of action, usually 1-2 hours.
Duration of action: The duration of action of Kayexalate is relatively long, usually 4-6 hours.
Dosage: The dosage of Kayexalate for hyperkalemia is typically 15-30 grams orally or rectally every 6 hours.
Additional considerations: Kayexalate can cause constipation and hypocalcemia. It should be used cautiously in patients with bowel obstruction or kidney disease.
- Insulin & dextrose
Mechanism of action: Insulin promotes the movement of potassium into cells, thus lowering serum potassium levels. Dextrose is given along with insulin to prevent hypoglycemia.
Onset of action: Insulin has a rapid onset of action, typically within 30 minutes.
Duration of action: The duration of action of insulin is relatively short, usually 4-6 hours.
Dosage: The dosage of insulin for hyperkalemia is typically 10 units of regular insulin IV push, followed by an infusion of 5-10 units per hour. The dosage of dextrose is typically 50 grams IV push, followed by an infusion of 10% dextrose at 100 mL/hour.
Additional considerations: Insulin can cause hypoglycemia. It should be used cautiously in patients with diabetes mellitus.
Correct Answer is A
Explanation
Choice A rationale:
Restriction of movement is not a necessary requirement following IV opioid administration during labor. While some healthcare providers may encourage laboring individuals to rest after receiving pain medication, it is not mandatory to remain in bed.
In fact, remaining upright and mobile can often be beneficial during labor. Movement can help encourage fetal descent, improve circulation, and potentially even shorten labor duration.
It's essential to educate clients about the benefits of staying active during labor, even after receiving pain medication. This can empower them to make informed choices about their comfort and positioning during the birthing process.
Choice B rationale:
This statement is accurate. IV opioids can cross the placenta and potentially affect the fetal heart rate.
It's crucial for clients to be aware of this potential effect so that they can understand the importance of fetal monitoring during labor. Healthcare providers will closely monitor the baby's heart rate to ensure it remains within a normal range.
Choice C rationale:
This statement is also accurate. If a baby is born too soon after the mother receives IV opioids, there is a risk of respiratory depression.
This is because the opioids can cross the placenta and affect the baby's breathing. Healthcare providers are trained to manage this risk and will take appropriate measures to ensure the baby's well-being, such as providing respiratory support if needed.
Choice D rationale:
This statement is correct. IV opioids are primarily used to relieve pain during labor, not to decrease the frequency of contractions.
While they may have some mild effects on contraction strength or duration, their primary purpose is to provide pain relief. It's important for clients to understand this distinction so that they have realistic expectations about the medication's effects.
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