A nurse is caring for a client who received meperidine (Demerol) IV for pain relief during labor 2 hours ago and is now ready to deliver vaginally.

Which of the following medications should the nurse have available to reverse respiratory depression in the newborn?

The correct answer is choice D. Both A and B.A boggy uterus is a uterus that is enlarged, soft, and tender due to the failure of the uterus to contract sufficiently after delivery.This condition is called uterine atony and it is the most common cause of postpartum hemorrhage.Postpartum hemorrhage is excessive bleeding after childbirth that can lead to shock and death if not treated promptly.

The nursing actions indicated for a boggy uterus are:

• Perform immediate fundal massage: This helps to stimulate uterine contractions and reduce bleeding.

• Ambulate to the bathroom or use bedpan to empty bladder: This helps to reduce bladder distension and allow the uterus to contract and descend into the pelvis.

Choice A is partially correct but not sufficient by itself.

Choice B is also partially correct but not sufficient by itself.Choice C is incorrect because administering oxytocin alone may not be effective in restoring uterine tone if there are other factors contributing to uterine atony, such as overdistension, prolonged labor, or infection.Oxytocin is a hormone that stimulates uterine contractions.

Increased sleepiness and difficulty waking up are signs of central nervous system (CNS) depression in breastfed infants exposed to codeine through breast milk.Codeine is converted into morphine in the body, which can pass into breast milk and cause adverse effects in the baby.Codeine use by breastfeeding mothers can cause CNS depression in breastfed infants.

Therefore, the nurse should watch for increased sleepiness and difficulty waking up in the baby.

Choice A is wrong because increased alertness and activity are not signs of CNS depression.

They are more likely to be signs of stimulation or agitation.

Choice B is wrong because decreased appetite and weight gain are not specific signs of codeine exposure.

They can be caused by many other factors, such as illness, infection, or poor latch.

Choice C is wrong because increased respiratory rate and depth are not signs of CNS depression.

They are more likely to be signs of respiratory distress or infection.

Choice D is wrong because decreased heart rate and blood pressure are not signs of CNS depression.

They are more likely to be signs of shock or hypovolemia.

Normal ranges for vital signs in newborns are:

• Heart rate: 100 to 160 beats per minute

• Respiratory rate: 30 to 60 breaths per minute