A patient experiencing back labor complains of intense pain in her lower back.
What would be an effective relief measure specific to back pain?
Guided imagery.
Progressive relaxation.
Slow, deep breathing.
Counterpressure against the sacrum.
The Correct Answer is D
Choice A rationale
Guided imagery is a cognitive-behavioral technique that uses mental focus on a peaceful scene or image to distract from pain. While it can be an effective pain management strategy for some women in labor, it is not specific to the physiological cause of back labor. Back labor pain is caused by the occiput of the fetus pressing against the maternal sacrum, which requires a physical, rather than a psychological, intervention to be most effective.
Choice B rationale
Progressive relaxation is a technique that involves tensing and relaxing different muscle groups throughout the body to relieve tension and promote comfort. Like guided imagery, it is a general pain management technique that can be useful for reducing overall labor discomfort. However, it does not directly address the specific cause of back labor, which is the physical pressure from the fetal head on the sacrum.
Choice C rationale
Slow, deep breathing is a common and effective technique for managing labor pain by promoting relaxation, increasing oxygenation, and distracting the patient. It helps the woman focus and cope with contractions. While beneficial for managing labor pain, it is not a targeted intervention for the intense, localized pressure and pain associated with back labor, which responds better to direct physical pressure.
Choice D rationale
Back labor pain is caused by the occiput of the fetus pressing against the maternal sacrum. Counterpressure is a physical intervention that involves applying firm, steady pressure with the heel of the hand or a fist against the sacral area during contractions. This direct pressure helps to displace the fetal head and counteract the pain, making it a highly effective and specific relief measure for back labor.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
A fern pattern on a microscope slide is the definitive diagnostic sign of premature rupture of membranes (PPROM). This occurs when amniotic fluid, which contains sodium chloride, dries on the slide, forming a crystalline, fern-like pattern. This positive "ferning" test confirms the presence of amniotic fluid, indicating that the membranes have ruptured.
Choice B rationale
White vaginal discharge is a common finding during pregnancy and is not indicative of PPROM. This discharge, known as leukorrhea, is a result of increased estrogen production and blood flow to the vaginal area. It is a normal physiological change and does not signify ruptured membranes.
Choice C rationale
A negative fetal fibronectin test indicates a low probability of preterm birth within the next one to two weeks. It does not diagnose PPROM. While PPROM often leads to preterm birth, the fFN test is a predictive tool for labor, whereas ferning is a direct diagnostic test for membrane rupture.
Choice D rationale
The pH of vaginal fluid is typically acidic, ranging from 3.8 to 4.5. Amniotic fluid, however, is alkaline, with a pH of 7.0 to 7.5. Therefore, a vaginal fluid pH of 4.5 would be considered normal and would not indicate the presence of alkaline amniotic fluid, which would raise the pH to above 6.5.
Correct Answer is B
Explanation
Choice A rationale
A fetus in a longitudinal lie, cephalic presentation, is positioned with its long axis parallel to the mother's spine, with the head presenting first. This is the most common and favorable position for vaginal delivery. The illustration depicts a vertical alignment of the fetus within the uterus.
Choice B rationale
A transverse lie is a fetal malpresentation where the long axis of the fetus is perpendicular to the long axis of the mother. The fetus's head and buttocks are positioned to the sides of the mother's abdomen, with the shoulder or trunk presenting first.
Choice C rationale
A fetus in a longitudinal lie, breech presentation, is positioned with its long axis parallel to the mother's spine. The fetal buttocks or feet are presenting first into the pelvic inlet. The illustration depicts a vertical alignment of the fetus with the head at the top of the uterus.
Choice D rationale
An oblique lie is an unstable fetal position where the fetal long axis is at an angle to the maternal long axis. This position often converts to a longitudinal or transverse lie during labor. The illustration depicts an angled fetal position, but it is not a true transverse lie. .
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