A practical nurse has gathered data on a laboring client who prefers nonpharmacological methods for pain management.
The client is experiencing anxiety, has an elevated blood pressure, and has erratic, rapid respirations. Which of the following methods will the practical nurse reinforce that will most likely aid in decreasing blood pressure and respiratory rate?
Acupressure.
Effleurage.
Bradley method.
Lamaze method.
Yoga.
The Correct Answer is D
Choice A rationale
Acupressure involves applying pressure to specific points on the body, aiming to stimulate energy flow and relieve pain. While it can promote relaxation and analgesia by releasing endorphins, its direct effect on significantly reducing blood pressure and respiratory rate in acute anxiety may be less pronounced compared to methods emphasizing controlled breathing techniques.
Choice B rationale
Effleurage is a light, stroking massage, typically applied to the abdomen during contractions. This technique can distract from pain and promote relaxation by stimulating large nerve fibers, thereby reducing pain perception. However, its primary physiological impact is generally on pain modulation and comfort, rather than a direct, strong reduction in elevated blood pressure and respiratory rate.
Choice C rationale
The Bradley method, also known as "husband-coached childbirth," emphasizes natural childbirth, focusing on deep abdominal breathing, relaxation, and partner support. While it promotes a calm environment and can reduce overall stress, its specific techniques for immediate physiological regulation of acutely elevated blood pressure and erratic respirations may not be as direct as methods specifically teaching controlled breathing.
Choice D rationale
The Lamaze method focuses on controlled breathing and relaxation techniques during labor. These techniques, particularly patterned breathing, directly influence the autonomic nervous system by increasing vagal tone, which can lead to a decrease in heart rate and respiratory rate, thereby lowering blood pressure and promoting a sense of calm during periods of anxiety.
Choice E rationale
Yoga incorporates physical postures, breathing exercises (pranayama), and meditation. While highly effective for long-term stress reduction and improving cardiovascular health, its immediate application in a laboring client experiencing acute anxiety with elevated vital signs might be less practical for immediate physiological regulation compared to targeted breathing methods like Lamaze.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Excessive dental caries and enlarged tonsils are more commonly associated with bulimia nervosa due to the repeated exposure of teeth to gastric acid from purging and chronic inflammation of the tonsils. Anorexia nervosa primarily involves severe caloric restriction, leading to different physiological adaptations.
Choice B rationale
Skeletal appearance with lanugo on arms is a classic physical finding supporting anorexia nervosa. The emaciated or skeletal appearance is due to severe caloric restriction and muscle wasting. Lanugo, fine downy hair, develops as the body attempts to conserve heat due to insufficient adipose tissue.
Choice C rationale
Irregular heart rate, specifically bradycardia, is common in anorexia nervosa due to metabolic slowdown. However, heavy menstruation (menorrhagia) is not typical; instead, amenorrhea (absence of menstruation) is a hallmark sign, resulting from hormonal imbalances due to malnutrition and low body fat.
Choice D rationale
Overweight with a puffy face is not indicative of anorexia nervosa. Anorexia nervosa is characterized by an extreme fear of gaining weight and a disturbed body image, leading to self-starvation and significant underweight. A puffy face can be associated with refeeding syndrome or specific medical conditions, not primary anorexia.
Correct Answer is A
Explanation
Choice A rationale
Variable decelerations are characterized by an abrupt decrease in the fetal heart rate, often V, W, or U-shaped, and are primarily caused by umbilical cord compression. This compression reduces blood flow and oxygen transfer to the fetus, leading to a transient hypoxic event and subsequent FHR deceleration.
Choice B rationale
Maternal fever typically causes fetal tachycardia, an elevated baseline fetal heart rate (above 160 beats per minute), due to increased fetal metabolic demands and a direct effect of elevated maternal temperature on fetal physiology. It does not directly cause variable decelerations.
Choice C rationale
Fetal head compression typically causes early decelerations, which are symmetrical, gradual decreases in FHR that mirror uterine contractions. This occurs due to increased intracranial pressure stimulating the vagus nerve, leading to a transient slowing of the heart rate.
Choice D rationale
Polyhydramnios, an excessive amount of amniotic fluid, is generally associated with conditions like maternal diabetes or fetal anomalies. While it can alter uterine distension, it is not a direct or primary cause of variable decelerations, which are specifically linked to cord compression.
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