A pregnant client is undergoing a quad screen test and inquires about the possible results.
Which of the following responses is most appropriate?

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.

Choice A rationale:

Attaching the IV line to the distal port is not a safe practice for oxytocin administration. This is because oxytocin is a high-alert medication that can have serious adverse effects if administered incorrectly. Attaching the IV line to the distal port increases the risk of the medication being infused too quickly, which can lead to uterine hyperstimulation, fetal distress, or even uterine rupture. The safest practice is to attach the IV line to the proximal port, which is closer to the patient's body and allows for slower infusion rates.

Choice B rationale:

Customizing the concentration of oxytocin is not a recommended practice. Oxytocin is available in a premixed solution of 10 units/mL, and this concentration should not be altered. Altering the concentration can lead to dosing errors and increase the risk of adverse effects.

Choice D rationale:

Titrating oxytocin to gravity is not a safe practice. Oxytocin should be administered using an infusion pump that can accurately control the infusion rate. Infusion pumps are necessary to ensure that the medication is administered at the correct dose and rate. Gravity-based infusions are less accurate and can lead to over- or under-infusion of the medication.

Choice C rationale:

Two RN verification is a safe practice for oxytocin administration. This practice involves having two registered nurses independently verify the medication, dose, and infusion rate before administration. This helps to prevent errors and ensure that the medication is administered safely.