The emergency department nurse notes that a patient with chronic kidney failure has a potassium level of 6.5 mEq/L. Which medications would the nurse expect to administer? Select all that apply.

Choice A rationale:

Visceral pain arises from the internal organs and is often described as dull, aching, cramping, or squeezing. During the first stage of labor, the uterus contracts forcefully to dilate the cervix and move the baby down the birth canal. This stretching and pressure on the uterus, cervix, and other pelvic organs stimulate pain receptors, resulting in visceral pain. This pain is typically located in the lower abdomen, back, and groin.

Key points about visceral pain in the first stage of labor:

It's often described as dull, aching, cramping, or squeezing.

It's caused by the stretching and pressure on the uterus, cervix, and other pelvic organs.

It's typically located in the lower abdomen, back, and groin.

It can be intermittent or continuous.

It can vary in intensity from mild to severe.

It's often accompanied by other symptoms such as nausea, vomiting, sweating, and anxiety.

Choice B rationale:

Referred pain is pain that is felt in a different location from the source of the pain. It's not typically associated with the first stage of labor.

Choice C rationale:

Somatic pain arises from the skin, muscles, bones, and joints. It's often described as sharp, stabbing, burning, or throbbing. The somatic pain of the second stage of labor is caused by the stretching and distension of the perineum and vagina as the baby descends. It's typically located in the lower back, buttocks, and thighs.

Choice D rationale:

Pain during the third stage of labor is typically mild compared to the first and second stages. It's caused by the contractions of the uterus as it expels the placenta. It's usually located in the lower abdomen and may be accompanied by a feeling of pressure or fullness.

Rationale for Choice A:

Administering oxygen via a mask or nasal cannula is the most appropriate nursing intervention in this situation. Here's a detailed explanation:

1. Addresses Hypoxia: The client's symptoms of lightheadedness, dizziness, and tingling fingers strongly suggest hyperventilation, which can lead to hypoxemia (low blood oxygen levels). Administering oxygen directly increases the concentration of oxygen in the client's bloodstream, rapidly addressing the hypoxia and its associated symptoms.
2. Promotes Calmness: Oxygen therapy can also have a calming effect, which can help to slow the client's breathing rate and further improve oxygenation. This is crucial during the transition phase of labor, as anxiety and stress can exacerbate hyperventilation.
3. Supports Fetal Oxygenation: Ensuring adequate maternal oxygenation is essential for fetal well-being. By providing oxygen to the mother, the nurse is also indirectly supporting the oxygen supply to the fetus.

Rationale for Choice B:

Telling the client to breathe at a normal rate is not an effective intervention for hyperventilation. It's often challenging for a client experiencing hyperventilation to control their breathing rate on command. This approach can also increase anxiety, potentially worsening the hyperventilation.

Rationale for Choice C:

While notifying the physician is important to keep them informed of the client's status, it's not the immediate priority in this situation. The nurse can independently initiate oxygen therapy to address the client's hypoxia and improve her condition. The physician can then be consulted for further guidance or interventions if needed.

Rationale for Choice D:

Instructing the client to breathe into her cupped hands is a technique that can sometimes help to slow breathing and increase carbon dioxide levels. However, it's not as effective as administering oxygen in addressing the underlying hypoxia and may not provide sufficient relief for the client's symptoms.