The nurse is caring for a client in labor whose fetus is in an occiput posterior position.
Which intervention would the nurse use to reduce this client's discomfort?
Place the client in a prone position.
Apply ice packs to the lower back.
Massage the lower back.
Place the client in the Trendelenburg position.
The Correct Answer is C
Choice A rationale
Placing the client in a prone position (on the abdomen) is generally contraindicated during labor, especially with an occupied uterus, as it places pressure on the gravid abdomen and can compromise fetal circulation or cause discomfort. Instead, positions that encourage pelvic rocking or shifting the baby's position, like hands-and-knees, are preferred to rotate the occiput posterior fetus.
Choice B rationale
The intense, poorly localized back pain associated with occiput posterior (OP) position is caused by the fetal head's occiput pressing directly against the maternal sacrum during contractions. Ice packs provide superficial vasoconstriction and temporary local analgesia, which is less effective than heat or deep pressure for the deep, visceral pain originating from this internal pressure point.
Choice C rationale
Massage (often counterpressure) applied directly to the lower back (sacral area) is the most effective non-pharmacological intervention for the pain of an OP position. The firm, consistent pressure helps to splint the sacrum, counteracting the intense pressure exerted by the fetal occiput during a contraction, thereby significantly reducing the client's discomfort through a mechanical mechanism.
Choice D rationale
The Trendelenburg position involves placing the head lower than the feet and is not typically used to alleviate back pain in labor or facilitate fetal rotation. This position increases intracranial pressure and can be uncomfortable. Positions that elevate the hips, such as hands-and-knees or forward-leaning, are more effective at encouraging the fetal occiput to rotate anteriorly and move off the sacrum.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["12"]
Explanation
Step 1 is to convert the oxytocin concentration from units to milliunits (mU):. 20 units× 1000 mU/unit = 20000 mU.
Step 2 is to determine the concentration in mU/mL:. 20000 mU÷ 1000 mL = 20 mU/mL.
Step 3 is to calculate the infusion rate in mL/min:. 4 mU/min÷ (20 mU/mL) = 0.2 mL/min.
Step 4 is to convert the infusion rate from mL/min to mL/hr:. 0.2 mL/min× 60 min/hr = 12 mL/hr. The final calculated answer is 12 mL/hr.
Correct Answer is C
Explanation
Choice A rationale
Placing the client in a prone position (on the abdomen) is generally contraindicated during labor, especially with an occupied uterus, as it places pressure on the gravid abdomen and can compromise fetal circulation or cause discomfort. Instead, positions that encourage pelvic rocking or shifting the baby's position, like hands-and-knees, are preferred to rotate the occiput posterior fetus.
Choice B rationale
The intense, poorly localized back pain associated with occiput posterior (OP) position is caused by the fetal head's occiput pressing directly against the maternal sacrum during contractions. Ice packs provide superficial vasoconstriction and temporary local analgesia, which is less effective than heat or deep pressure for the deep, visceral pain originating from this internal pressure point.
Choice C rationale
Massage (often counterpressure) applied directly to the lower back (sacral area) is the most effective non-pharmacological intervention for the pain of an OP position. The firm, consistent pressure helps to splint the sacrum, counteracting the intense pressure exerted by the fetal occiput during a contraction, thereby significantly reducing the client's discomfort through a mechanical mechanism.
Choice D rationale
The Trendelenburg position involves placing the head lower than the feet and is not typically used to alleviate back pain in labor or facilitate fetal rotation. This position increases intracranial pressure and can be uncomfortable. Positions that elevate the hips, such as hands-and-knees or forward-leaning, are more effective at encouraging the fetal occiput to rotate anteriorly and move off the sacrum.
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