The nurse is caring for a client that is Gravida 2 Para 1 admitted at 4-5 cm cervical dilation and is requesting pain medication.
Which of the following is the most appropriate method of pain management at this time:
Ibuprofen IM injection.
Pudendal block.
Spinal block.
Epidural analgesia.
The Correct Answer is D
Choice A rationale
Ibuprofen IM injection is not typically used for labor pain due to its limited effectiveness for severe pain and potential side effects on the mother and fetus.
Choice B rationale
Pudendal block provides pain relief during the second stage of labor, particularly for episiotomy or forceps delivery. It is not typically used during the active phase of labor dilation.
Choice C rationale
Spinal block is often used for cesarean sections or late-stage labor but is not commonly used for pain management during early or active labor due to its short duration of action.
Choice D rationale
Epidural analgesia is the most effective and widely used method for pain management during active labor. It provides continuous pain relief by administering medication through a catheter placed in the epidural space.
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Related Questions
Correct Answer is ["A","B","C","E"]
Explanation
A. Administer antihypertensive medication as prescribed - The client's blood pressure is elevated, and managing hypertension is crucial to prevent complications.
B. Initiate continuous fetal monitoring - The client is experiencing symptoms that could indicate preeclampsia, and continuous monitoring is essential to assess fetal well-being.
C. Monitor for signs of magnesium toxicity - Given the client's symptoms and lab results, monitoring for magnesium toxicity is important, especially if magnesium sulfate is being used for seizure prophylaxis.
D. Perform a vaginal exam to assess cervical status - This intervention is not a priority at this moment given the client's condition and the need to avoid unnecessary interventions that could cause stress or complications.
E. Assess for signs of placental abruption - Although the client denies vaginal bleeding, it's important to monitor for any signs of placental abruption due to her symptoms and hypertension.
Correct Answer is D
Explanation
Choice A rationale
A temperature of 37.8°C (100.3°F) is a low-grade fever that does not typically indicate a serious issue in the context of epidural analgesia during labor. It should be monitored, but it's not immediately concerning.
Choice B rationale
Generalized itching can be a common side effect of epidural analgesia due to the opioids used. It should be monitored and managed, but it does not typically require immediate physician notification.
Choice C rationale
Weakness of the lower extremities can be expected with epidural analgesia as it causes a loss of sensation and muscle control. This should be monitored, but it is not typically an emergency.
Choice D rationale
Fetal bradycardia is a serious concern that must be reported to the physician immediately. It can indicate fetal distress and requires urgent evaluation and intervention to ensure the well-being of the baby. .
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