The pregnant client term has in presented in the early phase of labor. She is experiencing abdominal pain and shows signs of growing anxiety about pain. What is the best pain management technique the nurse can suggest at this stage?

Practicing effleurage on the abdomen

Beginning epidural anesthesia

using on opioid antagonist, such aS Butorphanol

Immersing the client in hot water in a pool of Jacuzzi

Answer and Explanation

The Correct Answer is A

A) Practicing effleurage on the abdomen:
It is an excellent non-pharmacological pain management technique that can help distract the mother, reduce anxiety, and alleviate some of the discomfort associated with early labor. It also promotes relaxation and can help manage early labor pain effectively without the need for medications. This technique is easy to perform and can be done by the nurse or the partner, providing emotional support along with pain relief.

B) Beginning epidural anesthesia:
Epidural anesthesia is typically not initiated in the early phase of labor unless there is a specific indication or a desire for significant pain relief early in the process. An epidural is more commonly offered in the later stages of labor, when the pain is more intense and the cervix is further dilated. Starting an epidural too early could expose the mother to unnecessary risks and is generally not recommended unless it's requested or deemed medically necessary.

C) Using an opioid antagonist, such as Butorphanol:
Opioids, including Butorphanol, can have side effects such as drowsiness, nausea, and respiratory depression in both the mother and fetus. These medications are more commonly used in later stages of labor or when more potent pain relief is required. Additionally, opioid antagonists like Butorphanol may not be the best choice for a client who is experiencing anxiety and mild to moderate pain in the early phase, as they may not provide the relaxation and coping support that non-pharmacological methods like effleurage offer.

D) Immersing the client in hot water in a pool or Jacuzzi:
While immersion in water can be a helpful method of pain relief, especially during labor, it is generally recommended in the later stages of labor or when the cervix is dilated enough for water immersion to be safely utilized. Immersion in hot water may not be appropriate for all patients and could potentially lead to risks like overheating or changes in blood pressure. Additionally, the early phase of labor often involves less intense pain, and less invasive methods like effleurage are usually preferred first to manage discomfort and reduce anxiety.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is D

Explanation

A) Sublimation:
Sublimation refers to a defense mechanism where a person redirects potentially negative emotions or impulses into socially acceptable behaviors or activities. While this is a psychological concept, it does not apply to the father’s behavior immediately after birth. The father's actions, such as gazing at his baby and bonding, are not a result of sublimation but rather a normal part of bonding and attachment.

B) Claiming:
Claiming refers to the process where parents identify specific traits or characteristics in their newborn that they feel emotionally connected to, such as "He has my eyes" or "She has your nose." While the father might be engaging in claiming behaviors as he bonds with his baby, this term is more focused on recognizing physical attributes, rather than the intense emotional connection and captivation that is reflected in the scenario.

C) Mutuality:
Mutuality involves the reciprocal relationship between the newborn and the parents, where both give and receive emotional responses. It develops as the baby and parent interact, such as through eye contact, touch, and vocalizations. However, mutuality is a broader, ongoing process, while the father's behavior in this instance reflects a more specific emotional attachment and admiration, which aligns more closely with engrossment.

D) Engrossment:
Engrossment refers to the intense fascination and preoccupation that a parent, especially a father, feels toward their newborn. This process is characterized by behaviors such as gazing at the baby, holding them closely, and being captivated by their every movement. The father’s behavior in this scenario—staring into his baby’s eyes and showing deep emotional engagement—fits the definition of engrossment, which is a common and normal part of the bonding process immediately after birth.

A. Dry and stimulate newborn with towel. B. Place a hat on the newborn's head. C. Maintain the delivery room temperature at 20° C (68° F) D. Place a blanket on top of maternal dent and newborn.

Correct Answer is C

Explanation

A) Dry and stimulate newborn with towel:
Drying and stimulating the newborn immediately after birth is a standard practice to prevent heat loss and promote early bonding. This action helps to prevent heat loss through evaporation and stimulates the newborn to breathe. It is an appropriate intervention to reduce the risk of hypothermia, not increase it.

B) Place a hat on the newborn's head:
Placing a hat on the newborn’s head is an appropriate and helpful intervention. Since a significant amount of heat is lost through the head, especially in newborns who have a larger surface area relative to their body mass, keeping the head covered with a hat helps to retain warmth and reduce the risk of hypothermia. This would not place the newborn at risk for hypothermia.

C) Maintain the delivery room temperature at 20° C (68° F):
A delivery room temperature of 20° C (68° F) is on the lower end of the recommended range for newborn care. Newborns are particularly susceptible to heat loss due to their high surface area-to-body weight ratio and immature thermoregulation system. A cooler environment like 20°C increases the risk of hypothermia, as the newborn will lose heat more quickly than it can generate on its own.

D) Place a blanket on top of maternal and newborn:
Placing a blanket over the mother and newborn is an appropriate intervention to prevent heat loss. This promotes warmth by reducing heat loss from the newborn's body surface to the cooler environment. This would not place the newborn at risk for hypothermia; instead, it helps to maintain body temperature.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

The pregnant client term has in presented in the early phase of labor. She is experiencing abdominal pain and shows signs of growing anxiety about pain. What is the best pain management technique the nurse can suggest at this stage?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Immediately after birth, the father of the newborn holds the baby close, stares into his eyes, and seems captivated by him. The nurse recognizes this as the normal process of:

Correct Answer is D

Explanation

A nurse is caring for a client who has their newborn placed skin to skin immediately following birth with a temperature of 37° C (98.6" F). Which of the following interventions by the nurse would place the newborn at higher risk for hypothermia?

Correct Answer is C

Explanation

A nurse in a hospital is caring for a client who is 4 hour postpartum. Which of the following interventions should the nurse first perform after finding that the client's uterus is not firm? (Select All that Apply.)

If a fetus were not receiving enough oxygen during labor because of uteroplacental insufficiency, which pattern would the nurse anticipate seeing on the monitor?

A nurse is working with a client who is 6 hour postpartum following a vaginal birth with first -degree laceration. Which of the following, actions is an example of the nurse providing a stepwise approach to manage the client's pain?

Calculate the gravity rate for gentamycin 100 mg/100ml with secondary tubing (20gtts/mL) over 60 minutes.

A nurse is analyzing a fetal heart monitor strip and identifies a sinusoidal fetal heart rate pattern, which has been occurring for 30 min. Which of the following actions should the nurse take at this time?

A nurse is assessing a client who is 8 hour postpartum. Where should the nurse expect to find the fundus?