Which nursing care measure, commonly offered to women in labor, reflects the application of the gate-control theory?
Encourage the woman to rest between contractions.
Administer the prescribed medication.
Massage the woman’s back.
Change the woman’s position.
The Correct Answer is C
Rationale for Choice A:
Encouraging the woman to rest between contractions can promote relaxation and help conserve energy, but it does not directly address the mechanisms of pain transmission as explained by the gate-control theory. Rest can have indirect benefits for pain management, but it does not directly interfere with pain signals in the same way that massage does.
Rationale for Choice B:
Administering prescribed medication can effectively block pain signals, but it does not rely on the principles of the gatecontrol theory. Medications typically work through pharmacological mechanisms that target pain receptors or neurotransmitters, rather than by competing with pain signals at the spinal cord level.
Rationale for Choice D:
Changing the woman's position can sometimes alleviate discomfort by shifting pressure or encouraging fetal movement, but it does not directly apply the gate-control theory either. Position changes can offer some physical relief, but they do not directly modulate the transmission of pain signals.
Rationale for Choice C:
Massaging the woman's back directly aligns with the gate-control theory of pain management. This theory proposes that nonpainful sensory input can effectively compete with pain signals, preventing them from reaching the brain. The following mechanisms explain how massage applies this theory:
Stimulation of non-painful nerve fibers: Massage activates large-diameter nerve fibers that transmit touch, pressure, and vibration sensations. These signals travel faster than pain signals and can effectively "close the gate" at the spinal cord, preventing pain signals from ascending to the brain.
Release of endorphins: Massage can stimulate the release of endorphins, the body's natural pain relievers. Endorphins bind to opioid receptors in the brain and spinal cord, reducing the perception of pain.
Reduction of muscle tension: Labor pain often involves muscle tension and spasms. Massage can help relax tense muscles, which can indirectly reduce pain by decreasing muscle ischemia and the release of pain-provoking substances.
Promotion of relaxation and distraction: Massage can induce a state of relaxation and provide a distraction from pain. This psychological effect can further contribute to pain relief by reducing anxiety and focusing attention on pleasant sensations.
Conclusion:
Massage offers a non-pharmacological, evidence-based approach to pain management that directly aligns with the gate-control theory. By stimulating non-painful sensory input, promoting relaxation, and releasing endorphins, massage effectively interrupts pain signals and provides significant relief for women in labor.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
Bishop score: A tool used to assess the readiness of the cervix for labor induction. It evaluates factors such as cervical dilation, effacement, consistency, position, and station of the fetal presenting part.
Score ranges from 0 to 13: A higher score indicates a more favorable cervix for induction.
Score of 6 or less: Induction is less likely to be successful.
Score of 9 or higher: Induction is more likely to be successful.
Nurses understand: The importance of the Bishop score in predicting the likelihood of successful induction.
Nurses use this information: To counsel patients about the risks and benefits of induction, to prepare for induction, and to monitor progress during induction.
Choice B rationale:
Not always done for medical reasons: Induction can also be elective, meaning it is chosen for non-medical reasons, such as convenience or a desire to avoid a post-term pregnancy.
Examples of medical reasons:
Gestational hypertension or preeclampsia
Fetal growth restriction
Prolonged pregnancy
Chorioamnionitis
Oligohydramnios
Choice C rationale:
Trial of labor (TOL): A term used to describe a vaginal birth attempt after a previous cesarean delivery.
Not synonymous with induction of labor: TOL can occur spontaneously or be induced.
Choice D rationale:
Not always electively done at 37 weeks' gestation: The decision to induce labor at 37 weeks is made on a case-by-case basis.
Factors considered:
Maternal and fetal health
Bishop score
Patient preferences
Correct Answer is A
Explanation
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.
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