With regard to systemic analgesics administered during labor, nurses should be aware that:
Systemic analgesics cross the maternal blood-brain barrier as easily as they do the fetal blood-brain barrier.
Effects on the fetus and newborn can include decreased alertness and delayed sucking
Intravenous (IV) patient-controlled analgesia (PCA) results in increased use of an analgesic
Intramuscular (M) administration is preferred over IV administration
The Correct Answer is B
A. Systemic analgesics cross the maternal blood-brain barrier as easily as they do the fetal blood-brain barrier. While systemic analgesics do cross the placenta, they actually affect the fetus more readily than the mother because the fetal liver and kidneys are immature, making drug metabolism and excretion slower. This leads to prolonged effects on the newborn.
B. Effects on the fetus and newborn can include decreased alertness and delayed sucking. Opioid analgesics, such as fentanyl, meperidine, or morphine, can cause neonatal respiratory depression, reduced alertness, and difficulty initiating breastfeeding due to delayed sucking reflex. If administered too close to delivery, the newborn may require respiratory support or naloxone to reverse opioid effects.
C. Intravenous (IV) patient-controlled analgesia (PCA) results in increased use of an analgesic. PCA allows controlled dosing of pain medication, often leading to less total medication use because the patient receives smaller, more frequent doses rather than large, single doses. This helps maintain stable pain control without excessive sedation.
D. Intramuscular (IM) administration is preferred over IV administration. IV administration is preferred over IM because it provides faster pain relief and better dose control. IM injections have delayed absorption and an unpredictable effect, making IV the preferred route for labor analgesia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D"]
Explanation
A. Do you have any headaches or blurry vision? Headaches and blurry vision are common neurological symptoms of preeclampsia. These occur due to cerebral edema and hypertension-related vascular changes. Persistent headaches or visual disturbances (such as seeing spots or flashing lights) warrant further evaluation.
B. I am going to check your reflexes now. Hyperreflexia (brisk deep tendon reflexes) is a key neurological sign of worsening preeclampsia. Severe hyperreflexia can indicate impending eclampsia and increased seizure risk. Checking for clonus (involuntary rhythmic muscle contractions) is also important.
C. Have you been having trouble with urinary incontinence? Urinary incontinence is not a sign of preeclampsia. However, decreased urine output (oliguria) would be concerning as it may indicate worsening renal impairment, but incontinence itself is unrelated.
D. Do you have any right upper quadrant pain? Right upper quadrant or epigastric pain is a concerning sign of liver involvement in severe preeclampsia or HELLP syndrome. It occurs due to liver swelling and can be a precursor to serious complications such as hepatic rupture.
E. Have you had any nausea or vomiting recently? While nausea and vomiting are common in pregnancy, they are not defining symptoms of preeclampsia unless they are sudden and severe. If present in the third trimester, they may suggest worsening disease, but they are not primary indicators.
F. Do you feel safe at home? Screening for domestic violence is important in pregnancy, but it is not a diagnostic question for preeclampsia. While stress and abuse can impact blood pressure, this question does not help in determining preeclampsia.
Correct Answer is C
Explanation
A. Treat opportunistic infections. Antiretroviral drugs do not directly treat opportunistic infections. They help suppress the HIV virus, which in turn strengthens the immune system, reducing the risk of opportunistic infections, but specific infections require separate antimicrobial treatment.
B. Supplement radiation and chemotherapy. Antiretroviral therapy (ART) is not used as a supplement to radiation or chemotherapy. While HIV-positive patients can develop certain cancers like Kaposi’s sarcoma, ART is aimed at controlling HIV rather than being a direct cancer treatment.
C. Decrease viral loads in the blood. Antiretroviral drugs work by suppressing HIV replication, thereby decreasing viral load in the bloodstream. This helps maintain immune function, reduces the risk of perinatal transmission, and improves overall health outcomes. Consistent use of ART can even lower viral loads to undetectable levels, significantly reducing transmission risk.
D. Cure acute HIV/AIDS infections. There is no cure for HIV/AIDS. Antiretroviral therapy helps manage the disease by reducing viral replication and preventing progression to AIDS, but it does not eradicate the virus from the body. Lifelong adherence to ART is necessary for disease control.
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