Chapter 13 Promoting Patient Comfort During Labor and Birth

Chapter 13  Promoting Patient Comfort During Labor and Birth

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. The perinatal nurse explains to the student nurse that which of the following may increase labor discomfort?
A.
Amniotomy
B.
Correct use of breathing methods
C.
Fetus in an occiput anterior position
D.
Positional changes during active labor

ANS: A
Labor induction and augmentation, amniotomy, and vaginal examinations may be associated with intensifying labor discomfort. Amniotomy, which is the artificial rupture of the fetal membranes, may be performed using a plastic amnihook or surgical clamp. The occiput anterior position is the optimal position for the fetus. Proper breathing exercises and positional changes during labor facilitate comfort for the laboring woman.

Cognitive Level: Comprehension/Understanding
Content Area: Pediatrics/Maternity
Patient Needs: Health Promotion and Maintenance
Integrated Process: Teaching/Learning
Difficulty: Easy

PTS: 1

2. The perinatal nurse is caring for a woman in early labor with a fetus in the occiput posterior position. What action should the nurse perform to increase the woman’s comfort?
A.
Assist the woman into a hands-and-knees position.
B.
Encourage the woman to assume a sitting position.
C.
Have the woman walk to the bathroom and void.
D.
Provide soothing music as a distraction technique.

ANS: A
Assuming a hands-and-knees position will help relieve the pressure on the woman’s back when the fetus is in a posterior position. This also helps the fetus rotate to a more favorable position. The other interventions will not be as helpful.

Cognitive Level: Application/Applying
Content Area: Pediatrics/Maternity
Patient Needs: Physiological Integrity: Basic Care and Comfort
Integrated Process: Nursing Process: Implementation
Difficulty: Moderate

PTS: 1

3. The perinatal nurse suggests that a laboring woman may wish to use the birth ball. The patient questions the rationale for this suggestion. The best answer by the nurse is that use of the birth ball will facilitate what action?
A.
Decreased maternal anxiety
B.
Decreased transmission of pain
C.
Fetal descent
D.
Increased number of opioid receptors

ANS: C
Assuming a sitting position on the birth ball facilitates a supported squatting position that opens the pelvis to allow fetal descent in preparation for birth.

Cognitive Level: Comprehension/Understanding
Content Area: Pediatrics/Maternity
Patient Needs: Physiological Integrity: Basic Care and Comfort
Integrated Process: Teaching/Learning
Difficulty: Moderate

PTS: 1

4. The perinatal nurse observes a woman entering the transition phase of labor while she uses a patterned breathing method to cope with the increasing strength of contractions. She complains of light-headedness and tingling in her fingers. The most appropriate intervention by the nurse is to assist the patient in doing which of the following?
A.
Breathing more slowly and taking a cleansing breath
B.
Cupping her hands and breathing into them
C.
Putting her head between her knees
D.
Returning to bed and lying on her left side

ANS: B
The symptoms of respiratory alkalosis are light-headedness, dizziness, tingling of the fingers, or circumoral numbness. Strategies to eliminate respiratory alkalosis focus on replacement of the bicarbonate ion by rebreathing carbon dioxide. This can be accomplished by instructing the woman to breathe into a paper bag held tightly around the mouth and nose or, if no bag is available, instructing her to breathe into her cupped hands.

Cognitive Level: Application/Applying
Content Area: Pediatrics/Maternity
Patient Needs: Physiological Integrity: Basic Care and Comfort
Integrated Process: Nursing Process: Implementation
Difficulty: Moderate

PTS: 1

5. The perinatal nurse is aware that a 25-year-old woman with gestational hypertension in labor would benefit most from which pharmacological pain relief medication?
A.
Epidural bupivacaine
B.
Fentanyl intravenously
C.
Morphine intrathecally
D.
Secobarbital sodium per mouth

ANS: A
Epidural blocks are advantageous for patients with diabetes, heart disease, pulmonary disease, and, in some cases, gestational hypertension, because they essentially eliminate the pain associated with labor and thus reduce the maternal stress associated with labor discomfort.

Cognitive Level: Knowledge/Remembering
Content Area: Pediatrics/Maternity
Patient Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Integrated Process: Nursing Process: Assessment
Difficulty: Easy

PTS: 1