A client in labor is receiving an epidural for pain relief. What is the nurse's priority assessment immediately after the procedure?

Correct Answer: A

Rationale: In the context of pharmacology and maternal newborn care, the priority assessment immediately after administering an epidural for pain relief during labor is to monitor the maternal blood pressure (Option A). This is crucial because epidurals can cause a sudden drop in blood pressure, leading to maternal hypotension. Monitoring blood pressure allows the nurse to detect and intervene promptly to prevent adverse effects such as decreased placental perfusion, fetal distress, and maternal compromise. Assessing the fetal heart rate (Option B) is important but not the immediate priority after an epidural placement. While monitoring fetal well-being is essential during labor, maternal stability takes precedence in this scenario. Checking for bladder distention (Option C) is relevant for overall maternal well-being and prevention of urinary retention but is not the most critical assessment immediately post-epidural placement. Evaluating the client's pain level (Option D) is important for assessing the effectiveness of pain management but is secondary to monitoring maternal blood pressure, especially considering the potential complications associated with epidural-induced hypotension. Educationally, understanding the priority assessments after specific interventions like epidural administration enhances nurses' ability to provide safe and effective care to laboring women and their infants. It highlights the importance of timely interventions based on potential complications associated with pharmacological pain management strategies during childbirth.

Correct Answer: B

Rationale: In the context of caring for a client in labor receiving epidural anesthesia, the priority nursing assessment is to monitor maternal blood pressure (Option B). The rationale behind this priority is that epidural anesthesia can cause maternal hypotension, which can lead to decreased perfusion to the fetus and potential fetal distress. By monitoring the maternal blood pressure regularly, the nurse can detect any changes promptly and intervene to maintain adequate perfusion to both the mother and the fetus. Assessing for bladder distention (Option A) is important to prevent bladder overdistention, but it is not the priority over monitoring maternal blood pressure in this scenario. Evaluating the fetal heart rate (Option C) is crucial, but maternal parameters should be stabilized first to ensure optimal fetal oxygenation. Checking for pain relief (Option D) is important for the client's comfort but is not the priority assessment when considering the potential adverse effects of epidural anesthesia on maternal blood pressure and fetal well-being. In an educational context, understanding the priorities in caring for a client receiving epidural anesthesia during labor is crucial for maternal and fetal safety. Nurses need to prioritize assessments based on the potential risks associated with the anesthesia method being used and implement timely interventions to ensure positive outcomes for both the mother and the baby.

Correct Answer: D

Rationale: In the context of pharmacology, understanding the physiological process of labor and birth is crucial for nurses caring for maternal newborn clients. In this scenario, the finding that indicates birth is imminent is option D) Crowning is observed. Crowning refers to the appearance of the baby's head at the vaginal opening, indicating that the baby is descending and delivery is imminent. Option A) Cervix is fully dilated is an important milestone in labor progression but does not necessarily indicate imminent birth. The second stage of labor, when crowning occurs, follows full cervical dilation. Option B) Contractions every 2 minutes is a sign of active labor but does not specifically indicate that birth is imminent. Contractions may vary in frequency and intensity throughout labor. Option C) Fetal heart rate of 140 beats/minute is within a normal range but is not a direct indicator of imminent birth. Fetal heart rate monitoring is essential for assessing fetal well-being during labor but does not signify immediate delivery. Educationally, nurses must be able to recognize the signs of impending birth to provide timely and appropriate care during labor and delivery. Understanding these key indicators helps nurses anticipate the needs of both the mother and the newborn, ensuring a safe and positive birth experience.

Correct Answer: C

Rationale: In the context of pharmacology within maternal newborn care, understanding the physiological signs of labor progression is crucial for nurses. In this scenario, the correct answer is C) Fetal head is crowning. This finding indicates that the baby is descending through the birth canal and is on the verge of being born. Option A) Fetal head at station 0 may occur earlier in labor and does not necessarily indicate immediate readiness for delivery. Option B) Contractions every 3-5 minutes are indicative of active labor but do not specifically signal imminent delivery. Option D) Cervix dilated to 8 cm suggests progress in labor but does not provide a direct indication of readiness for delivery as crowning does. Educationally, nurses must grasp the significance of crowning as a definitive sign of imminent delivery during the second stage of labor. This knowledge allows for appropriate preparation, positioning, and support for the mother during the final moments of labor and birth. Understanding these key indicators enhances the nurse's ability to provide safe and effective care during this critical stage of childbirth.

Correct Answer: A

Rationale: Emergency contraception is most effective when taken within 72 hours of unprotected sex. Choice B is incorrect as it is not as effective after 5 days. Choice C is incorrect because emergency contraception works primarily by preventing ovulation, not by preventing implantation. Choice D is incorrect because most emergency contraception methods are available over the counter.