A G1P0, 8 cm dilated, is to receive pain medication. The health care practitioner has decided to order an opiate analgesic with an analgesic-potentiating medication. Which of the following medications would the nurse expect to be ordered as the analgesic-potentiating medication?

Correct Answer: B

Rationale: B: Phenergan (promethazine) is the correct answer. Promethazine is commonly used as an analgesic-potentiating medication in combination with opiates to enhance their pain-relieving effects. It acts as an adjunctive therapy by reducing nausea and vomiting, which can commonly occur with opiate use. This combination helps improve patient comfort and satisfaction during labor. A: Seconal (secobarbital) is incorrect because it is a barbiturate, not an analgesic-potentiating medication. Barbiturates are not typically used in combination with opiates for pain management during labor due to their sedative effects and potential for respiratory depression. C: Benadryl (diphenhydramine) is incorrect because it is an antihistamine, not an analgesic-potentiating medication. While Benadryl can have sedative effects and may be used for nausea or itching, it is not commonly used to enhance the effects of opiates for pain relief during labor. D: Tylenol (acetaminophen) is incorrect because it is not an analgesic-potentiating medication. Acetaminophen is a mild pain reliever often used for mild to moderate pain, but it does not potentiate the effects of opiates. It is not typically used in combination with opiates for pain management during labor.

Correct Answer: D

Rationale: Accepting the woman's loud verbalizations is the appropriate action when caring for a Chinese-speaking woman in active labor. In many Asian cultures, including Chinese culture, it is common for women to vocalize loudly during labor as a coping mechanism. By accepting and acknowledging these vocalizations, the nurse can provide culturally sensitive care and support the woman's needs during labor. Applying heat to the woman's back (choice A) may be comforting for some women in labor, but it is not specific to Chinese culture. Inquiring about the woman's pain level (choice B) is a standard nursing practice, but it may not address the specific cultural needs of a Chinese-speaking woman. Making sure that the woman's head is covered (choice C) is not a culturally appropriate action for caring for a Chinese-speaking woman in labor. In Chinese culture, covering the head may be seen as disrespectful or inappropriate during labor. Overall, the most important aspect of providing care to a Chinese-speaking woman in active labor is to be culturally sensitive and respectful of her cultural practices and preferences. Accepting and supporting the woman's loud verbalizations is a way to show understanding and respect for her cultural background and individual needs during labor.

Correct Answer: A

Rationale: Acupressure is a form of traditional Chinese medicine that involves applying pressure to specific points on the body to relieve pain and promote healing. In the case of labor pain relief, the best location for acupressure is on the malleolus of the wrist, which is also known as the LI4 or Hegu point. The LI4 point is located on the back of the hand, in the webbing between the thumb and index finger. This point is believed to have analgesic properties and is commonly used for pain relief, including labor pain. When pressure is applied to this point, it can help to alleviate pain and promote relaxation. Choice B, above the patella of the knee, is incorrect because this is not a commonly used acupressure point for labor pain relief. While there are acupressure points on the knee that can be used for other purposes, such as relieving knee pain, they are not typically used for labor pain relief. Choice C, on the medial aspect of the lower leg, is also incorrect because this is not a specific acupressure point that is commonly used for labor pain relief. While there are acupressure points on the lower leg that can be used for other purposes, they are not typically used for labor pain relief. Choice D, below the medial epicondyle of the elbow, is incorrect because this is not a commonly used acupressure point for labor pain relief. While there are acupressure points on the elbow that can be used for other purposes, such as relieving elbow pain, they are not typically used for labor pain relief. In conclusion, the correct answer is A because the malleolus of the wrist, specifically the LI4 point, is a commonly used acupressure point for labor pain relief due to its analgesic properties and effectiveness in promoting relaxation.

Correct Answer: A

Rationale: When the nurse palpates a thin cervix during a vaginal examination, it indicates that the client is progressing through the labor process. In this case, the client being 5 cm dilated and 90% effaced means that the cervix has thinned out and dilated to allow for the passage of the baby. The thin cervix is a positive sign of labor progression. Choice B, bulging fetal membranes, would typically be felt when the client is in the later stages of labor, particularly during the pushing phase. This sensation indicates that the amniotic sac is about to rupture or has already ruptured, allowing the amniotic fluid to flow out. Choice C, head at the pelvic outlet, would be felt when the client is fully dilated and ready to push. This sensation indicates that the baby's head has descended into the pelvis and is ready to be delivered. Choice D, closed cervix, would be felt in the early stages of labor when the cervix has not yet started to dilate. A closed cervix indicates that the labor process has not yet begun or is in the very early stages. In conclusion, the nurse palpating a thin cervix in this scenario is the correct answer because it aligns with the client being 5 cm dilated, 90% effaced, and station 2, indicating progression through the labor process.

Correct Answer: B

Rationale: If a woman is breathing rapidly with contractions, she is likely in the active phase of labor. During the active phase, contractions become more intense, frequent, and longer in duration. This increased intensity of contractions can cause the woman to breathe rapidly in order to cope with the pain and discomfort. The active phase typically occurs when the cervix is around 4-7 cm dilated. The latent phase (choice A) is the early stage of labor where contractions are mild and irregular. Women in this phase typically have more time between contractions and are able to cope with the discomfort without rapid breathing. The transition phase (choice C) is the most intense phase of labor where the cervix is fully dilated (10 cm). Contractions are very strong, close together, and can cause the woman to feel overwhelmed. While rapid breathing may occur during this phase, the description in the question fits better with the active phase. Choice D, showing signs of hypoxia and/or hypercapnia, is incorrect because rapid breathing during labor is a normal physiological response to intense contractions and is not necessarily indicative of respiratory distress. Hypoxia and hypercapnia would present with additional symptoms such as shortness of breath, cyanosis, confusion, and altered mental status.