During the third stage, the following physiological changes occur. Please place the changes in chronological order.

Correct Answer: B

Rationale: During the third stage of labor, the correct chronological order of physiological changes is as follows: B: Membranes separate from the uterine wall - This is the correct answer because during the third stage of labor, the placenta detaches from the uterine wall, and the amniotic sac is expelled. Now, let's discuss why the other choices are incorrect: A: Hematoma forms behind the placenta - This choice is incorrect because the formation of a hematoma typically occurs due to trauma or injury and is not a normal physiological change during the third stage of labor. C: The uterus contracts firmly - This choice is incorrect because uterine contractions typically occur during the first and second stages of labor to help push the baby out. In the third stage, the focus is on delivering the placenta, not on uterine contractions. D: The uterine surface area dramatically decreases - This choice is incorrect because the uterus does not decrease in size during the third stage of labor. After the delivery of the placenta, the uterus will continue to contract to help control bleeding and return to its pre-pregnancy size over time.

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: B

Rationale: After administration of epidural anesthesia, the nurse must monitor the mother for a drop in blood pressure. This is because epidural anesthesia can cause vasodilation, leading to hypotension. Monitoring for this potential complication is crucial to prevent adverse effects such as decreased perfusion to vital organs and fetal distress. Choice A, paresthesias in her feet and legs, is incorrect because while paresthesias can occur as a side effect of epidural anesthesia, they are not typically a cause for immediate concern unless they are severe or persistent. Choice C, an increase in central venous pressure, is incorrect because epidural anesthesia typically does not affect central venous pressure. Monitoring central venous pressure is not a standard practice following epidural administration. Choice D, fetal heart accelerations, is incorrect because fetal heart accelerations are not directly related to the mother's response to epidural anesthesia. Fetal heart rate monitoring is important during labor, but it is not a direct result of epidural administration. In summary, the correct answer is to monitor for a drop in blood pressure following epidural anesthesia due to the potential vasodilatory effects of the medication. Paresthesias, central venous pressure changes, and fetal heart accelerations are not typically immediate concerns following epidural administration.

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.