ATI RN
Promoting Client Comfort During Labor and Delivery Questions
Question 1 of 5
Nausea and vomiting are common discomforts in labor. When treating with promethazine, what must the nurse do when administering this medication?
Correct Answer: C
Rationale: The correct answer is C: Dilute before IV administration. Promethazine is a vesicant and can cause tissue damage if not properly diluted before IV administration. Diluting the medication helps reduce the risk of phlebitis and tissue irritation. Administering it subcutaneously (A) can cause pain and irritation at the injection site. Administering with an opioid (B) can increase the risk of respiratory depression. Administering promethazine in first stage labor (D) is generally safe, but diluting before IV administration is still necessary to prevent adverse effects.
Question 2 of 5
What are the side effects of spinal anesthesia? Select one that doesn't apply.
Correct Answer: C
Rationale: The correct answer is C: renal damage. Spinal anesthesia affects the nervous system, not the kidneys. Hypotension and respiratory depression are common side effects due to vasodilation and decreased respiratory drive. Infection can occur due to the invasive nature of the procedure. Renal damage is not a known side effect of spinal anesthesia as it does not directly affect kidney function.
Question 3 of 5
The nurse is monitoring the person's vital signs after the epidural is placed and notices a blood pressure of 80/50 mm Hg. What nursing intervention can be performed prior to the epidural placement to potentially reduce this side effect?
Correct Answer: B
Rationale: Correct Answer: B - IV fluid bolus Rationale: 1. IV fluid bolus can help increase blood volume and improve blood pressure. 2. Adequate hydration is crucial before epidural placement to prevent hypotension. 3. Other choices are not directly related to improving blood pressure in this scenario. Summary: - A: Routine use of ephedrine is not recommended as a routine prophylactic measure. - C: Insertion of indwelling urinary catheter is important for monitoring urine output but not for improving blood pressure. - D: Upright positioning may help prevent hypotension after epidural, but it's not a pre-epidural intervention to address low blood pressure.
Question 4 of 5
What is a side effect of general anesthesia that usually limits its use to cases of emergency?
Correct Answer: B
Rationale: The correct answer is B: newborn respiratory depression. General anesthesia can cross the placental barrier and affect the newborn's respiratory system, leading to potential complications such as respiratory depression. This side effect is a major concern, especially in non-emergency situations, as it can pose risks to the newborn's health. Hyperactive newborns (A), increase in uterine contractions (C), and decrease in cervical dilation (D) are not typical side effects of general anesthesia that limit its use in emergency cases. These options are unrelated to the primary concern of newborn respiratory depression in the context of administering general anesthesia during childbirth.
Question 5 of 5
What nursing intervention can be performed prior to epidural placement to potentially reduce a blood pressure drop?
Correct Answer: B
Rationale: The correct answer is B: IV fluid bolus. Prior to epidural placement, administering an IV fluid bolus can help prevent a drop in blood pressure by increasing preload and maintaining cardiac output. This helps offset the vasodilation effects of the epidural anesthesia. Options A, C, and D are incorrect. Ephedrine (A) is not routinely used before epidural placement due to its potential adverse effects. Insertion of a urinary catheter (C) is not directly related to preventing a blood pressure drop. Upright positioning (D) may actually worsen hypotension by pooling blood in the lower extremities.