What is the most appropriate nursing action when a laboring person requests pain relief during the first stage of labor?

Correct Answer: B

Rationale: The correct answer is B: administer epidural analgesia. In the first stage of labor, epidural analgesia is the most appropriate option for pain relief as it provides effective and continuous pain management without compromising maternal and fetal well-being. Epidural analgesia allows the laboring person to remain alert and actively participate in the birthing process. Non-pharmacological pain relief methods may not provide sufficient pain relief during the intense contractions of the first stage of labor. Administering IV analgesics may not effectively manage the pain in the first stage and can have sedative effects on the laboring person and newborn. Administering pain medication as requested without considering the most appropriate option may not provide optimal pain relief and may not be in the best interest of the laboring person and their baby.

Correct Answer: A

Rationale: The correct answer is A: increase the IV fluid rate. This intervention helps to increase blood volume and improve blood pressure, addressing hypotension commonly caused by epidural anesthesia. Administering an epidural bolus (B) can worsen hypotension. Administering an analgesic (C) is not the priority in this situation. Increasing monitoring frequency (D) is important but addressing the underlying cause of low blood pressure is crucial.

Correct Answer: B

Rationale: The correct answer is B: apply gentle pressure to the perineum. This intervention helps to support the perineum and reduce the risk of perineal tearing during childbirth. Applying gentle pressure can slow down the baby's descent and allow the perineum to stretch gradually, reducing the likelihood of severe tearing. This intervention is important to promote a safe and controlled delivery. Incorrect answer explanations: A: Applying warm compresses may provide some comfort but does not specifically address the need to support the perineum during childbirth. C: Episiotomy should be considered only when necessary and not as a routine intervention when the perineum bulges. D: Perineal massage is typically done during the prenatal period to help prepare the perineum for childbirth but is not the most appropriate intervention when the perineum starts to bulge during labor.

Correct Answer: A

Rationale: The correct answer is A: Fever. In the first 24 hours postpartum, fever is the most concerning finding as it can indicate infection, such as endometritis or mastitis. Fever is a common early sign of infection and requires immediate assessment and intervention. Redness and swelling at the site (B) could be normal postpartum findings. Increased heart rate (C) may be a nonspecific response to stress or dehydration. Fatigue (D) is common postpartum but not typically indicative of infection in the first 24 hours. Fever warrants prompt attention due to the risk of serious complications if left untreated.

Correct Answer: A

Rationale: The correct action is to perform uterine massage. This helps to prevent postpartum hemorrhage by promoting uterine contraction and reducing uterine atony. It stimulates the release of endogenous oxytocin, aiding in the expulsion of clots and reducing bleeding. Administering uterotonic medications (choice B) would be the next step if uterine massage alone is ineffective. Perineal massage (choice C) is unrelated to managing a boggy uterus. Administering oral pain relief (choice D) does not address the root cause of the issue.