What is the nurse's responsibility after epidural catheter insertion?

Correct Answer: A

Rationale: After epidural catheter insertion, the nurse's responsibility is to monitor vital signs every 5 to 15 minutes. This is the correct answer because monitoring vital signs is crucial to ensure the laboring person's safety and detect any potential complications related to the epidural anesthesia. Choice B, intermittent FHR monitoring, is incorrect because FHR monitoring is typically done continuously or periodically during labor to assess the baby's well-being, not specifically after epidural catheter insertion. Intermittent monitoring may still be necessary, but it is not the immediate responsibility after epidural insertion. Choice C, providing the laboring person a meal, is incorrect because it is generally not recommended to eat a heavy meal during labor, especially after epidural insertion. The laboring person may be restricted to clear liquids or ice chips to prevent aspiration in case emergency intervention is needed. Choice D, instructing the laboring person to get out of bed to use the restroom, is incorrect because after epidural insertion, the laboring person may have decreased sensation and mobility in their lower body. It is unsafe to ask them to get out of bed without assistance due to the risk of falls or injuries. In conclusion, monitoring vital signs every 5 to 15 minutes is the nurse's responsibility after epidural catheter insertion to ensure the laboring person's safety and well-being.

Correct Answer: B

Rationale: During the second stage of labor, it is crucial for the nurse to monitor the fetal heart rate regularly to ensure the well-being of the baby. Choice A, assessing every 5 minutes with contractions, may be too frequent and unnecessary in a low-risk person as it could interrupt the natural progression of labor. Choice C, assessing every 5-15 minutes, may be too variable and not provide a consistent monitoring schedule. Choice D, only assessing when the physician orders, is incorrect because continuous monitoring of the fetal heart rate is essential during labor, regardless of physician orders. This is to ensure any changes or signs of distress in the baby are promptly identified and addressed. The correct answer is B, to assess the fetal heart rate at least every 30 minutes during the second stage. This interval allows for regular monitoring without being overly intrusive, striking a balance between ensuring the baby's well-being and allowing the labor to progress naturally. It also aligns with best practice guidelines for fetal monitoring during labor in low-risk individuals.

Correct Answer: A

Rationale: During the second stage of labor, birthing person position changes play a crucial role in facilitating fetal descent. Option A is correct because different positions can help optimize the pelvis shape, allowing gravity to assist in the downward movement of the baby. This can aid in the progression of labor and reduce the risk of prolonged pushing. Option B is incorrect because position changes are meant to enhance the birthing experience and help with labor progress, rather than causing stress for the support person. In fact, involving the support person in position changes can provide emotional support and strengthen the birthing team. Option C is incorrect because while uterine contractions play a significant role in fetal descent, the position of the birthing person can also influence the process. By changing positions, the birthing person can help the baby navigate through the birth canal more effectively. Option D is incorrect because maintaining a supine position (lying on the back) is not always the safest option during the second stage of labor. In fact, this position can compress blood vessels, potentially reducing blood flow to the uterus and baby. Encouraging movement and different positions can promote comfort, reduce the risk of complications, and improve labor outcomes. In conclusion, choosing different birthing positions during the second stage can positively impact fetal descent and labor progress, making option A the most accurate description of the importance of position changes during this stage.

Correct Answer: B

Rationale: A second-degree laceration involves tearing through the vaginal mucosa and perineal muscles. This means that choice B is correct. Choice A is incorrect because a second-degree laceration extends beyond the vaginal mucosa and involves the perineal muscles as well. Choice C is also incorrect because a second-degree laceration is actually considered a moderate level of severity. First-degree lacerations involve only the vaginal mucosa, while third and fourth-degree lacerations are more severe and involve the anal sphincter and rectal mucosa. Choice D is incorrect because second-degree lacerations typically require suturing to promote proper healing and prevent complications such as infection or excessive bleeding. Suturing also helps to restore the anatomy of the perineum and promote optimal recovery for the patient.

Correct Answer: D

Rationale: Option D, providing the baby a bottle so that the birthing person can rest, is the correct answer for supporting involution of the uterus. This is because rest and relaxation are essential for the body to heal and recover effectively. By allowing the birthing person to rest while providing nourishment to the baby through a bottle, the nurse is promoting optimal conditions for the uterus to undergo involution, which is the process of the uterus returning to its pre-pregnancy size and position. Option A, uterotonics, may be used to help stimulate contractions of the uterus and promote involution. However, in the context of supporting involution, providing rest to the birthing person is more directly related to allowing the body to heal naturally without the use of medication. Option B, encouraging the birthing person to urinate, is important for preventing urinary retention and promoting comfort, but it is not directly related to supporting involution of the uterus. While emptying the bladder can help reduce pressure on the uterus, it is not as crucial as providing rest for promoting involution. Option C, fundal massage, is a technique used to stimulate contractions of the uterus and help prevent postpartum hemorrhage. While fundal massage can be beneficial in certain situations, it is not directly related to supporting involution of the uterus through rest and relaxation. Rest is more essential for promoting involution in this context.