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.

Correct Answer: A

Rationale: The correct answer is A: Latent phase. This stage is ideal for teaching nonpharmacologic pain control methods as the patient is usually more receptive, relaxed, and able to focus. During the latent phase, contractions are typically mild and irregular, allowing the patient to learn and practice techniques effectively. In contrast, the active phase (choice B) is characterized by increased intensity and frequency of contractions, making it challenging for the patient to concentrate on learning. The second stage (choice C) is the pushing stage, where the focus shifts to pushing efforts rather than learning new techniques. The transition phase (choice D) is the most intense stage of labor, making it difficult for the patient to absorb and apply nonpharmacologic pain control methods effectively.

Correct Answer: D

Rationale: The correct answer is D because excessive pain in labor can lead to increased maternal stress, which may result in decreased placental perfusion, compromising oxygen and nutrient delivery to the fetus. This can have serious implications for the baby's well-being. Choices A, B, and C are incorrect because excessive pain in labor does not necessarily lead to a more rapid labor, has an effect on the labor outcome by potentially impacting placental perfusion, and is not considered a normal occurrence that should be disregarded.

Correct Answer: C

Rationale: The correct answer is C: Epidural anesthesia. At 8 cm cervical dilation, the patient is in active labor and close to delivery. Epidural anesthesia is the safest method as it provides effective pain relief without affecting the baby's central nervous system. Narcotics can pass through the placenta and affect the baby's breathing. Spinal block may cause a sudden drop in blood pressure. Breathing and relaxation techniques may not be sufficient at 8 cm dilation. Epidural anesthesia is the most appropriate for pain management in this scenario.

Correct Answer: A

Rationale: The correct answer is A: epidural block. Epidural anesthesia in labor is considered the safest for the fetus because it does not directly affect the baby's central nervous system. It provides effective pain relief for the mother while minimizing the risk of medication passing to the fetus. It also allows for adjustment of the dose as needed during labor. Summary of why other choices are incorrect: B: Pudendal block is a regional anesthesia technique that primarily provides pain relief to the perineum and does not affect the fetus directly. C: Local infiltration anesthesia is limited in its coverage and may not provide adequate pain relief during labor. D: Spinal (subarachnoid) anesthesia may lead to a rapid and significant drop in blood pressure, affecting fetal oxygenation and require careful monitoring.