What would the nurse administer if the newborn has decreased or no respiratory effort at delivery after the person received an opiate?

Correct Answer: A

Rationale: The correct answer is A: naloxone (Narcan). If a newborn has decreased or no respiratory effort after the mother received an opiate, it indicates potential opiate toxicity in the newborn. Naloxone is an opioid antagonist that can reverse the effects of opiates, including respiratory depression. Administering naloxone can help stimulate the newborn's respiratory effort, promoting adequate oxygenation. Summary: - A: Naloxone is the correct answer as it reverses opiate effects. - B: Acetaminophen is a pain reliever and does not address respiratory depression. - C: Oxygen may help with oxygenation but does not address the underlying opiate toxicity. - D: Sodium bicarbonate is used to treat acid-base imbalances and does not address opiate toxicity or respiratory depression.

Correct Answer: A

Rationale: The correct answer is A: loss of sensation in the perineum. Pudendal anesthesia specifically targets the pudendal nerve, which supplies sensation to the perineum. By blocking this nerve, the expected effect is a loss of sensation in the perineal region. Choices B, C, and D are incorrect because pudendal anesthesia does not affect motor function, consciousness, or the ability to move one's legs. It is important to understand the specific nerve being targeted and its function to determine the expected effects of anesthesia.

Correct Answer: A

Rationale: The correct answer is A: monitoring vital signs every 5 to 15 minutes. After inserting the epidural catheter, continuous monitoring of vital signs is crucial to detect any potential complications like hypotension or respiratory depression promptly. Vital signs include blood pressure, heart rate, respiratory rate, and oxygen saturation. Intermittent FHR monitoring (B) may be necessary but is not the primary responsibility after epidural insertion. Providing a meal (C) is contraindicated due to the risk of aspiration. Instructing the laboring person to get out of bed to use the restroom (D) is not recommended as they may be at risk of falls due to decreased sensation and muscle weakness from the epidural.

Correct Answer: D

Rationale: The correct answer is D: pain during injection. Local anesthesia may cause pain during injection due to the needle piercing the skin, which can be uncomfortable for the patient. This is a common disadvantage of local anesthesia. A: Decreased motor function is not a typical disadvantage of local anesthesia as it mainly affects sensory nerves rather than motor nerves. B: Nausea is not a direct side effect of local anesthesia as it does not affect the gastrointestinal system. C: Hypotension is not a common disadvantage of local anesthesia, as it typically does not have a significant impact on blood pressure unless administered in large amounts or combined with other medications that can lower blood pressure.

Correct Answer: C

Rationale: The correct answer is C: During the increment of the next contraction. This is the best time for assessment as the patient is likely to be more focused and cooperative during this phase. Asking questions or performing procedures during the contraction or immediately after may be distracting or uncomfortable for the patient. Waiting until the contraction is over (choice A) may delay necessary assessment. Waiting for the coach's approval (choice B) may not always align with the patient's needs. Waiting until after administration of analgesic-anesthetic (choice D) may not be timely for necessary assessment and may also impact the patient's ability to provide accurate information.