Which of the following actions would the nurse expect to perform immediately before a woman is to have regional anesthesia? Select all that apply.

Correct Answer: D

Rationale: Before a woman undergoes regional anesthesia, it is crucial for the nurse to monitor her blood pressure every 5 minutes for the first 15 minutes after the anesthesia is administered. This is because regional anesthesia can cause a sudden drop in blood pressure, known as hypotension, which can be dangerous for both the mother and the fetus. By monitoring blood pressure closely, the nurse can quickly identify any signs of hypotension and take appropriate action to prevent any complications. Assessing the fetal heart rate (Choice A) is important during labor and delivery, but it is not a necessary step immediately before regional anesthesia. Infusing 1000 cc of Ringer's lactate (Choice B) is also not a standard pre-anesthesia procedure and may not be indicated for every patient. Having the woman empty her bladder (Choice C) is a common pre-anesthesia step to prevent discomfort during the procedure, but it is not as critical as monitoring blood pressure in this situation. Overall, monitoring blood pressure every 5 minutes for the first 15 minutes after regional anesthesia is the most important action to ensure the safety and well-being of the mother and fetus during the procedure.

Correct Answer: C

Rationale: Performing yoga exercises is a nonpharmacological intervention recommended by nurse midwives to help a client at full term go into labor. Yoga exercises can help promote relaxation, reduce stress, and increase circulation, all of which can potentially help stimulate labor. Additionally, certain yoga poses can help open up the pelvis and encourage the baby to move into the optimal position for birth. Engaging in sexual intercourse is also a commonly recommended nonpharmacological intervention to help induce labor. Sexual intercourse can help release oxytocin, a hormone that can stimulate contractions. Additionally, semen contains prostaglandins which can help soften the cervix. Ingesting evening primrose oil is not typically recommended as a method to induce labor. While evening primrose oil is sometimes used to help ripen the cervix, there is limited scientific evidence to support its effectiveness in stimulating labor. Massaging the breast and nipples is not a commonly recommended method to induce labor. While nipple stimulation can help release oxytocin and stimulate contractions, it should be done under the supervision of a healthcare provider due to the potential risks of overstimulation and uterine hyperstimulation.

Correct Answer: A

Rationale: To calculate the amount of medication to administer, we can use the formula: Dose prescribed (mg) / Concentration on hand (mg/mL) = Volume to administer (mL) In this case, the dose prescribed is 0.5 mg and the concentration on hand is 2 mg/mL. So, 0.5 mg / 2 mg/mL = 0.25 mL. Therefore, the nurse will administer 0.25 mL of Stadol to the laboring client. Choice B, C, and D are marked as N/A because they do not have any relevance to the question. The correct answer is based on the calculation of the dose prescribed and the concentration on hand, which results in 0.25 mL. Choice B, C, and D are incorrect because they do not provide a valid answer to the question. Only choice A provides a clear and accurate calculation based on the information given in the question.

Correct Answer: D

Rationale: A vaginal examination provides the best information about the status of labor because it allows healthcare providers to directly assess the cervix for dilation, effacement, and station of the baby. This information is crucial in determining the progress of labor and deciding on the appropriate course of action. Leopold's maneuvers (choice A) are a series of four movements used to assess the position of the fetus in the uterus. While they can provide some information about the baby's position, they do not give as much detail about the status of labor as a vaginal examination. Fundal contractility (choice B) refers to the strength and regularity of contractions, which is important in labor progress. However, this information alone does not provide a comprehensive picture of the status of labor as it does not give information on cervical dilation and effacement. Assessment of the fetal heart (choice C) is important for monitoring the well-being of the baby during labor, but it does not provide direct information about the progress of labor in terms of cervical changes. In conclusion, a vaginal examination is the best choice for assessing the status of labor as it provides direct and detailed information about cervical dilation, effacement, and station of the baby, which are crucial in managing labor effectively.

Correct Answer: A

Rationale: A: After all vaginal exams Assessing the fetal heart rate after all vaginal exams is crucial during labor because these exams can potentially cause changes in the fetal heart rate. Vaginal exams can stimulate the cervix and cause temporary changes in the baby's heart rate. Therefore, it is important to monitor the fetal heart rate immediately after these exams to ensure the baby's well-being. B: Before giving the mother any analgesics While it is important to monitor the fetal heart rate before giving the mother any analgesics, this is not the most critical time for assessment. Analgesics may affect the mother's pain perception and level of consciousness but do not directly impact the fetal heart rate. Monitoring the fetal heart rate after vaginal exams is more critical to ensure immediate safety. C: Periodically at the end of a contraction Monitoring the fetal heart rate periodically at the end of a contraction is important for assessing the baby's response to uterine contractions. However, this alone may not provide a comprehensive picture of the baby's well-being throughout labor. Assessing the fetal heart rate after all vaginal exams allows for immediate detection of any changes that may impact the baby's health. D: Every 1 hour during the latent phase of a low-risk labor Monitoring the fetal heart rate every hour during the latent phase of a low-risk labor is a good practice to ensure the baby's well-being over time. However, waiting for an hour between assessments may miss critical changes that can occur suddenly, especially after vaginal exams. Immediate assessment after vaginal exams is crucial for timely interventions if needed.