Maternal Child Nursing Care Ch14 Pain Management
Exam Revision Question with Complete Reliable
Solutions
The nurse acts as an advocate for the patient during an informed consent. What care must the nurse
take while obtaining an informed consent? Select all that apply.
1
Check for the patient's signature.
2
Ensure that the consent is in English.
3
Obtain a family member's signature.
4
Check for the date on the consent form.
5
Check the anesthetic care provider's signature. - Answer 1, 4, 5
The nurse must ensure that the consent form has the correct date. The nurse must ensure that the
patient has not been compelled to consent for the procedure. The form must carry the signature of the
anesthetic care provider, certifying that the patient has received and expresses understanding of the
explanation. The consent form must be written or explained in the patient's primary language. The nurse
need not obtain a family member's signature on the document. The patient's signature is important.
The nurse is teaching a class on childbirth. What does the nurse teach about signs of local anesthetic
toxicity? Select all that apply.
1
Tinnitus
2
Metallic taste
3
Slurred speech
,4
Long stage II labor
5
Increased use of oxytocin - Answer 1, 2, 3
The central nervous system can be affected if a local anesthetic agent is injected accidentally into a
blood vessel leading to local anesthetic toxicity . Signs include metallic taste, tinnitus, and slurred
speech. Longer stage II labor and increased use of oxytocin are side effects of epidural and spinal
anesthesia.
A woman in latent labor who is positive for opiates on the urine drug screen is complaining of severe
pain. Maternal vital signs are stable, and the fetal heart monitor displays a reassuring pattern. The
nurse's most appropriate analgesic for pain control is:
1
fentanyl (Sublimaze).
2
promethazine (Phenergan).
3
butorphanol tartrate (Stadol).
4
nalbuphine (Nubain) - Answer 1
Fentanyl is a commonly used opioid agonist analgesic for women in labor. It is fast and short acting. This
patient may require higher than normal doses to achieve pain relief due to her opiate use. Phenergan is
not an analgesic. Phenergan is an ataractic (tranquilizer) that may be used to augment the desirable
effects of the opioid analgesics but has few of those drugs' undesirable effects. Stadol is an opioid
agonist-antagonist analgesic. Its use may precipitate withdrawals in a patient with a history of opiate
use. Nubain is an opioid agonist-antagonist analgesic. Its use may precipitate withdrawals in a patient
with a history of opiate use.
The nurse is caring for a patient who is administered local perineal infiltration anesthesia. In what
situation does the nurse expect the use of local perineal infiltration anesthesia? When a(n):
1
, Episiotomy is required.
2
Forceps birth is expected.
3
Cesarean birth is expected.
4
Vacuum extractor is to be used. - Answer 1
Local perineal infiltration anesthesia may be used when an episiotomy is to be performed. It may also be
used when lacerations must be sutured after birth in a patient who does not have regional anesthesia.
Pudendal nerve block is administered late in the second stage of labor if an episiotomy is to be
performed or if forceps or a vacuum extractor is to be used to facilitate birth. Low spinal anesthesia
(block) may be used for cesarean birth.
When caring for a patient in the first phase of labor, the nurse observes that the patient is experiencing
visceral pain. In which area does visceral pain occur?
1
Abdominal wall and thighs
2
Gluteal area and iliac crests
3
Lumbosacral area of the back
4
Lower portion of the abdomen - Answer 4
Visceral pain in the first stage of labor occurs in the lower portion of the abdomen. Visceral pain is a
result of distention of the lower uterine segment and stretching of cervical tissue as it effaces and
dilates. Pressure and traction on uterine tubes, ovaries, ligaments, nerves, and uterine ischemia also
cause visceral pain. Pain that originates in the uterus radiates to the gluteal area, iliac crests, abdominal
wall, thighs, lumbosacral area of the back, and lower back. This pain is called referred pain.
What major side effect does the nurse expect if a patient in labor is administered diazepam (Valium)?
Exam Revision Question with Complete Reliable
Solutions
The nurse acts as an advocate for the patient during an informed consent. What care must the nurse
take while obtaining an informed consent? Select all that apply.
1
Check for the patient's signature.
2
Ensure that the consent is in English.
3
Obtain a family member's signature.
4
Check for the date on the consent form.
5
Check the anesthetic care provider's signature. - Answer 1, 4, 5
The nurse must ensure that the consent form has the correct date. The nurse must ensure that the
patient has not been compelled to consent for the procedure. The form must carry the signature of the
anesthetic care provider, certifying that the patient has received and expresses understanding of the
explanation. The consent form must be written or explained in the patient's primary language. The nurse
need not obtain a family member's signature on the document. The patient's signature is important.
The nurse is teaching a class on childbirth. What does the nurse teach about signs of local anesthetic
toxicity? Select all that apply.
1
Tinnitus
2
Metallic taste
3
Slurred speech
,4
Long stage II labor
5
Increased use of oxytocin - Answer 1, 2, 3
The central nervous system can be affected if a local anesthetic agent is injected accidentally into a
blood vessel leading to local anesthetic toxicity . Signs include metallic taste, tinnitus, and slurred
speech. Longer stage II labor and increased use of oxytocin are side effects of epidural and spinal
anesthesia.
A woman in latent labor who is positive for opiates on the urine drug screen is complaining of severe
pain. Maternal vital signs are stable, and the fetal heart monitor displays a reassuring pattern. The
nurse's most appropriate analgesic for pain control is:
1
fentanyl (Sublimaze).
2
promethazine (Phenergan).
3
butorphanol tartrate (Stadol).
4
nalbuphine (Nubain) - Answer 1
Fentanyl is a commonly used opioid agonist analgesic for women in labor. It is fast and short acting. This
patient may require higher than normal doses to achieve pain relief due to her opiate use. Phenergan is
not an analgesic. Phenergan is an ataractic (tranquilizer) that may be used to augment the desirable
effects of the opioid analgesics but has few of those drugs' undesirable effects. Stadol is an opioid
agonist-antagonist analgesic. Its use may precipitate withdrawals in a patient with a history of opiate
use. Nubain is an opioid agonist-antagonist analgesic. Its use may precipitate withdrawals in a patient
with a history of opiate use.
The nurse is caring for a patient who is administered local perineal infiltration anesthesia. In what
situation does the nurse expect the use of local perineal infiltration anesthesia? When a(n):
1
, Episiotomy is required.
2
Forceps birth is expected.
3
Cesarean birth is expected.
4
Vacuum extractor is to be used. - Answer 1
Local perineal infiltration anesthesia may be used when an episiotomy is to be performed. It may also be
used when lacerations must be sutured after birth in a patient who does not have regional anesthesia.
Pudendal nerve block is administered late in the second stage of labor if an episiotomy is to be
performed or if forceps or a vacuum extractor is to be used to facilitate birth. Low spinal anesthesia
(block) may be used for cesarean birth.
When caring for a patient in the first phase of labor, the nurse observes that the patient is experiencing
visceral pain. In which area does visceral pain occur?
1
Abdominal wall and thighs
2
Gluteal area and iliac crests
3
Lumbosacral area of the back
4
Lower portion of the abdomen - Answer 4
Visceral pain in the first stage of labor occurs in the lower portion of the abdomen. Visceral pain is a
result of distention of the lower uterine segment and stretching of cervical tissue as it effaces and
dilates. Pressure and traction on uterine tubes, ovaries, ligaments, nerves, and uterine ischemia also
cause visceral pain. Pain that originates in the uterus radiates to the gluteal area, iliac crests, abdominal
wall, thighs, lumbosacral area of the back, and lower back. This pain is called referred pain.
What major side effect does the nurse expect if a patient in labor is administered diazepam (Valium)?
