C HAPTER 07: N URSING M ANAGEMENT OF
P AIN D URING L ABOR AND B IRTH
Introduction to Maternity and Pediatric Nursing , 8th Edition ; Leifer
MULTIPLE CHOICE
1. The nurse is preparing a teaching plan for a woman receiving a
subarachnoid block before delivery. What nursing action will be included
in this plan to prevent the associated side effect of this t ype of
anaesthesia?
a. Restrict oral fluids.
b. Keep legs flexed.
c. Walk with assistance as soon as possible.
d. Lie flat for several hours.
ANS: D
The woman would be advised to remain flat for several hours after the
block to decrease the chance of post spinal headache.
DIF: Cognitive Level: Application REF: Page 173 OBJ: 7
TOP: Subarachnoid Block KEY: Nursing Process
Step: Planning MSC: NC LEX: Physiological Integrit y:
Reduction of Risk
,2. A woman requests a pudendal block to manage her labor pain. What
statement by the woman indicates a need for further explanation about the
pudendal block?
a. I’m having a contraction. Can I get the pudendal block now?
b. Ill get the pudendal block right before I deliver.
c. The nurse midwife will insert the needles into m y vagina.
d. It takes a few minutes after the medicine is administered to make
me feel numb.
ANS: A
The pudendal block does not block pain from contractions and is given
just before birth.
DIF: Cognitive Level: Comprehension REF: Page 173
OBJ: 7 TOP: Pudendal Block KEY: Nursing
Process Step: Evaluation MSC: NC LEX: Physiological
Integrit y: Basic Care and Comfort
3. An 18-year-old primigravida is 4 cm dilated and her contractions are 5
minutes apart. She received little prenatal care and had no childbirth
preparation. She is crying loudl y and shouting, please give me something
for the pain. I cant take the pain! What is the priorit y nursing diagnosis?
a. Pain related to uterine contractions
b. Knowledge deficit related to the birth experience
c. Ineffective coping related to inadequate preparation for labor
d. Risk for injury related to lack of prenatal care
ANS: A
, The most important issue for this woman, at this time, is effective pain
management.
DIF: Cognitive Level: Anal ysis REF: Page 177 OBJ: 3
TOP: Pain as a Priorit y KEY: Nursing Process Step:
Nursing Diagnosis MSC: NC LEX: Physiological Integrit y:
Basic Care and Comfort
4. The nurse who encourages the gate control theory of pain control would
advise a woman in labor and her partner to use which nonpharmacological
method of pain management?
a. Slow abdominal breathing
b. Guided relaxation
c. Listening to music
d. Massage
ANS: D
According to the gate control theory, stimulating large -diameter nerve
fibres temporaril y interferes with conduction of impulses through
small-diameter fibres. Massage is a technique that stimulates large -
diameter fibres and closes the gate.
DIF: Cognitive Level: Anal ysis REF: Page 166 TOP:
Gate Control KEY: Nursing Process Step: Implementation
MSC: NC LEX: Physiological Integrit y: Basic Care and
Comfort
P AIN D URING L ABOR AND B IRTH
Introduction to Maternity and Pediatric Nursing , 8th Edition ; Leifer
MULTIPLE CHOICE
1. The nurse is preparing a teaching plan for a woman receiving a
subarachnoid block before delivery. What nursing action will be included
in this plan to prevent the associated side effect of this t ype of
anaesthesia?
a. Restrict oral fluids.
b. Keep legs flexed.
c. Walk with assistance as soon as possible.
d. Lie flat for several hours.
ANS: D
The woman would be advised to remain flat for several hours after the
block to decrease the chance of post spinal headache.
DIF: Cognitive Level: Application REF: Page 173 OBJ: 7
TOP: Subarachnoid Block KEY: Nursing Process
Step: Planning MSC: NC LEX: Physiological Integrit y:
Reduction of Risk
,2. A woman requests a pudendal block to manage her labor pain. What
statement by the woman indicates a need for further explanation about the
pudendal block?
a. I’m having a contraction. Can I get the pudendal block now?
b. Ill get the pudendal block right before I deliver.
c. The nurse midwife will insert the needles into m y vagina.
d. It takes a few minutes after the medicine is administered to make
me feel numb.
ANS: A
The pudendal block does not block pain from contractions and is given
just before birth.
DIF: Cognitive Level: Comprehension REF: Page 173
OBJ: 7 TOP: Pudendal Block KEY: Nursing
Process Step: Evaluation MSC: NC LEX: Physiological
Integrit y: Basic Care and Comfort
3. An 18-year-old primigravida is 4 cm dilated and her contractions are 5
minutes apart. She received little prenatal care and had no childbirth
preparation. She is crying loudl y and shouting, please give me something
for the pain. I cant take the pain! What is the priorit y nursing diagnosis?
a. Pain related to uterine contractions
b. Knowledge deficit related to the birth experience
c. Ineffective coping related to inadequate preparation for labor
d. Risk for injury related to lack of prenatal care
ANS: A
, The most important issue for this woman, at this time, is effective pain
management.
DIF: Cognitive Level: Anal ysis REF: Page 177 OBJ: 3
TOP: Pain as a Priorit y KEY: Nursing Process Step:
Nursing Diagnosis MSC: NC LEX: Physiological Integrit y:
Basic Care and Comfort
4. The nurse who encourages the gate control theory of pain control would
advise a woman in labor and her partner to use which nonpharmacological
method of pain management?
a. Slow abdominal breathing
b. Guided relaxation
c. Listening to music
d. Massage
ANS: D
According to the gate control theory, stimulating large -diameter nerve
fibres temporaril y interferes with conduction of impulses through
small-diameter fibres. Massage is a technique that stimulates large -
diameter fibres and closes the gate.
DIF: Cognitive Level: Anal ysis REF: Page 166 TOP:
Gate Control KEY: Nursing Process Step: Implementation
MSC: NC LEX: Physiological Integrit y: Basic Care and
Comfort
