Chapter 15: Pain Management During Childbirth

Chapter 15: Pain Management During Childbirth

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. Childbirth preparation can be considered successful if the outcome is described as which of the following?

a.	Labor was pain-free.
b.	The birth experiences of friends and families were ignored.
c.	Only nonpharmacologic methods for pain control were used.
d.	The client rehearsed labor and practiced skills to master pain.

 

 

ANS:  D

Preparation allows the woman to rehearse for labor and to learn new skills to cope with the pain of labor and the expected behavioral changes. Childbirth preparation does not guarantee a pain-free labor. A woman should be prepared for pain and anesthesia-analgesia realistically. Friends and families can be an important source of support if they convey realistic information about labor pain. Women will not always achieve their desired level of pain control by using nonpharmacologic methods alone.

 

PTS:   1                    DIF:    Cognitive Level: Analysis                REF:   281

OBJ:   Nursing Process Step: Evaluation     MSC:  Client Needs: Psychosocial Integrity

 

2. A woman with a known heroin habit is admitted in early labor. Which drug is contraindicated with opiate-dependent patients?

a.	Nalbuphine (Nubain)
b.	Hydroxyzine (Vistaril)
c.	Promethazine (Phenergan)
d.	Diphenhydramine (Benadryl)

 

 

ANS:  A

Nalbuphine may precipitate withdrawal if given to an opiate-dependent woman. Hydroxyzine is an antihistamine with antiemetic effects. Promethazine usually relieves nausea and vomiting. Diphenhydramine is commonly used to relieve pruritus from epidural narcotics.

 

PTS:   1                    DIF:    Cognitive Level: Understanding       REF:   293

OBJ:   Nursing Process Step: Planning        MSC:  Client Needs: Physiologic Integrity

 

3. A client is admitted to the labor and birth room in active labor; contractions are 4 to 5 minutes apart and last for 30 seconds. The nurse needs to perform a detailed assessment. When is the best time to ask questions or do procedures?

a.	After the contraction is over
b.	When it is all right with the coach
c.	During increment of next contraction
d.	After administration of analgesic-anesthetic

 

 

ANS:  A

Reduce intrusions as much as possible. Longer assessments may span several contractions. The coach is the support person. The woman needs to feel confident in her ability to go through labor and birth, and she should be encouraged to express her own needs and concerns. The increment is the beginning of the next contraction. It is best to stop with questions and procedures during each contraction. An analgesic or anesthetic may cause adverse reactions in the woman, preventing her from answering questions correctly.

 

PTS:   1                    DIF:    Cognitive Level: Understanding       REF:   297

OBJ:   Nursing Process Step: Assessment   MSC:  Client Needs: Health Promotion and Maintenance

 

4. Childbirth pain is different from other types of pain in that it is:

a.	less intense.
b.	associated with a physiologic process.
c.	more responsive to pharmacologic management.
d.	designed to make one withdraw from the stimulus.

 

 

ANS:  B

Childbirth pain is part of a normal process, whereas other types of pain usually signify an injury or illness. Childbirth pain is not less intense than other types of pain. Pain management during labor may affect the course and length of labor. The pain with childbirth is a normal process; it is not caused by the type of injury as when withdrawal from the stimulus occurs.

 

PTS:   1                    DIF:    Cognitive Level: Understanding       REF:   278

OBJ:   Nursing Process Step: Assessment   MSC:  Client Needs: Physiologic Integrity

 

5. Excessive anxiety during labor heightens the client’s sensitivity to pain by increasing:

a.	muscle tension.
b.	the pain threshold.
c.	blood flow to the uterus.
d.	rest time between contractions.

 

 

ANS:  A

Anxiety and fear increase muscle tension, diverting oxygenated blood to the woman’s brain and skeletal muscles. Prolonged tension results in general fatigue, increased pain perception, and reduced ability to use coping skills. Anxiety will decrease the pain threshold. Anxiety can decrease blood flow to the uterus. Anxiety will decrease the amount of rest the mother gets between contractions.

 

PTS:   1                    DIF:    Cognitive Level: Understanding       REF:   280

OBJ:   Nursing Process Step: Assessment   MSC:  Client Needs: Psychosocial Integrity