A patient who wishes to have an unmedicated birth is in the ...

[mikaylakyoung]

A patient who wishes to have an unmedicated birth is in the transition stage. She is very uncomfortable and turns frequently in the bed. Her partner has stepped out momentarily. How can the nurse be most helpful?
 
  1. Talk to the patient the entire time.
  2. Turn on the television to distract the patient.
  3. Stand next to the bed with hands on the railing next to the patient.
  4. Sit silently in the room away from the bed.

Question 2

The nurse is analyzing assessment findings on four newborns. Which finding might suggest a congenital heart defect?
 
  1. Apical heart rate of 140 beats per minute
  2. Respiratory rate of 40
  3. Acrocyanosis
  4. Cyanosis of the buccal membranes

[perkiness]

Answer to Question 1

3
Rationale 1: Talking might irritate the patient.
Rationale 2: Turning on the television might irritate the patient.
Rationale 3: Standing next to the bed is supportive without being irritating.
Rationale 4: Sitting silently away from the patient can lead to her feeling abandoned.

Answer to Question 2

4
Rationale 1: An apical heart rate of 140 is a normal assessment finding for newborns.
Rationale 2: A respiratory rate of 40 is a normal assessment finding for newborns.
Rationale 3: Acrocyanosis (cyanosis of the extremities) is a normal assessment finding for newborns.
Rationale 4: Cyanosis of the buccal membranes is not a normal finding in a newborn, and could indicate a congenital heart defect.