A patient in labor with chronic back pain tells the nurse about ...

[Frost2351]

A patient in labor with chronic back pain tells the nurse about taking a dose of hydrocodone/acetaminophen (Vicodin) for labor pain prior to coming to the hospital. What should the nurse prepare to do once the fetus is delivered?
 
  A) Evaluate the fetus for withdrawal symptoms.
  B) Inform the physician so that liver effects can be monitored.
  C) Suggest that no additional narcotic pain medication be provided during labor.
  D) Coach the patient in breathing techniques because other pain medication is contraindicated.
  E) Request that the physician prescribe the same medication to be used for pain during labor.

Question 2

A nurse is assisting with the delivery of a newborn. The fetal head has just emerged. Which of the following would be done next?
 
  A) Suctioning of the mouth and nose
  B) Clamping of the umbilical cord
  C) Checking for the cord around the neck
  D) Drying of the newborn

[CAPTAINAMERICA]

Answer to Question 1

A, B
Feedback:
A typical prescription drug abused by women is hydrocodone/acetaminophen (Vicodin) because this is frequently prescribed for chronic back pain. The half-life of this drug is about 2 hours in addicted women. Even though it appears to have little effect on newborns, the newborn needs to be observed for both withdrawal and liver effects. The patient can receive other narcotic pain medication during labor. Other pain medication is not contraindicated for this patient. There are other, more safe pain medications that can be prescribed for the patient and fetus during labor.

Answer to Question 2

C
Feedback:
Once the fetal head has emerged, the primary care provider explores the fetal neck to see if the umbilical cord is wrapped around it. If it is, the cord is slipped over the head to facilitate delivery. Then the health care provider suctions the newborn's mouth first (because the newborn is an obligate nose breather) and then the nares with a bulb syringe to prevent aspiration of mucus, amniotic fluid, or meconium. Finally the umbilical cord is double-clamped and cut between the clamps. The newborn is placed under the radiant warmer, dried, assessed, wrapped in warm blankets and placed on the woman's abdomen for warmth and closeness.

[Frost2351]

Thank you

[CAPTAINAMERICA]

No problemo