During admission, a laboring patient tells the nurse, I'm so ...

[geoffrey]

During admission, a laboring patient tells the nurse, I'm so afraid I'll need a cesarean section. I don't want to be asleep for surgery when my baby is born Which of the following nursing responses is most appropriate?
 
  1. If a cesarean section is needed, that doesn't necessarily mean you'll need to go to sleep for surgery.
  2. Your anesthesia provider will require that you go to sleep for surgery.
  3. We'll do our best to make sure you deliver vaginally, so you don't need to have a cesarean section.
  4. If you need a cesarean section, the anesthesia provider will awaken you as soon as possible after delivery so that you can see your baby quickly.

Question 2

During her hospital admission, the laboring patient explicitly refused all pain medications and a labor epidural.
 
  Once dilated to 5 cm, the patient complains of intolerable discomfort and asks the nurse, If I have an epidural, how will you make sure it doesn't hurt my baby? The best response by the nurse is:
  1. We'll monitor your baby continuously so we can recognize and treat any changes that may be related to the epidural.
  2. Epidural anesthesia is very safe and there are no potential side effects that can affect your baby.
  3. We'll assess your blood pressure every 15 minutes to make sure the epidural is not having any negative effects on your baby.
  4. Before your epidural is placed, we'll administer IV fluid to you in order to prevent the epidural from causing you problems.

[princessflame2016]

Answer to Question 1

Correct Answer: 1
Rationale 1: While general anesthesia may be needed for cesarean birth and for surgical intervention with some complications, in modern obstetrics, general anesthesia is used in less than 1 of all obstetric births.
Rationale 2: General anesthesia may be needed for cesarean birth and for surgical intervention with some complications. However, in modern obstetrics, spinal anesthesia is often administered for delivery via cesarean section, while general anesthesia is used in less than 1 of all obstetric births.
Rationale 3: Reassuring the patient in this manner does not address the erroneous belief that general anesthesia is mandatory for women undergoing cesarean section.
Rationale 4: Reassuring the patient in this manner does not address the erroneous belief that general anesthesia is mandatory for women undergoing cesarean section.

Answer to Question 2

Correct Answer: 1
Rationale 1: Continuous electronic fetal monitoring to assess fetal status is indicated in the care of pregnant women who receive epidural anesthesia and allows for a more direct assessment of fetal status than does frequent monitoring of maternal BP and pulse, which are also indicated in the care of this patient.
Rationale 2: While proficient administration and monitoring of epidural anesthesia allows for a high degree of safety with this technique, maternal hypotension associated with epidural anesthesia may produce harmful fetal effects.
Rationale 3: While frequent monitoring of maternal blood pressure and pulse are indicated in the care of a patient who receives a labor epidural, continuous electronic fetal monitoring is also indicated for assessment of fetal status and allows for a more direct fetal assessment.
Rationale 4: While administration of a bolus of IV fluid is indicated in preparation for epidural placement and reduces the risk for maternal hypotension, this intervention neither guarantees the prevention of related complications nor allows for assessment of fetal status.

[geoffrey]

Correct answers!

[princessflame2016]

Great! Please up vote