The primiparous client has stated that she wants to avoid an ...

[xclash]

The primiparous client has stated that she wants to avoid an epidural, and would like to have an unmedicated birth. Which nursing action is most important for this client?
 
  1. Encourage the client to vocalize during contractions.
  2. Perform vaginal exams only between contractions.
  3. Provide a CD of soft music with sounds of nature.
  4. Offer to teach the partner how to massage tense muscles.

Question 2

The nurse is performing discharge teaching for a newly delivered first-time mom and her infant on the second postpartum day. Which statement indicates that teaching has been successful?
 
  1. Taking baths will help my perineum feel less sore each day.
  2. If I develop heavy bleeding, I should take my temperature.
  3. My bowel movements should resume in a week.
  4. I will go back to the doctor in four days for my RhoGAM shot.

[djpooyouma]

Answer to Question 1

4
Rationale:
1. Some clients want to vocalize during labor, and some will vocalize only when they perceive that they are losing control. The client should determine whether vocalization is desirable for her.
2. Vaginal exams are performed between contractions for all laboring clients in order to decrease discomfort.
3. Although music can be relaxing to laboring clients, the style of music they enjoy will vary. Ask the client what type of music she would like to listen to instead of making assumptions.
4. Massage is helpful for many clients, especially during latent and active labor. Massage can increase relaxation and therefore decrease tension and pain.

Answer to Question 2

1
Rationale:
1. Tub soaks or sitz baths will facilitate perineal healing.
2. If heavy bleeding begins, the client should call the doctor immediately, not take her temperature. Postpartum hemorrhage can be life-threatening.
3. Bowel movements should resume in 23 days after birth. A week is too long a time frame, and indicates constipation.
4. When RhoGAM is needed, it is given within 72 hours of birth, while still at the hospital.