Author Question: A laboring woman received an opioid agonist (meperidine) intravenously 90 minutes before she gave ... (Read 148 times)

gonzo233 · **on:** Jun 28, 2018

A laboring woman received an opioid agonist (meperidine) intravenously 90 minutes before she gave birth. Which medication should be available to reduce the postnatal effects of Demerol on the neonate?

a. Fentanyl (Sublimaze) c. Naloxone (Narcan)
b. Promethazine (Phenergan) d. Nalbuphine (Nubain)

Question 2

Nursing care measures are commonly offered to women in labor. Which nursing measure reflects application of the gate-control theory?

a. Massaging the woman's back
b. Changing the woman's position
c. Giving the prescribed medication
d. Encouraging the woman to rest between contractions

tanna.moeller · **Reply #1 on:** Jun 28, 2018

Answer to Question 1

ANS: C
An opioid antagonist can be given to the newborn as one part of the treatment for neonatal narcosis, which is a state of central nervous system (CNS) depression in the newborn produced by an opioid. Opioid antagonists such as naloxone (Narcan) can promptly reverse the CNS depressant effects, especially respiratory depression. Fentanyl, promethazine, and nalbuphine do not act as opioid antagonists to reduce the postnatal effects of Demerol on the neonate. Although meperidine (Demerol) is a low-cost medication and readily available, the use of Demerol in labor has been controversial because of its effects on the neonate.

Answer to Question 2

ANS: A
According to the gate-control theory, pain sensations travel along sensory nerve pathways to the brain, but only a limited number of sensations, or messages, can travel through these nerve pathways at one time. Distraction techniques such as massage or stroking, music, focal points, and imagery reduce or completely block the capacity of nerve pathways to transmit pain. These distractions are thought to work by closing down a hypothetic gate in the spinal cord and thus preventing pain signals from reaching the brain. The perception of pain is thereby diminished. Changing the woman's position, giving prescribed medication, and encouraging rest do not reduce or block the capacity of nerve pathways to transmit pain using the gate-control theory.