Meperidine (Demerol), 50 mg IV, has been ordered for a laboring ...

[ericka1]

Meperidine (Demerol), 50 mg IV, has been ordered for a laboring patient. The patient is contracting every 3 minutes, with a duration of 45 to 60 seconds. What is the nurse's best plan for administering the IV medication?
 
  a. Inject the medication between two contractions.
  b. Inject the medication during and after a single contraction.
  c. Inject the medication at the start of the next two contractions.
  d. Inject the medication throughout the duration of a single contraction.

Question 2

A multipara's labor plan includes the use of jet hydrotherapy during the active phase of labor. What is the priority patient assessment prior to assisting the patient with this request?
 
  a. Maternal pulse
  b. Maternal temperature
  c. Maternal blood pressure
  d. Maternal blood glucose level

[medine]

Answer to Question 1

ANS: C
The suggested administration of IV Demerol is 25 mg/min and therefore will need to be administered over the course of two contractions. Opioid analgesics are given in small frequent doses by the IV route during labor to provide a rapid onset of analgesia and predictable duration of action. The woman will benefit from rapid pain control, with less likelihood of neonatal respiratory depression. Starting the injection at the beginning of the contraction, when blood flow to the placenta is normally reduced, limits transfer to the fetus. When placental blood flow resumes, more of the drug is in maternal tissues.

Answer to Question 2

ANS: B
A shower, tub bath, or whirlpool bath is relaxing and provides thermal stimulation. Several studies have shown benefits of water therapy during labor, including immersion in a tub or whirlpool (jet hydrotherapy, or Jacuzzi). The major concern about immersion therapy has been newborn and postpartum maternal infections caused by microorganisms in the water. Infections can be caused by the woman's own ascending vaginal bacteria or by preexisting organisms in an improperly cleaned tub. However, several studies have not found a significant association between newborn or postpartum maternal infections and the use of immersion hydrotherapy with proper cleaning.

[ericka1]

TYSM

[T4T]

Excellent