The perinatal nurse prepares to assess the labor of a patient who ...

[pane00]

The perinatal nurse prepares to assess the labor of a patient who is in the triage area with her partner. She is contracting every 5 to 7 minutes and is very fearful about going home due to extreme fatigue and the distance to her house.
 
  The perinatal nurse determines that the patient is a fingertip dilated and50 effaced, and the cervix is anterior. The nurse might anticipate an order for what medication?
  A.
  Diphenhydramine (Benadryl)
  B.
  Lorazepam (Ativan)
  C.
  Promethazine (Phenergan)
  D.
  Secobarbitol sodium (Seconal)

Question 2

A woman is being prepared for an elective cesarean birth. The perinatal nurse assists the anesthesiologist with the spinal block and then positions the patient in a supine position.
 
  The patient's blood pressure drops to 90/52 mm Hg and there is a decrease in the fetal heart rate to 110 beats/minute. Which response by the nurse is best?
  A.
  Administer naloxone (Narcan) per protocol.
  B.
  Discontinue the patient's intravenous infusion.
  C.
  Have ephedrine ready for administration.
  D.
  Place a wedge under the patient's left hip.

[moormoney]

Answer to Question 1

ANS: D
Secobarbital is the most commonly used barbiturate in labor. It is a fast-acting oral agent that produces mild sedation within 15 minutes following administration, and its effects last for 3 to 4 hours. For this woman, who is not yet ready for admission and exhausted, prescribed rest would be of benefit.

Answer to Question 2

ANS: D
In the event of severe maternal hypotension, the nurse should place the patient in a lateral position or use a wedge under the hip to displace the uterus, elevate the legs, maintain or increase the IV infusion rate, and administer oxygen by face mask at 10 to 12 L/min, or according to institution protocol. Narcan is used to reverse the effects of opioids. Ephedrine would be the drug of choice for refractory hypotension if other measures don't work. The IV would not be discontinued.

[pane00]

Thanks for the timely response, appreciate it

[bulacsom]

Excellent