The nurse is providing care to a patient in the active phase of the first stage of labor. The patient is crying out loudly with each contraction. What is the nurse's priority action for this patient?
a. Ask the patient's labor coach if this is a usual expression of pain for her.
b. Refer to the patient's chart to determine any orders for pain medication.
c. Tell the patient that she is disturbing the other laboring patients on the unit.
d. Encourage the patient to try to suppress her noisiness during contractions.
ANS: A
Women should be encouraged to express themselves in any way they find comforting, and the diversity of their expressions must be respected. Loud and vigorous expression may be a woman's personal pain coping mechanism, whereas a quiet woman may need medication relief but feels the need to remain stoic. Accepting a woman's individual response to labor and pain promotes a therapeutic relationship. Restraint is difficult because noisy women are challenging to work with and may disturb others.
You might also like to view...
The terminally ill client states to the nurse, "I'm just not ready to go." The most appropriate response by the nurse would be:
a. Tell me more about what you mean when you say that you're not ready. b. You're not ready to go where? c. Oh, there's really nothing to be afraid of, dying is a natural process. d. I can understand that. Most people don't want to die.
The nurse at the prenatal clinic has four calls to return. Which phone call should the nurse return first?
1. Client at 32 weeks, reports headache and blurred vision. 2. Client at 18 weeks, reports no fetal movement in this pregnancy. 3. Client at 16 weeks, reports increased urinary frequency. 4. Client at 40 weeks, reports sudden gush of fluid and contractions.
During a well-child visit with a 4-year-old girl the nurse notes that the parents speaks harshly to the child and used negative remarks when speaking with the nurse. Which statement by the nurse would be beneficial in this situation?
1. "Perhaps you should leave the room so that I can speak with your child privately." 2. "I am going to refer you for counseling since your interactions with your child seem so negative." 3. Addressing the child, the nurse says, "Are you unhappy when mommy talks to you like this?" 4. "Let's talk privately. We should discuss the way you speak with your child and possible ways to be more positive."
Which of the following positions maximizes the nurse's ability to assess the client's upper body for symmetry?
a. Sitting b. Supine c. Prone d. Dorsal recumbent