Becky is in early labor and you are discussing what type of pain relief options she is considering. She states that she wants an epidural "no matter what!" Your best response is:
1. "I'll make sure that you get your epidural.".
2. "You can have an epidural only if your doctor allows it.".
3. "You can have an epidural only if you are going to deliver vaginally.".
4. "The type of analgesia or anesthesia to be used is determined in part by the stage of your labor and the method of birth.".
4
1. Incorrect. A plan of care is developed for each woman to address her particular clinical and nursing problems. The nurse collaborates with the primary health care provider and la-boring woman in selecting those aspects of care relevant to the woman and her family. The decision to use an epidural for laboring pain relief is multifactorial. A blanket statement should not be made to guarantee the patient one kind of pharmacologic option versus another until a complete history and physical examination are obtained.
2. Incorrect. A physician's order is required for pharmacologic pain management options. However, this is not the nurse's best response.
3. Incorrect. An epidural is an effective pharmacologic pain management option for many laboring women. It can also be used for anesthesia control if a woman is to undergo an oper-ative delivery.
4. Correct. Generally, pharmacologic measures for pain relief are not implemented until labor has advanced to the active phase of the first stage of labor and the cervix is dilated ap-proximately 4 to 5 cm to avoid suppressing the progress of labor.
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