The laboring patient has rated her pain at 9 on a scale of 1–10, and she requests IV pain medication

Question

She has refused epidural anesthesia, but her certified nurse-midwife (CNM) has ordered butorphanol tartrate (Stadol) for administration to the patient. Which action should the nurse complete next?
1. Advise the woman as to the actions and contraindications associated with butorphanol tartrate and obtain her consent for administration of the medication.
2. Offer the woman epidural anesthesia once more and describe the effectiveness of this method of labor pain control.
3. Obtain maternal vital signs and assess the fetal heart rate (FHR).
4. Administer oxygen via face mask at 6 to 10 liters per minute.

Answer 1

Correct Answer: 1
Rationale 1: Prior to administration of medication, the nurse must explain the pharmacologic effects of the medication and obtain consent for administration.
Rationale 2: The woman has refused epidural anesthesia but is authorized to receive butorphanol tartrate. The nurse's next step is to advise the woman as to the actions and contraindications associated with butorphanol tartrate and obtain her consent for administration of the medication.
Rationale 3: Prior to obtaining maternal vital signs and assessing FHR, the nurse should advise the woman as to the actions and contraindications associated with butorphanol tartrate and obtain her consent for administration of the medication.
Rationale 4: Routine oxygen administration is not indicated for administration of butorphanol tartrate to an asymptomatic patient in labor. The nurse's next step is to advise the woman as to the actions and contraindications associated with butorphanol tartrate and obtain her consent for administration of the medication.