Question

The client is admitted at 39 weeks gestation for induction of labor. If the doctor uses prostaglandin gel the nurse should: ? A. Administer Stadol (butorphanol) prior to the prostaglandin gel ? B. Tell the client that the labor will be more painful ? C. Elevate the client’s hips for 30 minutes after the gel is inserted ? D. Insert a Foley catheter prior to insertion of the gel

Short answer

Answer: Elevate the client's hips for 30 minutes after the gel is inserted.

Step-by-step solution

Option A: Administer Stadol (butorphanol) prior to the prostaglandin gel#advertisement#

Although Stadol is a pain medication, administering it before applying the prostaglandin gel is not necessary, as there is no clear indication that it would be beneficial at this stage of induction. Also, we do not know the patient's overall health status or prior history of medication use. Option A is not the correct choice in this situation.

Option B: Tell the client that the labor will be more painful#advertisement#

The use of prostaglandin gel for induction of labor may cause stronger contractions than for spontaneous labor. However, the varying degrees of pain experienced during labor is an individual and subjective experience, it is important to address patient concerns and provide them with appropriate information. While it's possible the induced labor could be more painful, making this statement to the patient may increase their anxiety levels, which is not helpful in this situation. Option B is not the best choice.

Option C: Elevate the client’s hips for 30 minutes after the gel is inserted#advertisement#

Elevating the patient’s hips after inserting the prostaglandin gel can reduce the risk of the gel flowing out of the cervix and help maximize its effectiveness. It can also increase the contact of the gel with the cervix, which would be beneficial in stimulating labor. Option C is the correct choice and is part of the standard protocol for administering prostaglandin gel for induction of labor.

Option D: Insert a Foley catheter prior to insertion of the gel#advertisement#

Inserting a Foley catheter prior to applying the prostaglandin gel is not necessary, as it does not have a direct impact on the success of the induction process. In fact, the procedure may cause discomfort to the patient and harbors potential risks of inducing a urinary tract infection. A urinary catheter will be inserted only if necessary and would depend on several factors that were not presented in the exercise. Option D is not the correct choice in this situation. Therefore, the correct answer is:

Correct answer:

Option C: Elevate the client's hips for 30 minutes after the gel is inserted.

Key concepts

Prostaglandin Gel

Among the medical methods for inducing labor, prostaglandin gel is widely used to ripen the cervix and encourage contractions. It contains synthetic forms of prostaglandins, hormones that naturally help to soften and dilate the cervix.

When administering prostaglandin gel, a standard procedure is followed. After insertion of the gel into the vagina near the cervix, the nurse should instruct the patient to remain lying down, usually with their hips elevated, for about 30 minutes. This position helps the gel stay in close contact with the cervix, enhancing its absorption and effectiveness.

It's important to monitor the patient for signs of uterine hyperstimulation, such as contractions that are too strong or too frequent, as well as the fetal heart rate. By following these guidelines, healthcare providers aim to facilitate a safe and effective labor induction process.

Nursing care during Labor Induction

Effective nursing care is crucial during labor induction. Nurses play a pivotal role in managing the physical and emotional needs of the patient.

When a labor induction is ordered, the nurse should take steps to:

• Provide clear and compassionate education about the induction process and what to expect.
• Assess for potential risks associated with the induction method.
• Monitor contractions and fetal heart rate consistently to detect any complications early.
• Support the patient's comfort with pain management strategies as needed.
• Encourage the patient to assume positions that aid in advancing labor, such as walking or using a birthing ball, if appropriate.

Patient advocacy is also a vital aspect of nursing care. Nurses should ensure informed consent is obtained, address concerns, and facilitate communication between the patient and the healthcare team.

NCLEX-PN Exam Preparation

Preparing for the NCLEX-PN exam, which is required for practical nursing licensure, involves a thorough study of various nursing concepts, including labor induction and obstetric care.

To effectively prepare, students should:

• Understand the indications, methods, and complications of labor induction.
• Review clinical protocols for administrating medications like prostaglandin gel.
• Master the nuances of nursing care before, during, and after labor induction.
• Ensure familiarity with patient communication and documentation requirements.

Practice questions and simulations of labor induction scenarios are beneficial in consolidating knowledge and building the confidence needed to handle such questions on the exam. Students should study from reliable sources and consider joining a study group or seeking help from an instructor if they find certain topics challenging.