A client is receiving an epidural anesthesia during labor. Which observation is the most important adverse effect that the practical nurse (PN) should assess for following the administration of the epidural?
Maternal hypotension.
A vaginal hematoma.
A continuous headache.
Urinary retention.
The Correct Answer is A
A. Maternal hypotension is a significant adverse effect of epidural anesthesia that can lead to decreased uterine blood flow and fetal distress. Monitoring for hypotension is critical to ensure both maternal and fetal well-being.
B. While a vaginal hematoma is a potential complication, it is less immediately associated with the administration of epidural anesthesia compared to hypotension.
C. A continuous headache could indicate post-dural puncture but is less common and not the primary immediate concern compared to hypotension following an epidural.
D. Urinary retention can occur with epidural anesthesia, but maternal hypotension is a more urgent and significant immediate concern.
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Related Questions
Correct Answer is B
Explanation
A. Assisting a client with urinary urgency and incontinence with a bedpan is a basic care task that the UAP can perform under supervision.
B. A client with continuous urinary bladder irrigation via a 3-way catheter requires tasks that involve monitoring and potentially troubleshooting the system, which are within the PN's scope of practice and not appropriate for a UAP.
C. Changing a urinary condom catheter is a routine task that can be performed by a UAP, as it does not require complex decision-making or assessment skills.
D. Managing a full urinary bedside drainage unit after receiving a diuretic is a task that the UAP can handle as long as there are no specific complications or concerns to address.
Correct Answer is B
Explanation
A. Turning on the infant warmer is a necessary step but comes after confirming that the infant is actually being born. The immediate priority is to assess the situation to ensure the health and safety of both the mother and baby.
B. Pushing the call light alerts other healthcare professionals that immediate assistance is needed. Given that the baby is crying, it suggests that the birth may have occurred unexpectedly, and help is required to manage the situation safely.
C. Notifying a healthcare provider is essential, but the PN should first verify the situation to provide accurate information and context for the healthcare provider's arrival.
D. Inspecting the perineum is important to assess for any complications or to check if delivery has occurred. However, this action should follow ensuring that help is called and that the environment is safe for both mother and baby. The primary focus should be on ensuring that assistance is on the way before performing an assessment.
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