A nurse in assessing a client who is in labor and has received epidural analgesia. Which of the following findings should the nurse recognize and document as an adverse effect of epidural analgesia?

A. The client’s fundus is firm and midline: Oxytocin is commonly administered in the third stage of labor to promote uterine contraction and prevent postpartum hemorrhage. A therapeutic effect of oxytocin is the firm and midline positioning of the uterus, indicating effective contraction and the prevention of excessive bleeding.

B. The client’s umbilical cord lengthens: The lengthening of the umbilical cord is not an expected therapeutic effect of oxytocin administration. Oxytocin primarily affects uterine contractions.

C. The client reports a feeling of vaginal fullness: A feeling of vaginal fullness is not a typical therapeutic effect of oxytocin administration. It may be associated with other factors, such as the presence of blood clots or retained placental fragments, and should be further assessed.

D. The client saturates a perineal pad in 1 hour: Saturating a perineal pad in 1 hour is not an expected therapeutic effect of oxytocin. Excessive bleeding or saturation of perineal pads may be a sign of postpartum hemorrhage and requires immediate attention.

A. Fetal heart rate 152/min: Fetal heart rate is not typically considered an adverse effect of epidural analgesia. The focus of epidural analgesia is on providing pain relief for the mother rather than directly affecting the fetal heart rate.

B. Hypotension: Hypotension (low blood pressure) is a common adverse effect of epidural analgesia. Epidural anesthesia can cause vasodilation, leading to a decrease in blood pressure. The nurse should monitor the client's blood pressure closely and administer interventions as needed, such as IV fluids or medications to address hypotension.

C. Polyuria: Polyuria (excessive urination) is not a direct adverse effect of epidural analgesia. Epidural analgesia primarily affects pain sensation rather than urinary function.

D. Maternal temperature of 37.4 C (99.4 F): A slightly elevated maternal temperature is not a common adverse effect of epidural analgesia. However, the nurse should monitor for signs of infection or other complications and report any significant temperature changes to the healthcare provider.