How it Works
Try Naxlex NCLEX-RN (Free-Trial)

A nurse is caring for a 26-year-old gravida 2 para 1 client in the labor and delivery unit.

Exhibits
Click to indicate which interventions the nurse would include in the plan of care to support the expected outcomes of adequate epidural anesthesia on the mother and the fetus. Each column must have at least one response selected.

A.

Assisting with pushing efforts

B.

Administering bolus fluids

C.

Monitoring blood pressure

D.

Administering IV fluids

E.

Side positioning

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"A,B"},"D":{"answers":"A"},"E":{"answers":"A,B"}}

Interventions

Support Epidural Anesthesia for Mother

Support Epidural Anesthesia for Fetus

Assisting with pushing efforts

✓

  

Administering bolus fluids

✓

  

Monitoring blood pressure

✓

✓

Administering IV fluids

✓

  

Side positioning

✓

✓


Assisting with pushing efforts:

  • Goal: Support Epidural Anesthesia for Mother
  • Reason: Epidural anesthesia can diminish the mother's ability to feel the urge to push during labor. Assisting with pushing efforts helps ensure effective delivery and supports the mother's ability to participate actively in the birthing process.

Administering bolus fluids:

  • Goal: Support Epidural Anesthesia for Mother
  • Reason: Administering bolus fluids can help prevent hypotension, a common side effect of epidural anesthesia. Ensuring adequate fluid volume maintains blood pressure and supports overall maternal hemodynamic stability.

Monitoring blood pressure:

  • Goal: Support Epidural Anesthesia for Mother and Fetus
  • Reason: Continuous monitoring of blood pressure is essential to detect and manage hypotension, ensuring both maternal and fetal well-being. It helps maintain adequate blood flow to the uterus and placenta, optimizing fetal perfusion.

Administering IV fluids:

  • Goal: Support Epidural Anesthesia for Mother
  • Reason: Administering IV fluids helps maintain hydration and blood pressure, counteracting the potential hypotensive effects of epidural anesthesia. It supports the mother's hemodynamic stability during labor.

Side positioning:

  • Goal: Support Epidural Anesthesia for Mother and Fetus
  • Reason: Side positioning optimizes uteroplacental blood flow and reduces the risk of aortocaval compression by the gravid uterus. It ensures better fetal perfusion and maternal comfort while receiving epidural anesthesia.


Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Free Nursing Study Resources

Related Questions

Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"E"}

Explanation

Epidural anesthesia can cause vasodilation and a resultant drop in blood pressure, hence the importance of close monitoring and IV fluid administration to maintain blood pressure levels.

Risk Factors:

  1. Peripheral vasodilation: This is related to the relaxation of blood vessels, which can lead to a drop in blood pressure (hypotension). It is not a direct risk on its own but a cause of hypotension.
  2. Hypotension: This is the correct answer. Epidural anesthesia can cause a significant drop in blood pressure due to vasodilation.
  3. Urinary retention: This can occur with epidural anesthesia as the sensation to urinate may be diminished, causing the bladder to fill and potentially lead to bladder distention and discomfort.
  4. Fluid overload: This is less commonly associated with epidural anesthesia. It is typically related to excessive intravenous fluid administration.

Causes:

  1. Inadequate pain relief: This would not directly cause the issues mentioned above but would indicate that the epidural is not effectively managing the client's pain.
  2. Decreased fetal heart rate: This can be a consequence of maternal hypotension, which reduces blood flow to the placenta.
  3. Full urinary bladder: This can be a result of urinary retention due to the effects of the epidural, but it is not a direct cause of hypotension.
  4. Inability to push: This can occur with epidural anesthesia as it may decrease the ability to feel contractions and effectively push during delivery, but it is not related to hypotension.

Correct Answer is ["A","B","C","D"]

Explanation

Choice A rationale

Rechecking all vital signs, including core temperature, is essential to assess the client's overall status and identify any changes that may indicate a worsening condition or complications such as infection.

Choice B rationale

Applying oxygen via nasal prongs at 4 L/minute helps ensure adequate oxygenation, which is crucial for patients who may be experiencing postoperative complications, including fever and increased metabolic demand.

Choice C rationale

Continuing to monitor vital signs every hour is important to detect any further changes in the patient's condition and provide timely interventions if needed. Frequent monitoring allows for close observation of trends.

Choice D rationale

Exposing the client's extremities and applying ice packs to the axilla can help reduce fever by promoting heat loss. This intervention is beneficial in managing elevated body temperature and preventing complications associated with hyperthermia.

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

Register