A nurse is caring for a client who has maternal hypotension following the placement of an epidural. Which of the following actions should the nurse take?

The correct answer is choiceB. Decreased ability to bear down.

Choice A rationale:

Fetal bradycardia is not a common adverse effect of a pudendal nerve block.This block primarily affects the mother’s pelvic region and does not typically impact fetal heart rate.

Choice B rationale:

Decreased ability to bear down is correct because the pudendal nerve block can numb the perineal area, reducing the mother’s ability to feel contractions and effectively bear down during labor.

Choice C rationale:

Maternal hypertension is not associated with pudendal nerve blocks.This block is localized and does not generally affect systemic blood pressure.

Choice D rationale:

Uterine hyperstimulation is not a known adverse effect of pudendal nerve blocks.This condition is more commonly associated with the use of labor-inducing drugs like oxytocin.

Choice A rationale:

Amniotic fluid embolism is a rare but serious complication during labor or immediately after delivery, where amniotic fluid, fetal cells, hair, or other debris enter the mother's bloodstream and cause a severe reaction. While it may present with sudden and severe symptoms, such as hypotension and respiratory distress, it does not typically cause uterine rupture.

Choice B rationale:

Uterine rupture is a life-threatening emergency that can occur during labor, especially in women with previous uterine surgeries or trauma. The sudden, severe lower abdominal pain, drop in blood pressure, cool skin, and pallor could indicate internal bleeding and shock, which are consistent with uterine rupture. Prolonged bradycardia on the fetal heart rate tracing suggests fetal distress due to compromised blood flow.

Choice C rationale:

Umbilical cord prolapse is another obstetric emergency that occurs when the umbilical cord slips through the cervix and gets compressed during labor, leading to fetal distress. It may cause variable decelerations in fetal heart rate, but it does not explain the maternal symptoms described in the scenario, such as the sudden, severe lower abdominal pain, hypotension, cool skin, and pallor.

Choice D rationale:

Placenta previa is a condition where the placenta covers part or all of the cervix, and it can lead to painless vaginal bleeding. While it can cause fetal distress, it does not explain the maternal symptoms like the sudden, severe lower abdominal pain, hypotension, cool skin, and pallor. Prolonged bradycardia on the fetal heart rate tracing is more suggestive of uterine rupture.