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?
Position the client in a knee-chest position.
Administer a bolus infusion of lactated Ringer's.
Give terbutaline subcutaneously.
Apply oxygen via a nonrebreather face mask at 2 L/min.
The Correct Answer is B
The correct answer is choice B: Administer a bolus infusion of lactated Ringer’s.
Choice A rationale:
Positioning the client in a knee-chest position is not the standard intervention for maternal hypotension following epidural placement. This position is more commonly associated with cord prolapse or to relieve pressure on the vena cava.
Choice B rationale:
Administering a bolus infusion of lactated Ringer’s is the correct action. Hypotension during epidural analgesia is treated with additional intravenous boluses of crystalloid solution. This helps to increase the circulating blood volume and counteract the vasodilation caused by the epidural.
Choice C rationale:
Terbutaline is a medication used to relax the uterus and prevent premature labor, not for treating hypotension.
Choice D rationale:
Applying oxygen via a nonrebreather face mask at 2 L/min is not the primary treatment for maternal hypotension. Oxygen may be used as a supportive measure if there is evidence of fetal distress or maternal hypoxemia, but the first line of treatment for hypotension is fluid administration.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale:
Levothyroxine is not a medication used to treat gestational diabetes mellitus. Levothyroxine is a synthetic thyroid hormone used to treat hypothyroidism, which is a different medical condition.
Choice B rationale:
Nifedipine is a calcium channel blocker primarily used to manage hypertension and angina. It is not indicated for the treatment of gestational diabetes mellitus.
Choice C rationale:
Chlorpromazine is an antipsychotic medication used to treat conditions like schizophrenia and bipolar disorder. It has no role in the treatment of gestational diabetes mellitus.
Choice D rationale:
Glyburide is the correct medication to expect for administering to a client with gestational diabetes mellitus. Glyburide is an oral antidiabetic agent that helps lower blood glucose levels by increasing insulin secretion from the pancreas. It is often used when dietary and lifestyle modifications are not sufficient in managing gestational diabetes. However, it is essential to follow healthcare provider guidelines and closely monitor the client's blood glucose levels while on this medication. In some cases, insulin may be required if glyburide alone is inadequate in controlling blood sugar levels.
Correct Answer is D
Explanation
Choice A rationale:
Intense contractions lasting 45 to 60 seconds are normal during labour and indicate effective uterine activity. This finding does not warrant immediate reassessment.
Choice B rationale:
Progressive sacral discomfort during contractions can be a normal part of labour as the baby descends into the birth canal. It does not necessarily indicate a need for reassessment.
Choice C rationale:
A sense of excitement and warm, flushed skin can be a common emotional and physiological response during labour, particularly as the woman reaches the final stages of delivery. This finding does not necessarily require immediate reassessment.
Choice D rationale:
"An urge to have a bowel movement during contractions”. is the correct answer because it could be an indication that the client is experiencing the urge to push, which means the baby's head is descending and nearing delivery. The nurse should reassess the client promptly to determine if she is fully dilated and ready to push.
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