A nurse is caring for a client who is in labor and just received epidural anesthesia. The client's blood pressure is 90/50 mm Hg. Which of the following actions should the nurse take?

Turn the client onto their side.

Initiate an amnio-infusion for the client.

Administer naloxone to the client.

Monitor the client's blood pressure every 15 min.

Answer and Explanation

The Correct Answer is A

Epidural anesthesia can cause hypotension in the mother, which can decrease blood flow to the fetus. Turning the client onto their side can help to improve blood flow to the fetus by reducing the pressure of the uterus on the vena cava and increasing venous return to the heart.

Option B is incorrect because an amnio-infusion is not indicated for hypotension related to epidural anesthesia.

Option C is also incorrect because naloxone is a medication used to reverse the effects of opioid medications and would not be appropriate for treating hypotension related to epidural anesthesia.

Option D is partially correct but does not address the immediate need to improve blood flow to the fetus. The nurse should monitor the client's blood pressure regularly but should also take immediate action to turn the client onto their side to improve blood flow.

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Correct Answer is A

Explanation

An episiotomy is a surgical incision made in the perineum to enlarge the vaginal opening during delivery. A midline episiotomy is an incision made in the midline of the perineum, which has been associated with a higher risk of infection than a mediolateral episiotomy.

Option B is incorrect because meconium-stained fluid does not necessarily place the postpartum client at increased risk for infection. However, it can indicate that the fetus was stressed during delivery and may require additional monitoring after birth.

Option C is also incorrect because gestational hypertension, while it can lead to complications during pregnancy and delivery, does not necessarily place the postpartum client at increased risk for infection.

Option D is also incorrect because placenta previa is a condition in which the placenta is low-lying and can partially or completely cover the cervix. It can cause bleeding during pregnancy and delivery but does not necessarily place the postpartum client at increased risk for infection.

A. Pregnancy induced hypertension B. Retained placental fragments C. Oligohydramnios D. Meconium stained fluid

Correct Answer is B

Explanation

Retained placental fragments is a risk factor for postpartum hemorrhage. When placental fragments remain in the uterus, they prevent the uterus from contracting down and can cause significant bleeding. Pregnancy-induced hypertension, oligohydramnios, and meconium-stained fluid are not considered risk factors for postpartum hemorrhage.

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A nurse is caring for a client who is in labor and just received epidural anesthesia. The client's blood pressure is 90/50 mm Hg. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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