A nurse is planning care for a client who is in labor and is requesting epidural anesthesia for pain control. Which of the following actions should the nurse include in the plan of care?

Place the client in a supine position for 30 min following the first dose of anesthetic solution.

Administer 1.000 mL of dextrose 5% in water prior to the first dose of anesthetic solution.

Monitor the client's blood pressure every minute following the first dose of anesthetic solution.

Ensure the client has been NPO 4 hr prior to the treatment of the epidural and the first dose of anesthetic solution.

Answer and Explanation

The Correct Answer is C

Choice A Reason:

Placing the client in a supine position for 30 minutes following the first dose of anesthetic solution is not a standard recommendation. The positioning during epidural placement is typically a seated or side-lying position.

Choice B Reason:

Administering 1,000 mL of dextrose 5% in water prior to the first dose of anesthetic solution is not a standard practice for epidural anesthesi

A. Fluids may be administered, but the type and volume depend on the patient's individual needs and the healthcare provider's orders.

Choice C Reason:

Monitoring the client's blood pressure every minute following the first dose of anesthetic solution is appropriate. Epidural anesthesia can potentially cause hypotension (low blood pressure), which is a common side effect. Therefore, close monitoring of the client's blood pressure is crucial, especially following the administration of the initial dose of the anesthetic solution. The goal is to promptly detect and manage any decrease in blood pressure to ensure the well-being of both the mother and the baby.

Choice D Reason:

Ensuring the client has been NPO (nothing by mouth) for 4 hours prior to the placement of the epidural and the first dose of anesthetic solution is not a specific requirement for epidural anesthesi

A. NPO status is more relevant to surgical procedures involving general anesthesia and is not typically a strict requirement for epidural placement.

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Correct Answer is B

Explanation

The correct answer is B. An excessive amount of amniotic fluid is present.

A. Polyhydramnios is primarily characterized by an increased volume of amniotic fluid, and it is not directly linked to congenital anomalies, growth restriction, or fetal distress. However, it can be associated with certain conditions that affect fetal swallowing or the production of amniotic fluid.

B. Correct. Polyhydramnios refers to an abnormal increase in the amount of amniotic fluid surrounding the fetus. This condition can result from various factors, such as fetal anomalies, maternal diabetes, or gastrointestinal malformations in the fetus that affect the swallowing of amniotic fluid.

C. An elevated level of alpha-fetoprotein (AFP) in the amniotic fluid is associated with neural

tube defects, not polyhydramnios.

D. Carrying more than one fetus (multifetal gestation) can be associated with an increased risk of polyhydramnios due to factors such as increased fetal urine production, but the presence of polyhydramnios does not necessarily indicate a multifetal pregnancy.

A. Resting tone of 15 mmHg B. Frequency of every two minutes C. intensity of 60 to 90 mmHg D. Duration of 90 to 120 seconds

Correct Answer is D

Explanation

A. Resting tone of 15 mmHg:A resting tone of 15 mmHg is generally acceptable and indicates normal uterine resting pressure, which should be between 5 and 20 mmHg.

B. Frequency of every two minutes. A frequency of every two minutes can be acceptable during labor, especially if the contractions are not too long or intense. The key consideration is the duration and intensity of the contractions.

C. Intensity of 60 to 90 mmHg: This intensity is typically acceptable for labor induction and signifies effective contractions. There’s no indication to stop oxytocin based solely on this intensity range.

D. Duration of 90 to 120 seconds:A contraction lasting 90 to 120 seconds is concerning and indicates potential uterine hyperstimulation, warranting the discontinuation of oxytocin to protect both the mother and fetus from adverse effects.

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A nurse is planning care for a client who is in labor and is requesting epidural anesthesia for pain control. Which of the following actions should the nurse include in the plan of care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who was admitted to the maternity unit at 38 weeks of gestation and who is experiencing polyhydramnios. The nurse should understand that this diagnosis means which of the following?

Correct Answer is B

Explanation

A nurse is caring for a client who is receiving oxytocin for induction of labor and has an intrauterine pressure catheter (IUPC) placed to monitor uterine contractions. For which of the following contraction patterns should the nurse discontinue the infusion of oxytocin?

Correct Answer is D

Explanation

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