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 A

Explanation

Choice A Reason:

Bilirubin 9 mg/dL is correct. A bilirubin level of 9 mg/dL in a newborn, especially at 4 hours old, is elevated and needs prompt attention. High bilirubin levels in newborns can be indicative of jaundice, and severe jaundice may lead to complications such as kernicterus. Monitoring and managing bilirubin levels are crucial to prevent potential neurologic damage.

Choice B Reason:

Hemoglobin 15 g/dL is incorrect. This hemoglobin level is within the normal range for a newborn. It's important to note that newborns often have higher hemoglobin levels shortly after birth, and this value is consistent with normal physiological ranges.

Choice C Reason:

Platelets 175,000/mm³ is incorrect. A platelet count of 175,000/mm³ is within the normal range for a newborn. There is no immediate concern based on this platelet count.

Choice D Reason:

Hematocrit 45% is incorrect. A hematocrit level of 45% is within the normal range for a newborn. Like hemoglobin, hematocrit levels can be higher in newborns shortly after birth, and this value falls within the expected range.

A. Insert the syringe tip before compressing the bulb. B. Suction each of the nares before suctioning the mouth. C. insert the tip of the syringe into the center of the newborn's mouth. D. Stop suctioning when the newborn's cry sounds clear

Correct Answer is D

Explanation

The correct answer is D.

A. Insert the syringe tip before compressing the bulb: This is incorrect. The nurse should compress the bulb syringe first, then gently insert the tip into the newborn's nose, and then release the bulb to create suction for removing the mucus.

B.The client should suction the mouth first then the nares.

C. Insert the tip of the syringe into the center of the newborn's mouth: This is incorrect. The tip of the bulb syringe should be inserted into the side of the baby's mouth to avoid causing discomfort or stimulating the gag reflex.

D. When the newborn's cry may sound clear due to vocalization, but this may indicate that the airways are clear of secretions.

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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

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Correct Answer is D

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