A nurse is preparing a client who is in active labor for epidural analgesia. Which of the following actions should the nurse take?
Administer a 500 mL bolus of 5% dextrose in water prior to the epidural administration.
Inform the client that the anesthetic effect will last for approximately 6 hours.
Obtain a 30 min electronic fetal monitoring (EFM) strip and prepare to give a bolus of Lactated Ringers solution prior to the epidural administration.
Have the client stand very still at the bedside with her arms at her side.
The Correct Answer is C
A: Administering a 500 mL bolus of 5% dextrose in water is not necessary before the epidural administration, and it may not be recommended in active labor as it can increase the risk of fluid overload.
B: The duration of the anesthetic effect of the epidural can vary depending on the medication used, and it is not the nurse's priority during the preparation process.
C: Prior to administering epidural analgesia, the nurse should obtain a 30minute electronic fetal monitoring (EFM) strip to assess the fetal heart rate and monitor for any signs of fetal distress during the procedure.
D: Having the client stand very still with her arms at her side is not practical or necessary for epidural administration and could be uncomfortable for the client during labor.
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Related Questions
Correct Answer is C
Explanation
A. 1 cm below the umbilicus: This is too low for a client at 22 weeks of gestation.
B. 3 cm below the umbilicus: This is also too low for a client at 22 weeks of gestation.
C. 2 cm above the umbilicus: At 22 weeks of gestation, the fundus should be palpated about 2 cm above the umbilicus, which is at approximately the level of the maternal belly button.
D. 3 cm above the umbilicus: This is too high for a client at 22 weeks of gestation.
Correct Answer is D
Explanation
A) "It is used to treat genital herpes simplex virus.": This statement is incorrect. Dinoprostone (Cervidil) gel is not used to treat genital herpes simplex virus; it is used in obstetrics to ripen the cervix and prepare it for labor induction.
B) "This medicine causes relaxation of the uterine muscles.": While dinoprostone is a prostaglandin that can induce uterine contractions, its primary use in this context is cervical ripening, not uterine muscle relaxation.
C) "This medication is used to treat preeclampsia.": Dinoprostone is not used to treat preeclampsia. It is used for cervical ripening and labor induction in appropriate situations.
D) "This medication is used to ripen, or soften, the cervix.": This is the correct answer. Dinoprostone (Cervidil) gel is used to ripen the cervix, making it more favorable for labor induction, especially in cases where the cervix is not yet fully dilated or effaced.
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