A patient who is 37 weeks pregnant and has gestational diabetes is admitted to the labor and delivery unit for induction.
The patient is placed on an external fetal monitor and receives an epidural anesthesia.Which action should the nurse take to identify a potential side effect of the epidural?
Assess the patient’s urine for acetone.
Monitor the patient’s deep tendon reflexes.
Assess the patient’s pupillary accommodation.
Monitor the patient’s blood pressure.
The Correct Answer is D
This is because epidural anesthesia can cause hypotension (low blood pressure) which can affect the placental blood flow and fetal oxygenation.
The nurse should monitor the patient’s blood pressure frequently and intervene if it drops below the baseline.
Choice A is wrong because assessing the patient’s urine for acetone is not relevant to the side effects of epidural anesthesia. Acetone in urine can indicate diabetic ketoacidosis, a complication of diabetes that occurs when the body breaks down fat for energy due to lack of insulin.
However, this is not related to epidural anesthesia.
Choice B is wrong because monitoring the patient’s deep tendon reflexes is not relevant to the side effects of epidural anesthesia. Deep tendon reflexes can be affected by magnesium sulfate, a medication used to prevent seizures in patients with preeclampsia (a condition characterized by high blood pressure and proteinuria in pregnancy).
However, this is not related to epidural anesthesia.
Choice C is wrong because assessing the patient’s pupillary accommodation is not relevant to the side effects of epidural anesthesia.
Pupillary accommodation is the ability of the eye to adjust its focus from distant to near objects. It can be impaired by drugs that affect the nervous system, such as opioids or anticholinergics.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The correct answer is choice D. Leaning slightly backwards when walking can increase the curvature of the lower spine and worsen back pain.
The other choices are helpful methods to alleviate back pain during pregnancy.
Choice A is correct because pelvic tilt exercises can strengthen the abdominal muscles and reduce the strain on the lower back.
Choice B is correct because wearing shoes with low heels can improve posture and balance and prevent excessive arching of the lower back.
Choice C is correct because sleeping on the side with a pillow beneath the knees can support the spine and pelvis and relieve pressure on the lower back.
Normal ranges for back pain during pregnancy vary depending on the individual, but some common factors that can affect it are weight gain, hormonal changes, center of gravity shift, stress and muscle separation.
Correct Answer is B
Explanation
A transverse lie means that the baby is lying sideways across the uterus, instead of head-down or breech.
This position makes vaginal delivery impossible and increases the risk of umbilical cord prolapse, which can compromise fetal oxygen supply.Therefore, a cesarean delivery is indicated for a fetus in a transverse lie.
Choice A is wrong because having extremely slender hips does not necessarily mean that a woman cannot deliver vaginally.
The size and shape of the pelvis, not the external appearance, determines the adequacy of the birth canal.A trial of labor may be attempted for women with borderline pelvic measurements.
Choice C is wrong because fetal hyperactivity is not a reason for a cesarean delivery.
Fetal movements may vary depending on the time of day, maternal activity, maternal blood sugar level, and other factors.Fetal well-being can be assessed by fetal heart rate monitoring and biophysical profile.
Choice D is wrong because having a posterior cervix does not indicate the need for a cesarean delivery.
A posterior cervix means that the cervix is tilted toward the back of the uterus, which may make cervical dilation slower and more painful.However, with adequate contractions and maternal pushing, the cervix can move to an anterior position and allow vaginal delivery.
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