The nurse is monitoring a client in active labor who has an epidural in place. Which of the following findings should be reported to the anesthesiologist immediately? (Select All that Apply.)

Slurred speech

Respiratory depression

Decreased sensation in the lower extremities

Sustained fetal heart rate of 150 bpm

Blood pressure 108/62

Answer and Explanation

Correct Answer : A,B

A. Slurred speech – Slurred speech may indicate systemic absorption of the epidural medication, leading to toxicity or excessive central nervous system depression, which requires immediate intervention.

B. Respiratory depression – A serious complication of epidural anesthesia is respiratory depression, which may result from excessive medication spread, affecting respiratory function. Immediate intervention is required.

C. Decreased sensation in the lower extremities – This is an expected effect of an epidural and does not necessarily require immediate reporting unless it extends beyond expected levels.

D. Sustained fetal heart rate of 150 bpm – This fetal heart rate is within the normal range (110-160 bpm) and does not indicate distress.

E. Blood pressure 108/62 – While hypotension can be a side effect of epidural anesthesia, this blood pressure is within an acceptable range for many clients and does not require immediate intervention unless the client is symptomatic.

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Correct Answer is ["B","D","E"]

Explanation

A. Passage of fetal tissue – This finding is more consistent with an incomplete or complete abortion, not a threatened abortion.

B. Bright red vaginal bleeding – A threatened abortion involves vaginal bleeding during the first 20 weeks of pregnancy, often bright red in color. The cervix remains closed, and fetal cardiac activity may still be present.

C. Severe cramping and pelvic pain – Severe pain is more typical of an inevitable or incomplete abortion rather than a threatened abortion.

D. Closed cervix upon examination – In a threatened abortion, the cervix remains closed. If the cervix opens, the risk of progressing to an inevitable abortion increases.

E. Mild to moderate lower abdominal cramping – Mild cramping or lower abdominal discomfort is common in a threatened abortion due to uterine contractions. However, severe cramping and passage of fetal tissue would indicate a more advanced pregnancy loss.

A. The client's vaginal pH may increase during menopause B. The client's dietary habits and fluid intake C. The client's genitourinary disorder will be alleviated over time D. The client's history of sexually transmitted infections

Correct Answer is A

Explanation

A. The client's vaginal pH may increase during menopause – During menopause, estrogen levels decrease, leading to a higher vaginal pH. This disrupts the normal vaginal flora, making the client more susceptible to infections and irritation.

B. The client's dietary habits and fluid intake – While nutrition and hydration affect overall health, they are not the primary cause of menopausal vaginal symptoms and infections.

C. The client's genitourinary disorder will be alleviated over time – Without treatment (e.g., vaginal estrogen therapy or lubricants), menopausal atrophic changes usually persist or worsen, rather than resolve over time.

D. The client's history of sexually transmitted infections – While STIs can cause vaginal discomfort, the client’s symptoms are more likely due to menopausal changes rather than a past history of STIs.

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The nurse is monitoring a client in active labor who has an epidural in place. Which of the following findings should be reported to the anesthesiologist immediately? (Select All that Apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is admitted with a threatened abortion. Which assessment findings would the nurse expect? Select all that apply. (Select All that Apply.)

Correct Answer is ["B","D","E"]

Explanation

A 56-year-old menopausal woman reports to the registered nurse that she has been experiencing vaginal itching, burning, and an increase in vaginal infections over the past 3 years. What important factor should the nurse consider before responding to the client's concerns?

Correct Answer is A

Explanation

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