The nurse is caring for a laboring patient who is receiving ...

[APUS57]

The nurse is caring for a laboring patient who is receiving continuous epidural anesthesia via infusion. The maternal blood pressure decreases from 132/78 to 78/42. Which intervention should the nurse implement first?
 
  1. Increase the flow rate of infusion of intravenous crystalloid solution.
  2. Verify the patient is positioned to promote left uterine displacement.
  3. Administer oxygen.
  4. Administer ephedrine 5 to 10 mg intravenously.

Question 2

A laboring patient has received an order for epidural anesthesia. In order to prevent the most common complication associated with this procedure, the nurse would expect to do which of the following?
 
  1. Observe fetal heart rate variability.
  2. Rapidly infuse 5001,000 ml of intravenous fluids.
  3. Place the patient in the semi-Fowler's position.
  4. Teach the patient appropriate breathing techniques.

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Answer to Question 1

Correct Answer: 1
Rationale: If hypotension occurs secondary to epidural anesthesia, the nurse increases the IV flow rate, ensures or verifies left uterine displacement, and administers oxygen. If blood pressure is not restored in 1 to 2 minutes, ephedrine, 5 to 10 mg IV, is administered.

Answer to Question 2

Correct Answer: 2
Rationale: Administering a fluid bolus prior to an epidural generally prevents maternal hypotension, which is the most common side effect of an epidural.