A woman has requested an epidural for her pain. She is 5 cm ...

[piesebel]

A woman has requested an epidural for her pain. She is 5 cm dilated and 100 effaced. The baby is in a vertex position and is engaged. The nurse increases the woman's intra-venous fluid for a preprocedural bolus.
 
  She reviews her laboratory values and notes that the woman's hemoglobin is 12 g/dl, hematocrit is 38, platelets are 67,000, and white blood cells (WBCs) are 12,000/mm3 . Which factor would contraindicate an epidural for the woman? a. She is too far dilated.
  b. She is anemic.
  c. She has thrombocytopenia.
  d. She is septic.

Question 2

Which of the following is the priority nursing intervention for a stable infant who has supraventricular tachycardia?
 
  1. Application of ice to the face
  2. Administration of intravenous adenosine (Adenocard)
  3. Administration of intravenous amiodarone (Cordarone)
  4. Preparation for cardioversion

[Swizqar]

Answer to Question 1

C

Feedback
A Typically epidural analgesia/anesthesia is used in the laboring woman when a regular labor pattern has been achieved, as evidenced by progressive cervical change.
B The laboratory values show that the woman's hemoglobin and hematocrit are in the normal range.
C The platelet count indicates thrombocytopenia (low platelets), which is a con-traindication to epidural analgesia/anesthesia.
D The laboratory values show a slight increase in the WBC count; this is not un-common in laboring women.

Answer to Question 2

1
Rationale:
1. Supraventricular tachycardia episodes initially are treated with vagal maneuvers to slow the heart rate when the infant is stable. In infants, the application of ice or iced saline solution to the face can reduce the heart rate. Adenosine or amiodarone may be given when the vagal maneuvers are unsuccessful.
2. Supraventricular tachycardia episodes initially are treated with vagal maneuvers to slow the heart rate when the infant is stable. In infants, the application of ice or iced saline solution to the face can reduce the heart rate. Adenosine may be given when the vagal maneuvers are unsuccessful.
3. Supraventricular tachycardia episodes initially are treated with vagal maneuvers to slow the heart rate when the infant is stable. In infants, the application of ice or iced saline solution to the face can reduce the heart rate. Amiodarone may be given when the vagal maneuvers are unsuccessful
4. Cardioversion is used in an urgent situation.

[piesebel]

Thank you

[Swizqar]

Happy to help you