Author Question: The anesthesia provider has just administered an epidural anesthetic in a laboring patient and local ... (Read 40 times)

jparksx · **on:** Jun 28, 2018

The anesthesia provider has just administered an epidural anesthetic in a laboring patient and local anesthesia is continuously infusing via the epidural catheter. Suddenly, the patient asks, Why are my ears ringing?

What is the most likely cause of the patient's complaint?
1. Hypotension
2. Allergic reaction
3. Dehydration
4. Local anesthetic toxicity

Question 2

Which of the following nursing actions can prevent or detect common side effects of epidural anesthesia?

1. Preloading the patient with a rapid infusion of IV fluids
2. Continuing the patient on p.o. fluids only to prevent hypotension
3. Monitoring the FHR for late deceleration and decrease in rate
4. Use of intermittent FHR monitoring so the patient can use the birthing ball

onowka · **Reply #1 on:** Jun 28, 2018

Answer to Question 1

Correct Answer: 4
Rationale 1: Although maternal hypotension is associated with epidural anesthesia, a sensation of ringing in the ears is associated with local anesthetic toxicity.
Rationale 2: Sensation of ringing in the ears is associated with local anesthetic toxicity.
Rationale 3: Sensation of ringing in the ears is associated with local anesthetic toxicity.
Rationale 4: Sensation of ringing in the ears is associated with local anesthetic toxicity.

Answer to Question 2

Correct Answer: 1,3
Rationale: Hypotension can be prevented by preloading with rapid IV infusion followed by continuous IV infusion. Variability of FHR and late decelerations can occur if maternal hypotension occurs. Continuing FHR monitoring is essential.