Two hours after an epidural infusion has begun, a patient ...

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Two hours after an epidural infusion has begun, a patient complains of itching on her face and neck. The nurse should:
 
  1. Remove the epidural catheter and apply a Band-Aid to the injection site.
  2. Offer the patient a cool cloth and let her know the itching is temporary.
  3. Recognize that this is a common side effect, and follow protocol for administration of diphenhydramine (Benadryl).
  4. Call the anesthesia care provider to re-dose the epidural catheter.

Question 2

The nurse is preparing an educational in-service presentation about jaundice in the newborn.
 
  What content should the nurse include in this presentation? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Physiologic jaundice occurs after 24 hours of age.
  2. Pathologic jaundice occurs after 24 hours of age.
  3. Phototherapy is required when bilirubin levels exceed 14.
  4. The need for phototherapy depends on the bilirubin level and age of the infant.
  5. Kernicterus causes irreversible neurological damage.

[Qarqy]

Answer to Question 1

3
Rationale 1: Removing the epidural catheter does not address the side effects of the medication.
Rationale 2: Using a cool cloth does not address the side effects of the medication.
Rationale 3: Itching is a side effect of the medication used for an epidural infusion. Benadryl is given to counteract the effects of the medication.
Rationale 4: The anesthesia care provider would not re-dose, as that would continue or worsen the effects of the medication.

Answer to Question 2

1,4,5
Rationale 1: Jaundice that occurs after 24 hours is physiologic.
Rationale 2: Jaundice that appears within 24 hours is pathologic.
Rationale 3: This might not be true, depending on a number of factors.
Rationale 4: Phototherapy need is determined by the bilirubin level and age of the infant.
Rationale 5: Kernicterus is the buildup of bilirubin in the gray matter cells of the brain. It causes irreversible neurological damage.