Author Question: A patient in labor has been given a local anesthetic. A nurse is monitoring the patient and the ... (Read 22 times)

genevieve1028 · **on:** Jul 23, 2018

A patient in labor has been given a local anesthetic. A nurse is monitoring the patient and the fetus via a maternal-fetal monitor. Which clinical finding would the nurse anticipate in the fetus initially?

a. Tachycardia
b. Bradycardia
c. Fetal distress
d. Uterine contractility

Question 2

A nurse is assisting the physician, who is inserting a central venous access port into a patient at the bedside.

A local anesthetic is administered. Within minutes of administration of the anesthetic, the vital signs reveal a pulse of 54/minute, respirations of 18/minute, and blood pressure of 90/42. The nurse should monitor the patient for further signs of
a. heart block.
b. anaphylaxis.
c. central nervous system excitation.
d. respiratory depression.

sarahccccc · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: B
Local anesthetics can cross the placenta, causing bradycardia and central nervous system depression in the neonate.
Local anesthetics do not cause fetal tachycardia.
Local anesthetics might cause fetal distress, but this would be preceded by initial bradycardia.
Local anesthetics can depress uterine contractility and maternal expulsion effort.

Answer to Question 2

ANS: A
When absorbed in sufficient amount, local anesthetics can affect the heart and blood vessels. These drugs suppress excitability in the myocardium and conduction system and can cause hypotension, bradycardia, heart block, and potentially cardiac arrest.
Anaphylaxis would be manifested by hypotension, bronchoconstriction, and edema of the glottis.
Central nervous system excitation would be manifested by hyperactivity, restlessness, and anxiety and may be followed by convulsions.
No evidence indicates respiratory depression; this patient's respirations are within normal limits.