A nurse is collecting data from a client who is receiving epidural anesthesia.Which of the following findings indicates an adverse effect of this method of pain management?
Hypertension.
Tachypnea.
Tachycardia.
Fever.
The Correct Answer is D
Choice A rationale
Hypertension is not a common adverse effect of epidural anesthesia. In fact, epidurals can cause hypotension due to the blockade of sympathetic nerves.
Choice B rationale
Tachypnea is not typically associated with epidural anesthesia. Common side effects include low blood pressure and headache.
Choice C rationale
Tachycardia is not a common adverse effect of epidural anesthesia. More common side effects include low blood pressure and urinary retention.
Choice D rationale
Fever is a known adverse effect of epidural anesthesia. It can occur due to the body’s response to the epidural procedure.
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Correct Answer is C
Explanation
Choice A rationale
Administering NSAIDs every 4 to 6 hours is not a primary measure to prevent thrombophlebitis. NSAIDs are used for pain relief and inflammation reduction, but they do not directly prevent blood clots.
Choice B rationale
Applying elastic stockings before the client gets out of bed can help prevent blood clots by promoting blood flow in the legs. However, this measure alone is not sufficient to prevent thrombophlebitis.
Choice C rationale
Ambulation, or walking, is one of the most effective measures to prevent thrombophlebitis. It promotes circulation and prevents blood from pooling in the legs, reducing the risk of clot formation.
Choice D rationale
Applying warm, moist packs to the client’s lower legs can help relieve pain and inflammation but does not directly prevent thrombophlebitis. This measure is more supportive rather than preventive.
Correct Answer is B
Explanation
Choice A rationale
Lying in a left side-lying position for 30 minutes after meals can help reduce heartburn symptoms by preventing stomach acid from flowing back into the esophagus. However, it is not the most effective recommendation for managing heartburn during pregnancy.
Choice B rationale
Taking sips of milk between meals can help neutralize stomach acid and provide relief from heartburn. Milk can act as a buffer, reducing the acidity in the stomach and alleviating discomfort.
Choice C rationale
Eating three large meals per day can exacerbate heartburn symptoms by increasing the amount of stomach acid produced. Smaller, more frequent meals are recommended to help manage heartburn during pregnancy.
Choice D rationale
Drinking a cup of black coffee before breakfast can worsen heartburn symptoms due to its acidic nature and caffeine content. It is not recommended for individuals experiencing frequent heartburn, especially during pregnancy.