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 D
Explanation
Choice A rationale
A BP of 132/84 mm Hg is within the normal range for a pregnant woman and does not require immediate reporting.
Choice B rationale
A weight gain of 1 kg (2.2 lb) in one month is within the expected range for a pregnant woman at 26 weeks gestation.
Choice C rationale
Pedal edema is a common symptom in pregnancy and is usually not a cause for concern unless accompanied by other symptoms.
Choice D rationale
Double vision is a concerning symptom that could indicate a serious condition such as preeclampsia. It should be reported to the provider immediately.
Correct Answer is D
Explanation
Choice A rationale
Assessing the client’s socioeconomic status is important but not the primary action the nurse should take in the maternal newborn unit. The focus should be on providing unbiased teachings based on the client’s needs.
Choice B rationale
Collecting a dietary history is important but not the primary action the nurse should take in the maternal newborn unit. The focus should be on providing unbiased teachings based on the client’s needs.
Choice C rationale
Determining the best method of contraception for the client is important but not the primary action the nurse should take in the maternal newborn unit. The focus should be on providing unbiased teachings based on the client’s needs.
Choice D rationale
Performing unbiased teachings based on the client’s needs is the primary action the nurse should take in the maternal newborn unit. This ensures that the client receives accurate and relevant information tailored to their specific situation.