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The nurse is caring for a client immediately after epidural. Which of the following findings should the nurse report to the anesthesia provider?

A.

Dizziness.

B.

Blood pressure 88/52 mmHg.

C.

Pain of 1 on a 0 to 10 scale.

D.

Pulse 88 bpm.

Answer and Explanation

The Correct Answer is B

Choice A rationale

 

Dizziness can be a side effect of epidural anesthesia, but it is not as critical as hypotension. It should be monitored, but it does not require immediate reporting unless it is severe or accompanied by other symptoms.

 

Choice B rationale

 

Blood pressure of 88/52 mmHg indicates hypotension, which is a common and potentially serious side effect of epidural anesthesia. Hypotension can lead to decreased placental perfusion and fetal distress, so it requires immediate attention and reporting to the anesthesia provider.

 

Choice C rationale

 

A pain level of 1 on a 0 to 10 scale indicates that the epidural is effectively managing the client’s pain. This is a positive outcome and does not require reporting.

 

Choice D rationale

 

A pulse of 88 bpm is within the normal range for an adult and does not indicate any immediate concern that needs to be reported to the anesthesia provider.

 


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View Related questions

Correct Answer is A

Explanation

Choice A rationale

Breech presentation means the fetus’s buttocks or feet are positioned to be delivered first. Fetal heart tones are often heard above the umbilicus in this position.

Choice B rationale

Transverse lie means the fetus is lying horizontally in the uterus. Fetal heart tones would typically be heard at the sides of the abdomen.

Choice C rationale

Cephalic presentation means the fetus’s head is positioned to be delivered first. Fetal heart tones are usually heard below the umbilicus in this position.

Choice D rationale

Oblique lie means the fetus is positioned diagonally in the uterus. Fetal heart tones can be variable depending on the exact position.

Correct Answer is A

Explanation

Choice A rationale

Terbutaline is a beta-adrenergic agonist that works by relaxing the smooth muscles of the uterus, thereby reducing uterine contractions. It is commonly used in cases of tachysystole and recurrent late decelerations to decrease uterine activity and improve fetal oxygenation. Terbutaline’s mechanism of action involves stimulating beta-2 adrenergic receptors, which leads to an increase in cyclic AMP and subsequent relaxation of uterine smooth muscle.

Choice B rationale

Oxytocin is a hormone that stimulates uterine contractions and is typically used to induce or augment labor. Administering oxytocin in a situation where there is already tachysystole and recurrent late decelerations would exacerbate the problem by increasing uterine contractions, potentially leading to further fetal distress.

Choice C rationale

Misoprostol is a prostaglandin analog used to ripen the cervix and induce labor. Similar to oxytocin, it would not be appropriate in this scenario as it would increase uterine contractions, worsening the tachysystole and late decelerations.

Choice D rationale

Magnesium sulfate is primarily used as a tocolytic to prevent preterm labor and as a neuroprotective agent for the fetus in cases of preeclampsia. While it has some uterine relaxation properties, it is not the first-line treatment for reducing uterine activity in the context of tachysystole and late decelerations.

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