The nurse is caring for a client. Which of the following findings would the nurse report to the anesthesia provider?
Pulse 88 bpm.
Pain of 1 on a 0 to 10 scale.
Blood pressure 88/52 mmHg.
Dizziness.
The Correct Answer is C
Choice A 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.
Choice B 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 C 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 D 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.
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Correct Answer is A
Explanation
Choice A rationale
This statement is incorrect. Vagus nerve stimulation actually decreases FHR variability. The vagus nerve, part of the parasympathetic nervous system, slows the heart rate and reduces variability.
Choice B rationale
This statement is correct. Baroreceptors are sensors located in blood vessels that help regulate blood pressure by detecting changes in the stretch of the vessel walls. They play a crucial role in maintaining stable blood pressure levels.
Choice C rationale
This statement is correct. The autonomic nervous system, which includes the sympathetic and parasympathetic nervous systems, controls the fetal heart rate. It regulates the balance between heart rate acceleration and deceleration.
Choice D rationale
This statement is correct. Chemoreceptors respond to changes in blood gas levels, such as oxygen and carbon dioxide. They help regulate respiratory and cardiovascular responses to maintain homeostasis.
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.