A nurse is caring for a client who is in labor and just received epidural anesthesia. The client's blood pressure is 90/50 mm Hg.
Which of the following actions should the nurse take?
Initiate an amnioinfusion for the client.
Turn the client onto their side.
Monitor the client's blood pressure every 15 min.
Administer naloxone to the client.
The Correct Answer is B
It’s normal for blood pressure to fall a little when a client receives an epidural.
If necessary, fluids and medicine can be given through a drip to keep blood pressure normal.
Choice A) is not correct because initiating an amnioinfusion is not mentioned as an immediate intervention for low blood pressure after epidural anesthesia .
Choice C) is not correct because monitoring the client’s blood pressure every 15 min is not mentioned as an immediate intervention for low blood pressure after epidural anesthesia .
Choice D) is not correct because administering naloxone to the client is not mentioned as an immediate intervention for low blood pressure after epidural anesthesia .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
It is important for the nurse to verify that informed consent has been obtained before administering any medication or treatment.
Choice B is incorrect because there is no need for the client to avoid urinary elimination prior to administration of a dinoprostone insert.
Choice C is incorrect because there is no need to allow the medication to reach room temperature prior to administration.
Choice D is incorrect because there is no need for the client to be placed in a semi-Fowler’s position after administration of a dinoprostone insert.
Correct Answer is C
Explanation
A newborn who is 10 hr old and has onset tachypnea.
Tachypnea means rapid breathing and can be a sign of respiratory distress.
Transient tachypnea of the newborn (TTN) is a respiratory disorder usually seen shortly after delivery in babies who are born near or at term.
It is important for the nurse to assess this newborn first to determine the cause of the tachypnea and provide appropriate care.
Choice A, a newborn who is 24 hr old and has not had a meconium stool, may
require further assessment but is not as urgent as a newborn with tachypnea.
Choice B, a newborn who has a short frenulum and is having difficulty breastfeeding, may require assistance with feeding but is not as urgent as a newborn with tachypnea.
Choice D, a newborn who is 30 hr old and has blood-tinged discharge in her diaper, may have pseudomenstruation which is normal and not a cause for concern.
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