A nurse is caring for a client who received epidural anesthesia during hip surgery. Which of the following manifestations should the nurse monitor as an adverse reaction?

Severe headache

Rapid rise in temperature

Hypertension

Tachycardia

Answer and Explanation

The Correct Answer is A

A. Severe headache can result from epidural anesthesia due to post-dural puncture headache caused by leakage of cerebrospinal fluid.

B. Rapid rise in temperature may indicate infection but is not a common reaction to epidural anesthesia.

C. Hypertension is not a common adverse effect of epidural anesthesia; in fact, hypotension is more typical due to sympathetic blockade.

D. Tachycardia is not a typical adverse reaction, and the most likely response to epidural anesthesia is bradycardia due to autonomic blockade.

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Correct Answer is C

Explanation

A. Administering a PCA dose prior to dressing changes is appropriate for managing pain before potentially painful activities.

B. Ambulating with the PCA pump is acceptable, as long as the client is not disconnected and it does not interfere with the pump's function.

C. Requesting a partner to administer PCA doses is incorrect because only the patient should administer PCA doses to prevent overmedication and to ensure that the client is aware of their pain level.

D. Administering PCA doses as soon as pain returns is appropriate as long as the client follows the prescribed timing for PCA use.

A. Heart rate 112/min B. Blood pressure 108/60 mm Hg C. Temperature 38.3° C (101° F) D. Respiratory rate 14/min

Correct Answer is A

Explanation

A. Albuterol, a beta2-adrenergic agonist, can cause tachycardia as an adverse effect due to systemic absorption and stimulation of beta1 receptors at higher doses.

B. BP of 108/60 mm Hg is within normal limits and not indicative of an adverse effect.

C. A mild fever is not commonly associated with albuterol use and may reflect an underlying condition, not the medication.

D. A respiratory rate of 14/min is normal and does not indicate an adverse response.

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A nurse is caring for a client who received epidural anesthesia during hip surgery. Which of the following manifestations should the nurse monitor as an adverse reaction?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is A

Explanation

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