A patient who is 37 weeks pregnant and has gestational diabetes is admitted to the labor and delivery unit for induction.
The patient is placed on an external fetal monitor and receives an epidural anesthesia.Which action should the nurse take to identify a potential side effect of the epidural?
Assess the patient’s urine for acetone.
Monitor the patient’s deep tendon reflexes.
Assess the patient’s pupillary accommodation.
Monitor the patient’s blood pressure.
The Correct Answer is D
This is because epidural anesthesia can cause hypotension (low blood pressure) which can affect the placental blood flow and fetal oxygenation.
The nurse should monitor the patient’s blood pressure frequently and intervene if it drops below the baseline.
Choice A is wrong because assessing the patient’s urine for acetone is not relevant to the side effects of epidural anesthesia. Acetone in urine can indicate diabetic ketoacidosis, a complication of diabetes that occurs when the body breaks down fat for energy due to lack of insulin.
However, this is not related to epidural anesthesia.
Choice B is wrong because monitoring the patient’s deep tendon reflexes is not relevant to the side effects of epidural anesthesia. Deep tendon reflexes can be affected by magnesium sulfate, a medication used to prevent seizures in patients with preeclampsia (a condition characterized by high blood pressure and proteinuria in pregnancy).
However, this is not related to epidural anesthesia.
Choice C is wrong because assessing the patient’s pupillary accommodation is not relevant to the side effects of epidural anesthesia.
Pupillary accommodation is the ability of the eye to adjust its focus from distant to near objects. It can be impaired by drugs that affect the nervous system, such as opioids or anticholinergics.
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Related Questions
Correct Answer is C
Explanation
This is because urine toxicology studies can detect the presence of cocaine and other drugs in the body of the pregnant woman and her unborn baby.Cocaine use during pregnancy can have serious consequences for both the mother and the baby, such as high blood pressure, premature labor, low birth weight, and developmental problems.
Choice A is wrong because urine estriol levels are used to measure the activity of the placenta and the fetal adrenal glands.They are not related to cocaine use.
Choice B is wrong because serum bilirubin levels are used to assess the liver function and the risk of jaundice in newborns.They are not related to cocaine use.
Choice D is wrong because lecithin-sphingomyelin ratio is used to evaluate the fetal lung maturity and the risk of respiratory distress syndrome.It is not related to cocaine use.
Correct Answer is A
Explanation
The correct answer is choice A. “Your labor may slow down if you receive an epidural now.” An epidural is a type of regional anesthesia that blocks pain in a specific area of the body.
It can be used to reduce pain during labor and delivery.
However, an epidural can also have some side effects, such as lowering blood pressure, causing fever, and slowing down labor progress.
Therefore, it is usually recommended to wait until the cervix is at least 4 to 5 cm dilated and the contractions are strong and regular before receiving an epidural.
Choice B is wrong because there is no fixed rule about how dilated the cervix needs to be before receiving an epidural.
Some women may receive an epidural earlier or later than others, depending on their pain level, medical history, and preferences.
Choice C is wrong because catheterization is not a prerequisite for receiving an epidural.
Catheterization is the insertion of a tube into the bladder to drain urine.
It may be done after receiving an epidural because the anesthesia can affect the ability to urinate.
However, it is not required before receiving an epidural.
Choice D is wrong because the station of the baby does not determine when a woman can have an epidural.
The station of the baby refers to how far the baby has descended into the pelvis.
It is measured in relation to the ischial spines, which are bony landmarks in the pelvis.
A positive station means that the baby is below the spines, while a negative station means that the baby is above the spines.
Zero station means that the baby is at the level of the spines.
The station of the baby does not affect the administration of an epidural, as long as there are no other complications or contraindications.
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