A primigravida dilated to 5 cm will receive an epidural for pain.
Which of the following interventions will help prevent hypotension in the patient?
Administering epinephrine before the procedure.
Positioning client on her back prior to the procedure.
Having her eat a carbohydrate snack prior to the procedure.
Administering a bolus of 0.9% Normal saline IV fluid before the procedure.
The Correct Answer is D
Choice A rationale
Administering epinephrine before the procedure is not standard practice to prevent hypotension associated with epidurals. Epinephrine is used in emergency situations to treat severe allergic reactions or cardiac arrest, not for preventing epidural-induced hypotension.
Choice B rationale
Positioning the client on her back prior to the procedure is not recommended, as it can exacerbate hypotension due to compression of the inferior vena cava by the gravid uterus. This position can decrease venous return to the heart and reduce cardiac output.
Choice C rationale
Having the patient eat a carbohydrate snack prior to the procedure is not a standard intervention to prevent hypotension during an epidural. Dietary intake does not directly prevent the vasodilatory effects of the epidural anesthesia.
Choice D rationale
Administering a bolus of 0.9% Normal saline IV fluid before the procedure is the correct intervention to prevent hypotension. Preloading with IV fluids increases intravascular volume, counteracting the vasodilation and potential drop in blood pressure caused by the epidural anesthesia. .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","E"]
Explanation
A. Administer antihypertensive medication as prescribed - The client's blood pressure is elevated, and managing hypertension is crucial to prevent complications.
B. Initiate continuous fetal monitoring - The client is experiencing symptoms that could indicate preeclampsia, and continuous monitoring is essential to assess fetal well-being.
C. Monitor for signs of magnesium toxicity - Given the client's symptoms and lab results, monitoring for magnesium toxicity is important, especially if magnesium sulfate is being used for seizure prophylaxis.
D. Perform a vaginal exam to assess cervical status - This intervention is not a priority at this moment given the client's condition and the need to avoid unnecessary interventions that could cause stress or complications.
E. Assess for signs of placental abruption - Although the client denies vaginal bleeding, it's important to monitor for any signs of placental abruption due to her symptoms and hypertension.
Correct Answer is B
Explanation
Choice A rationale
A magnesium sulfate level of 61 mEq/L is high and may cause toxicity, but the most critical level is higher.
Choice B rationale
A magnesium sulfate level of 70 mEq/L is extremely high and most likely to result in toxicity, including respiratory and cardiac complications.
Choice C rationale
A magnesium sulfate level of 29 mEq/L is elevated but not necessarily indicative of toxicity.
Choice D rationale
A magnesium sulfate level of 45 mEq/L is also high but less critical compared to 70 mEq/L.
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