Click to indicate which interventions the nurse would include in the plan of care to support the expected outcomes of adequate epidural anesthesia on the mother and the fetus. Each column must have a least one response selected.

Administering bolus fluids

Side positioning

Urinary drainage

Assisting with pushing efforts

Administering IV fluids

Monitoring blood pressure

Answer and Explanation

The Correct Answer is {"A":{"answers":"A,B"},"B":{"answers":"A,B"},"C":{"answers":"B"},"D":{"answers":"B"},"E":{"answers":"B"},"F":{"answers":"A,B"}}

Intervention	Fetus	Maternal
Administering bolus fluids	✔	✔
Side positioning	✔	✔
Urinary drainage		✔
Assisting with pushing efforts		✔
Administering IV fluids		✔
Monitoring blood pressure	✔	✔

• Administering bolus fluids: Increases maternal intravascular volume to reduce the risk of epidural-induced hypotension. Stable maternal blood pressure helps maintain adequate uteroplacental perfusion. This ensures continuous oxygen delivery to the fetus during labor.

• Side positioning: Prevents compression of the inferior vena cava by the gravid uterus. This improves venous return and cardiac output, enhancing blood flow to the placenta. Helps avoid supine hypotension syndrome, maintaining maternal blood pressure and fetal perfusion. Fetal oxygenation is better preserved in side-lying positions.

• Urinary drainage: Prevents bladder overdistention caused by sensory and motor blockade from epidural anesthesia. A full bladder can hinder fetal descent and prolong labor. Catheterization protects maternal comfort and labor progression.

• Assisting with pushing efforts: Supports the second stage of labor when the epidural limits maternal bearing-down ability. Coaching synchronizes maternal effort with contractions. This intervention improves efficiency of pushing and fetal descent.

• Administering IV fluids: Maintains adequate preload to prevent vasodilation-related hypotension after epidural administration. Consistent fluid support sustains maternal blood pressure and perfusion to uterine arteries during labor.

• Monitoring blood pressure: Detects early signs of hypotension, a common adverse effect of epidural anesthesia. Frequent readings guide prompt intervention to stabilize maternal hemodynamics. This protects both maternal safety and fetal well-being.

Nursing Test Bank

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Correct Answer is B

Explanation

A. Arrange a meeting with the family to discuss the client's situation: Meeting with the family may provide useful information and support, but it does not address the client's immediate needs for basic care, safety, and engagement in a therapeutic environment.

B. Establish a structured routine for the client to follow: Establishing a structured daily routine provides clear expectations and promotes regular sleep, hygiene, and eating habits, which are crucial first steps in managing depressive symptoms and preventing further deterioration.

C. Administer the client's antidepressant medication as prescribed: Administering antidepressants is necessary for treatment, but the therapeutic effects typically take several weeks; immediate behavioral interventions are needed to prevent worsening self-care deficits.

D. Assess the client's ability to communicate with the other staff members: Assessing communication skills is important for planning therapeutic interventions, but it is not the most urgent priority compared to establishing structure that directly impacts the client’s daily functioning.

A. It prevents mouth infections when an inhaler is used. B. It allows the medication to slowly enter the lungs. C. It increases the effectiveness of the medication. D. It allows time to inhale the entire dispensed dose.

Correct Answer is C

Explanation

A. It prevents mouth infections when an inhaler is used: While spacers can reduce oral side effects like thrush with steroid inhalers, preventing mouth infections is not the primary reason for using a spacer with bronchodilators.

B. It allows the medication to slowly enter the lungs: A spacer doesn't slow down medication entry; it holds the medication briefly, allowing the client more time to inhale effectively, but the primary goal is improving delivery efficiency.

C. It increases the effectiveness of the medication: Using a spacer improves medication delivery by reducing the amount deposited in the mouth and throat and maximizing the dose that reaches the lungs, making treatment more effective.

D. It allows time to inhale the entire dispensed dose: Although a spacer gives a few extra seconds to inhale the medication, the main advantage is optimizing deposition in the lungs rather than just allowing more time.

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Click to indicate which interventions the nurse would include in the plan of care to support the expected outcomes of adequate epidural anesthesia on the mother and the fetus. Each column must have a least one response selected.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client admitted to the psychiatric unit diagnosed with major depression wants to sleep during the day, refuses to take a bath, and refuses to eat. Which nursing intervention should the nurse implement first?

Correct Answer is B

Explanation

The client who has emphysema and recently experienced a stroke receives a prescription for a metered-dose inhaler with a spacer device. The client asks the nurse if using the spacer is necessary. Which information should the nurse provide?

Correct Answer is C

Explanation

The nurse is providing education to a client who receives a prescription for zolpidem. Which information about the medication should the nurse include?

The nurse is developing a plan of care for an older male client with type 2 diabetes who reports blurred vision. Which outcome should the nurse include in the plan of care for this client?

An unlicensed assistive personnel (UAP) leaves the unit without notifying the staff. In which order should the unit manager implement these interventions to address the UAP's behavior? (Place the actions in order from first on top to last on bottom.)

The nurse is concerned about the client's temperature. Which interventions can the nurse use to address the client's temperature? Select all that apply.

The school nurse is preparing a teaching pamphlet in response to requests from parents regarding an outbreak of pinworms at the local preschool. Which information about the most commonly prescribed medication, mebendazole, should be included?

A client with pancreatitis reports severe epigastric pain, so the nurse administers a prescribed narcotic analgesic. Ten minutes later, the client insists on sitting up and leaning forward. Which intervention should the nurse implement?

A client with a history of inflammatory bowel disease develops severe ulcerative colitis and is admitted to the intensive care unit after surgery for a fistula repair. Which intervention is most important for the nurse to include in the plan of care?