The nurse at an OBGYN clinic evaluates a client over the phone who recently started taking oral contraceptives.

The client reports shortness of breath, chest pain, and a mild elevation in blood pressure.

What advice will the nurse give to the client?

Epidural anesthesia provides effective pain relief during labor by blocking nerve impulses in the spinal cord. Nurses must apply knowledge of sympathetic nervous system blockade to educate clients on common side effects, specifically hemodynamic changes that require proactive monitoring and management.

Choice A rationale

Epidural anesthesia causes sympathetic blockade, leading to peripheral vasodilation and a subsequent drop in blood pressure. Hypotension is the most frequent side effect, often requiring intravenous fluid preloading and frequent blood pressure monitoring to ensure fetal safety.

Choice B rationale

Epidural anesthesia involves local anesthetics and sometimes opioids injected into the epidural space, not the systemic bloodstream. Unlike systemic IV opioids, it does not typically cause significant drowsiness, as the primary effect is regional sensory and motor blockade.

Choice C rationale

An epidural actually decreases the sensation of a full bladder by blocking the nerves responsible for bladder awareness. Clients are less likely to feel the need to urinate and usually require intermittent or indwelling catheterization for drainage.

Choice D rationale

While uneven distribution of medication can cause one-sided numbness, lying flat on the back is contraindicated. This position causes supine hypotensive syndrome due to vena cava compression. Clients are encouraged to change sides to balance the block..

Management of labor induction requires continuous physiological monitoring to ensure maternal and fetal safety. Nurses must apply knowledge of uterine tachysystole and fetal oxygenation to prevent hypoxic injury. Establishing baseline data for uterine activity and fetal heart patterns is the primary prerequisite.

Choice A rationale

Administering large fluid boluses is not standard prior to oxytocin unless anesthesia is imminent. While hydration is important, preventing hypotension is more relevant to regional blocks than to the initiation of synthetic oxytocin for uterine contractions.

Choice B rationale

Patient education is a vital component of informed consent and nursing care. However, in an acute clinical setting, ensuring physiological safety through monitoring takes precedence over documentation of teaching before the medication is physically started.

Choice C rationale

Vertex cephalic presentation is the ideal longitudinal lie for vaginal delivery. Notifying the provider of malposition would be inaccurate as the fetus is correctly positioned. Holding the medication based on this assessment would be clinically inappropriate.

Choice D rationale

Oxytocin carries a high risk for uterine hyperstimulation. Continuous electronic fetal monitoring is essential to establish a baseline fetal heart rate and evaluate contraction frequency, ensuring the fetus tolerates the induced stress of labor contractions.