The nurse is educating a laboring client who is about to receive epidural anesthesia.
Which statement by the nurse best describes the side effects the client may experience?
It is possible to experience a drop in blood pressure afterward.
You may experience some drowsiness as the medication gets in your bloodstream.
You may feel a frequent need to urinate after the effects set in.
It is possible to feel more numbness on one side, so you should lie flat on your back.
The Correct Answer is A
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..
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","D","E"]
Explanation
This scenario involves preconception care and identifying reproductive risk factors. Knowledge of advanced parental age, recurrent pregnancy loss, and heritable genetic conditions is applied to determine which clients require specialized counseling to assess risks for chromosomal abnormalities or genetic disorders.
Choice A rationale
Advanced maternal age (≥ 35) and paternal age (≥ 40) increase the risk of chromosomal abnormalities like Down syndrome or new gene mutations. Counseling helps couples understand these statistical risks and available prenatal diagnostic testing options.
Choice B rationale
Macrosomia related to gestational diabetes is a metabolic and glycemic management issue rather than a primary genetic disorder. This clinical history does not typically warrant genetic counseling unless other risk factors for congenital anomalies are present.
Choice C rationale
Having a child with a congenital anomaly increases the risk of recurrence in subsequent pregnancies. Genetic counseling is essential to identify the inheritance pattern and provide the couple with specific risks for future children.
Choice D rationale
Recurrent pregnancy loss, defined as 3 or more miscarriages, may be caused by parental balanced translocations or other genetic factors. Investigation through counseling and karyotyping is recommended to identify the underlying cause of losses.
Choice E rationale
A family history of X-linked disorders, such as hemophilia or Duchenne muscular dystrophy, carries a specific inheritance risk. Counseling allows the client to understand the probability of passing the gene to their offspring.
Correct Answer is C
Explanation
Neonatal transition assessment requires specific timing to evaluate extrauterine adaptation accurately. Knowledge of the APGAR scoring system, which measures heart rate, respiratory effort, muscle tone, reflex irritability, and color, must be applied to determine the infant's immediate clinical status.
Choice A rationale
While signs of distress require immediate intervention, APGAR scoring is a standardized tool used for all newborns regardless of clinical appearance. Waiting for distress ignores the preventive and baseline value of the scheduled one-minute and five-minute assessments.
Choice B rationale
Although providers may be present, the nurse often performs the APGAR assessment in the delivery room. Nurses are trained to evaluate the five parameters to determine if neonatal resuscitation protocols, such as positive pressure ventilation, are necessary.
Choice C rationale
Standard practice dictates APGAR scoring at one and five minutes after birth. A score of 7 to 10 is normal. If the five-minute score is < 7, assessments continue every five minutes for up to twenty minutes.
Choice D rationale
Assessing APGAR every fifteen minutes is not standard practice and would interfere with thermoregulation and bonding. Vital signs are monitored frequently during the first hour, but the specific APGAR tool is limited to the immediate transition.
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