Which of the following information should a nurse plan to include when teaching a client about Sitz baths?

Choice A reason: Polyuria is not an adverse effect of epidural analgesia. Epidurals may cause urinary retention due to bladder sensation loss from nerve blockade, not increased urine output. Polyuria could reflect unrelated conditions like diabetes insipidus, but it does not align with epidural’s neurological effects on bladder function.

Choice B reason: A maternal temperature of 37.4°C (99.4°F) is within normal range and not an adverse effect of epidural analgesia. Epidurals may rarely cause fever due to immune responses, but this temperature is physiological. It does not indicate a complication requiring documentation, per obstetric monitoring standards.

Choice C reason: Hypotension is a common adverse effect of epidural analgesia, as sympathetic blockade causes vasodilation, reducing blood pressure. This can impair placental perfusion, risking fetal hypoxia. Documentation is critical to prompt interventions like fluid boluses, ensuring maternal and fetal stability, per epidural pharmacology and obstetric care protocols.

Choice D reason: A fetal heart rate of 152/min is within the normal range (110-160/min) and not an adverse effect of epidural analgesia. While epidurals may cause maternal hypotension affecting fetal perfusion, this rate indicates fetal well-being, not requiring documentation as an adverse effect, per fetal monitoring guidelines.

Choice A reason: Fentanyl citrate is appropriate for severe labor pain, as it provides rapid-onset analgesia via IV administration, crossing the blood-brain barrier to block pain signals. Its short half-life minimizes fetal respiratory depression, making it safe for labor. Fentanyl targets opioid receptors, offering effective pain relief, per obstetric analgesia protocols.

Choice B reason: Naloxone hydrochloride is an opioid antagonist used to reverse opioid overdose, not to manage labor pain. It blocks opioid receptors, reversing analgesia, which would exacerbate pain. In labor, naloxone is reserved for neonatal respiratory depression from maternal opioids, not maternal pain relief, per pharmacological principles.

Choice C reason: Naproxen, a nonsteroidal anti-inflammatory drug, is unsuitable for labor pain, as it primarily reduces inflammation and mild pain via prostaglandin inhibition. Labor pain requires rapid, potent analgesia like fentanyl. Naproxen’s slow onset and limited efficacy for visceral pain make it inappropriate for active labor, per pain management guidelines.

Choice D reason: Hydrocodone, an oral opioid, is not used in active labor due to its slow onset and prolonged duration, risking fetal respiratory depression. IV fentanyl provides faster, controlled analgesia suitable for labor’s acute pain. Hydrocodone’s pharmacokinetics are better suited for postpartum or chronic pain, not intrapartum use.