Question

A nurse is planning care for a client who is in labor and is requesting epidural anesthesia for pain control: True/ False Which of the following actions should the nurse include in the plan of care?

a) Place the client in a supine position for 30 min following the first dose of anesthetic solution: True/ False
b) Administer 1,000 mL of dextrose 5% in water prior to the first dose of anesthetic solution: True/ False
c) Monitor the client's blood pressure every 5 min following the first dose of anesthetic solution: True/ False
d)Ensure the client has been NPO 4 hr prior to the placement of the epidural and the first dose of anesthetic solution: True/ False

Answer 1

When planning care for a client who is requesting epidural anesthesia during labor, it is important to avoid placing the client in a supine position and to use an appropriate IV fluid such as normal saline, not dextrose 5% in water. Similarly, close monitoring of blood pressure following administration of anesthetic solution is important to prevent hypotension while there is no NPO requirement prior to epidural placement.

Step-by-step explanation:

Planning Care for a Client Requesting Epidural Anesthesia

When planning care for a client in labor who is requesting epidural anesthesia, a nurse should consider the following statements:

• Place the client in a supine position for 30 min following the first dose of anesthetic solution: False. It is generally recommended to avoid the supine position to prevent supine hypotensive syndrome due to pressure from the uterus on the vena cava.
• Administer 1,000 mL of dextrose 5% in water prior to the first dose of anesthetic solution: False. Lactated Ringer’s solution or normal saline is commonly used to preload the vasculature and help prevent hypotension, not dextrose 5% in water.
• Monitor the client's blood pressure every 5 min following the first dose of anesthetic solution: True. Blood pressure should be monitored closely after an epidural is administered due to the risk of hypotension.
• Ensure the client has been NPO 4 hr prior to the placement of the epidural and the first dose of anesthetic solution: False. There is no strict requirement for the client to be NPO (nothing by mouth) before receiving an epidural anesthesia.

Correct care planning ensures both the safety of the mother and the effectiveness of pain control measures during labor.

Answer 2

The following actions should the nurse include in the plan of care:

c) Monitor the client's blood pressure every 5 min following the first dose of anesthetic solution

d) Ensure the client has been NPO 4 hr prior to the placement of the epidural and the first dose of anesthetic solution.

Step-by-step explanation:

a) Placing the client in a supine position for 30 minutes following the first dose of anesthetic solution is generally not recommended. The client should be repositioned regularly to prevent complications, and supine positioning can lead to hypotension. False.

b) Administering 1,000 mL of dextrose 5% in water prior to the first dose of anesthetic solution is not a standard practice for epidural anesthesia. Typically, the focus is on hydration with crystalloid solutions. False.

c) Monitoring the client's blood pressure every 5 minutes following the first dose of anesthetic solution is a common nursing intervention. Frequent blood pressure monitoring helps detect and manage potential hypotension associated with epidural anesthesia. True.

d) Ensuring the client has been NPO (nothing by mouth) for 4 hours prior to the placement of the epidural and the first dose of anesthetic solution is a standard practice to reduce the risk of aspiration if general anesthesia is needed. True.

Hence, option c and option d are correct.