The perinatal nurse prepares the laboring woman for an epidural anesthesia insertion. What action is best to help prevent maternal hypotension?

Question

A.
Administer an intravenous infusion of 500 mL of normal saline.
B.
Assess vital signs every 5 minutes after the epidural insertion.
C.
Assist the woman to lie down in a supine position.
D.
Encourage frequent cleansing breaths during the procedure.

Answer 1

ANS: A
Complications that may occur with spinal anesthesia block include maternal hypotension, decreased placental perfusion, and an ineffective breathing pattern. Prior to administration, the patient's fluid balance is assessed, and IV fluids are administered to reduce the potential for sympathetic blockade (decreased cardiac output that results from vasodilation with pooling of blood in the lower extremities). Following administration of the anesthetic, the patient's blood pressure, pulse and respirations, and fetal heart rate must be taken and documented every 5 to 10 minutes; however, assessing vital signs will not prevent hypotension from occurring. The woman is helped to a sitting position on the side of the bed. Deep cleansing breaths may be helpful for relaxation, but will not help prevent hypotension.