The nurse detects hypotension in a laboring client after an epidural. Which actions should the nurse plan to implement? (Select all that apply.)
a. Encourage the client to drink fluids.
b. Place the client in a Trendelenburg position.
c. Administer a normal saline bolus as prescribed.
d. Administer oxygen at 8 to 10 L/min per face mask.
e. Administer IV ephedrine in 5- to 10-mg increments as prescribed.
ANS: C, D, E
If hypotension occurs after an epidural has been placed, techniques such as a rapid nondextrose IV fluid bolus, maternal repositioning, and oxygen administration are implemented. If those interventions are ineffective, IV ephedrine in 5- to 10-mg increments can be prescribed to promote vasoconstriction to raise the blood pressure. The client in active labor should not be encouraged to drink fluids. In a Trendelenburg position, the body is flat, with the feet elevated. This would not be a position to use for a pregnant client.
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