A client in labor who is requesting an epidural asks if the baby will be harmed. How should the nurse respond?
1. "Epidural anesthesia is very safe and there are no potential side effects that can affect your baby."
2. "We'll monitor your baby continuously so we can recognize and treat any changes that may be related to the epidural."
3. "We'll assess your blood pressure every 15 minutes to make sure the epidural is not having any negative effects on your baby."
4. "Before your epidural is placed, we'll administer IV fluid to you in order to prevent the epidural from causing you problems."
2
Explanation:
1. While proficient administration and monitoring of epidural anesthesia allow for a high degree of safety with this technique, maternal hypotension associated with epidural anesthesia may produce harmful fetal effects.
2. Continuous electronic fetal monitoring to assess fetal status is indicated in the care of pregnant clients who receive epidural anesthesia and allows for a more direct assessment of fetal status than does frequent monitoring of maternal blood pressure and pulse, which is also indicated in the care of this client.
3. While frequent monitoring of maternal blood pressure and pulse is indicated in the care of a client who receives an epidural during labor, continuous electronic fetal monitoring is also indicated for assessment of fetal status and allows for a more direct fetal assessment.
4. While administration of a bolus of IV fluid is indicated in preparation for epidural placement and reduces the risk for maternal hypotension, this intervention neither guarantees the prevention of related complications nor allows for assessment of fetal status.
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