The nurse is assisting with placement of epidural anesthesia for a woman who is in labor. To help prevent maternal hypotension, which is the nurse's initial action?
a. Administer 40 to 80 mcg of intravenous phenylephrine.
b. Infuse a bolus of 500 to 1000 mL of IV crystalloid solution.
c. Monitor the patient's blood pressure closely during epidural placement.
d. Turn the patient onto her left side and give a rapid bolus of crystalloid solution.
ANS: B
To decrease maternal hypotension before epidural placement, an IV bolus of 500 to 1000 mL of crystalloid solution is given. When hypotension develops, the woman should be turned to her left side and administered a rapid bolus of crystalloid solution. Phenylephrine is given if hypotension does not improve. Blood pressure should be monitored throughout the procedure.
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