The charge nurse is reviewing the plans of care for four clients in labor. Which care plan requires additional information before implementing?
1. Administration of a spinal anesthetic to a client who is scheduled for a vaginal delivery
2. Administration of a spinal anesthetic to a client with a history of irritable bowel syndrome (IBS)
3. Administration of epidural anesthesia to a client who is in the first stage of labor and has a shellfish allergy
4. Administration of epidural anesthesia to a client with a history of vomiting secondary to hyperemesis gravidarum
4
Explanation:
1. Spinal anesthetics may be used to provide anesthesia for cesarean birth and occasionally for vaginal birth.
2. Spinal anesthesia is not contraindicated for irritable bowel syndrome (IBS).
3. A lumbar epidural relieves pain associated with the first and second stages of labor. An allergy to shellfish is not a contraindication to epidural anesthesia.
4. Contraindications to epidural anesthesia include severe hypovolemia of any etiology. The client with hyperemesis gravidarum should be evaluated for severity of dehydration prior to administration of epidural anesthesia.
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