A woman has requested an epidural for her pain. She is 5 cm dilated and 100% effaced. The baby is in a vertex position and is engaged. The nurse increases the woman's intra-venous fluid for a preprocedural bolus
She reviews her laboratory values and notes that the woman's hemoglobin is 12 g/dl, hematocrit is 38%, platelets are 67,000, and white blood cells (WBCs) are 12,000/mm3 . Which factor would contraindicate an epidural for the woman? a. She is too far dilated.
b. She is anemic.
c. She has thrombocytopenia.
d. She is septic.
C
Feedback
A Typically epidural analgesia/anesthesia is used in the laboring woman when a regular labor pattern has been achieved, as evidenced by progressive cervical change.
B The laboratory values show that the woman's hemoglobin and hematocrit are in the normal range.
C The platelet count indicates thrombocytopenia (low platelets), which is a con-traindication to epidural analgesia/anesthesia.
D The laboratory values show a slight increase in the WBC count; this is not un-common in laboring women.
You might also like to view...
The nurse is counseling the parents an adolescent client who is experiencing behavioral problems. Which assessment tool would be appropriate for the nurse to use to further assess this adolescent?
1. Family Psychosocial Screening. 2. Eyeburg Child Behavior Inventory. 3. Ages and Stages Questionnaire. 4. Child Development Inventory.
A 30-year-old male client is admitted to the psychiatric unit with a diagnosis of bipolar disorder
His family reports that for the past 2 months he has been in constant motion, sleeping very little, spending lots of money, and has been "full of ideas." During the initial assessment with the client, the nurse would expect him to exhibit which of the following? A. Short, polite responses to interview questions B. Introspection related to his present situation C. Exaggerated self-importance D. Feelings of helplessness and hopelessness
A female client with a diagnosis of a dissociative disorder who attends group meetings at a community mental health clinic often voices that her boss at work frequently complains that she is working at a level below her capabilities
The client also states that she feels that she "never gets anything done." Which nursing diagnosis best addresses these issues? a. Self-esteem, low b. Social isolation c. Body-image, disturbed d. Memory, impaired
The nurse is caring for a client who has just undergone surgery for oral cancer. What advice does the nurse give the client to assist in maintaining the airway?
a. "Limit your fluids to 3 cups of water a day." b. "Take deep breaths, hold, then cough to mobilize any secretions." c. "Lying flat in bed will be more comforta-ble for breathing." d. "Usually suctioning is not needed after oral surgery."