Mrs. R. 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 IV fluid for a preprocedure bolus
She reviews her labs and notes that the woman's hemoglobin is 12 g/dl, hematocrit is 38%, platelets are 67,000, and white blood cells are 12,000/mm. What factor would be contraindicated for the woman to receive an epidural? 1. She is too far dilated.
2. She is anemic.
3. She has thrombocytopenia.
4. She is septic.
3
1. Incorrect. Typically, epidural analgesia/anesthesia is used in the laboring woman when a regular labor pattern has been achieved, as evidenced by progressive cervical change.
2. Incorrect. The labs reveal that the woman's H&H are in the normal range
3. Correct. The platelet count reveals thrombocytopenia (low platelets), which would be a contraindication for the patient to receive an epidural.
4. Incorrect. The lab values reveal a slight increase in the WBC count; this is not uncommon in laboring women.
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