A woman (Tanya) is being prepared for an elective cesarean birth. The perinatal nurse assists the anesthesiologist with the spinal block and then positions the patient in a supine position
A. Administer naloxone (Narcan) per protocol.
B. Discontinue the patient's intravenous infusion.
C. Have ephedrine ready for administration.
D. Place a wedge under the patient's left hip.
ANS: D
In the event of severe maternal hypotension, the nurse should place the patient in a lateral position or use a wedge under the hip to displace the uterus, elevate the legs, maintain or increase the IV infusion rate, and administer oxygen by face mask at 10 to 12 L/min, or according to institution protocol. Narcan is used to reverse the effects of opioids. Ephedrine would be the drug of choice for refractory hypotension if other measures don't work. The IV would not be discontinued.
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