NUR 148 Test 2 - Answer 20 cc of patient's blood infused in epid...

NUR 148 Test 2

• What is a blood patch?

Answer 20 cc of patient's blood infused in epidural space, creating a clot and sealing the leak in the dura that caused the postdural puncture headache

• S/S of maternal hypotension after epidural?

Answer -lightheadedness -low BP -syncope -low oxygen saturation

• What is the RN role r/t maternal hypotension after epidural?

Answer -Turn woman to lateral position

-If supine wedge pillow under hips and elevate legs -Administer IVF bolus -Administer oxygen via NRB at 10 L/min -Notify CRNA/MD -Anticipate administration of vasopressor drug -Remain with patient (monitor until resolved) -Remember the BABY! (may see fetal bradycardia)

• Examples of nonpharmacological methods of pain relief in labor?

Answer -Focusing and relaxation

-Imagery -Breathing 1 / 2

-Effleurage -Counterpressure to lower back -Music -Hydrotherapy -Intradermal water block -TENS unit -acupressure/acupuncture -freedom of movement -heat/cold Gate theory of pain!

• What are the S/E of epidural?

Answer -Maternal hypotension

-Urinary retention -May delay 2nd phase of labor 30 mins -Postdural puncture headache -May experience "hot spots" -Permanent nerve damage

• What should the nurse educate about with epidurals?

Answer -urinate before epidural

-walking or getting up won't be possible -Risk for postdural headache -takes about 15 mins to work -S/E of hypotension and urinary retention -can't get epidural after 8-9cm dilation -cant't get epidural if platelets aren't 80,000

• What should the nurse educate about with spinals?

Answer -effects last long time

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