The client has elected to have epidural anesthesia to relieve labor pain. If the client experiences hypotension, the nurse would:
A. Place her in Trendelenburg position
B. Decrease the rate of IV infusion
C. Administer oxygen per nasal cannula
D. Increase the rate of the IV infusion
Correct Answer: D. Increase the rate of the IV infusion
If the client experiences hypotension after an injection of epidural anesthetic, the nurse should turn her to the left side, apply oxygen by mask, and speed the IV infusion. If the blood pressure does not return to normal, the physician should be contacted. Epinephrine should be kept for emergency administration.
Option A: Placing the client in Trendelenburg position (head down) will allow the anesthesia to move up above the respiratory center, thereby decreasing the diaphragm’s ability to move up and down and ventilate the client.
Option B: The IV rate should be increased, not decreased. Monitoring the patient hemodynamic status during the procedure is very important. The minimum monitors required are pulse oximeter for pulse and oxygen saturation as well as blood pressure cuff and continuous EKG to assess cardiovascular status.
Option C: The oxygen should be applied by mask, not cannula. Epidural anesthesia is achievable using either the classic epidural, the combined spinal-epidural (CSE) technique, or dural puncture epidural (DPE). CSE and DPE include an additional step consisting of delivering a spinal dose of LA and co adjuvants (CSE) or only puncturing the dura mater (DPE) using a spinal needle.