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23 Cards in this Set
- Front
- Back
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Benefits of an epidural are that it provides ? pain relief whil being ? and alert.
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excellent,
awake |
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Epidural studies have shown that there is an improvement in ? blood flow especially in PIH pts so the fetus benefits by getting more ?
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intervillous,
blood flow |
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contraindications for epidurals include ? disorders,what meds would tip you off to this ?, ? b/c ? is never used with pregnant women.
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coagulation,
lovenox, heparin, coumadin |
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If a womans has a low platelet count < ? this is a contraindication for an ?
We should always notify an MD if the platelet count is < ? |
75,000,
epidural, 150,000 |
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More contraindications for and epidural include If there is a local ? at the site of the epidural, any abnormalities of the ? column, diseases of the ? system, and if there is a non-reassuring FHR pattern we would expect the Dr. to proceed with ?/? now.
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infection,
spinal, nervous, C/S-birth |
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If there is maternal hypotension/shock this would be a contraindicatin for an ?
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epidural
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How do we know what is expected of the Nurse when caring for a pt that has had an epidural ? For the most part the RN does not ? the epidural medicines for the pt, the RN ?'s the pt and notifies the MD if there is problem.
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Check institutional policy,
manage, monitors |
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What is expected of the nurse during the epidural procedure ? We need to monitor the mom for ? relief, any ?'s, mom may develop a ? Monitor fetus for ?
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Teach the pt what is going to happen IV, FHRM, Catheter, etc... during the procedure.,
pain, complications, fever, well-being |
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If the epidural is not relieving pain we should check that the ? and ? and ? mechanisms are intact and working or the pt may need an ? in dose.
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catheter,
tubing, dosing, increase |
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If we determine that the pt needs an increase in epidural analgesic medicine we need to call ? PRN
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anesthesia
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Nursing Dx for epidural anesthesia is ?
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Risk for injury rt potential complications
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The main complications of epidural anesthesia is maternal ?, why is it a risk, b/c the epidural medicine causes a ? block which creates ? In order to prevent this complication we will give ?ml LR in IV prior to ?
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hypotension,
parasympathetic, vasodilation, 1000 ml LR, epidural |
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What position is good to prevent hypotension ? or ? What symptoms would alert you to the pt having symptoms of hypotension ?, ?, ? If the pt is experiencing any of these S/S we should ? the med.
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head up, side lying,
lightheadedness, N/V, pale, withhold |
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What is the cause of supine hypotension during pregnancy ? and this causes moms BP to drop and this causes a decrease in ? to the placenta thereby to the ?
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the uterus is lying on top of the inferior vena cava, reducing blood flow back to the heart.,
oxygen, fetus |
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What does the RN monitor when mom develops hypotension after epidural placement ? Monitor ?,?, and ? sat q ? min for ? min. We should expect ? to stay for the first ? min
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B/P, pulse, O2,
5min, 30min, anesthesia, 15min |
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If hypotension occurs due to epidural during labor the RN can increase ? solution over the current rate, make sure the pt is ? lying, evaluate the ? response and take action ? If none of this works we should contact the ? and be ready to administer ?mg of ? slow IVP and monitor pt response. If there is no improvement after the MD has you administer the med, call him back and tell him you need him there ?
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plain IV, side, fetal, prn,
MD, 5mg of ephedrine, STAT |
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The action of Ephedrine is ? which causes an increase in ?
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vasoconstriction,
BP |
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If the epidural goes to far and into the dura or subarachnoid space the catheter should be withdrawn by ?
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anesthesia
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What are s/s of a subarachnoid placement of epidural catheter ?, ? paralysis, and the pt will need ? support, we should get the ? ready just in case.
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hypotension,
ascending, respiratory, crash |
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If there is a toxic effect of the epidural med we may see ?, ?,? and the pt may need ? support.
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tinnitus, drowsiness, disorientaton,
respiratory |
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The spinal opiates that are used post-op for C/S pain and during C/S by anesthesia are ? and ?
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duramorph,
astromorph |
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The therapeutic effects of duramorph and astromorph are that there is a high concentration of narcotic receptors along the spinal cord, brain stem and thalamus, so a ? quantity of narcotics lasts a long time, around ? hrs.
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small,
24hrs |
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Benefits of Duramorph and Astromorph are that the pts experience much ? post-op pain, are able to ? sooner and care for their ?
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less,
ambulate, infant |
