Question 1

When general anesthesia is necessary for a cesarean delivery, the nurse should be prepared to:

Accepted Answer

The answer of When general anesthesia is necessary for a...

Question 2

The patient at 39 weeks' gestation is undergoing a cesarean birth due to breech presentation. General anesthesia is being used. Which situation requires immediate intervention?

Accepted Answer

A fetal heart rate of 70 prior to making the skin incision is a sign of fetal distress and requires immediate intervention. This may indicate that the baby is not receiving adequate oxygen and may require delivery as soon as possible to prevent further complications. The other options are normal findings that do not require immediate intervention. Blue hands and feet at 1 minute after birth can be a transient issue and usually resolves within a few minutes. Clear fluid in the baby's oropharynx is a normal finding after birth. Crying prior to delivery of the body is a normal sign of neonatal respiratory effort.

Question 3

To reduce possible side effects from a cesarean section under general anesthesia, patients are routinely given which type of medication?

Accepted Answer

Antacids are given to patients to reduce the acidity of the stomach's contents. This is important during cesarean sections under general anesthesia to minimize the risk of aspiration pneumonia, which can occur if the acidic stomach contents are inhaled into the lungs while the patient is unconscious.

Question 4

The patient with a normal pregnancy had an emergency cesarean birth under general anesthesia 2 hours ago. The patient now has a respiratory rate of 30, pale blue nailbeds, a pulse rate of 110, and a temperature of 102.6°F, and is complaining of chest pain. The nurse understands that the patient most likely is experiencing:

Accepted Answer

The answer of The patient with a normal pregnancy had...

Question 5

A cesarean section is ordered. Because the patient is to receive general anesthesia, the primary danger with which the nurse is concerned is:

Accepted Answer

General anesthesia can cross the placental barrier, leading to fetal depression. This is a primary concern when administering general anesthesia for a cesarean section, as it can affect the baby's respiratory status and overall health at birth.

Question 6

A patient received epidural anesthesia during the first stage of labor. The epidural is discontinued immediately after delivery. This patient is at increased risk for which problem during the fourth stage of labor?

Accepted Answer

Epidural anesthesia can cause decreased sensation and awareness of bladder fullness, leading to bladder distention if not monitored and managed properly after delivery.

Question 7

A patient with an internal fetal monitor catheter has received IV stadol for pain relief. Which changes on the monitor should the nurse expect?

Accepted Answer

Stadol, a narcotic analgesic, can depress the central nervous system and therefore can affect the fetal heart rate (FHR) by decreasing variability, making it difficult to assess fetal well-being. It is important for the nurse to monitor the FHR pattern closely and report any significant changes to the provider. Early decelerations are usually not affected by pain medications, late decelerations can be worsened by medication, and accelerations can occur as a result of fetal movement, not medication.

Question 8

The nurse is inducing the labor of a patient with severe preeclampsia. As labor progresses, fetal intolerance of labor develops. The induction medication is turned off, and the patient is prepared for cesarean birth. Which statement should the nurse include in her preoperative teaching? "Because of your preeclampsia:

Accepted Answer

Patients with preeclampsia are at higher risk for hypotension after receiving epidural anesthesia due to decreased vascular resistance and volume expansion. This information is important to include in preoperative teaching so the patient can be informed and prepared for potential side effects of the anesthesia. Options B and C are not necessarily related to preeclampsia or the planned cesarean birth. Option D is incorrect as it is not related to the patient's medical condition but rather hospital policy.

Question 9

For what common side effects of epidural anesthesia should the nurse watch?

Accepted Answer

Epidural anesthesia can lead to several common side effects, including elevated maternal temperature, urinary retention, nausea, and local itching. Long-term back pain is a misconception and not a common side effect of epidural anesthesia.

Question 10

A primigravida dilated to 5 cm has just received an epidural for pain. She complains of feeling lightheaded and dizzy within 10 minutes after the procedure. Her blood pressure was 120/80 before the procedure and is now 80/ 52. In addition to the bolus of fluids she has been given, which medication is preferred to increase her BP?

Accepted Answer

Ephedrine is a medication commonly used to treat hypotension caused by epidural anesthesia. It works by constricting blood vessels and increasing heart rate, thus raising blood pressure. Epinephrine and terbutaline are not commonly used in this setting and may cause adverse effects such as tachycardia and arrhythmias. Epifoam is not a medication and is not relevant to this scenario.

Question 11

The primary physician orders a narcotic analgesic for a patient in labor. Which situations would lead the nurse to hold the medication?

Accepted Answer

Late decelerations in fetal heart rate can indicate fetal distress, which is a contraindication for administering narcotics as they could further compromise the fetus. A blood pressure of 80/42 indicates hypotension, which could be exacerbated by narcotic analgesics, potentially endangering both the mother and the fetus.

Question 12

An anesthesiologist informs the nurse that a patient scheduled for a caesarean section will be having general anesthesia with postoperative self-controlled analgesia. For which patients would a general anesthesia be recommended?

Accepted Answer

The answer of An anesthesiologist informs the nurse that a...

Question 13

The nurse is caring for a laboring patient with thrombocytopenia. During labor, it is determined that the patient requires a cesarean delivery. The nurse is preparing the patient for surgery, and should instruct the patient that the recommended method of anesthesia is:

Accepted Answer

General anesthesia is recommended for patients with thrombocytopenia undergoing cesarean delivery because epidural or spinal anesthesia could increase the risk of spinal hematoma due to the patient's low platelet count.

Question 14

The nurse is providing preoperative teaching to a patient for whom a cesarean birth under general anesthesia is scheduled for the next day. Which statement by the patient indicates that she requires additional information? "General anesthesia:

Accepted Answer

General anesthesia does not provide pain relief after the birth since it affects the entire body, including the respiratory and cardiovascular systems, and the patient is unable to feel or move. The patient may require additional pain management after waking up from general anesthesia.

Question 15

A cesarean section is ordered for the laboring patient with whom the nurse has worked all shift. The patient will receive general anesthesia. The nurse knows that potential complications of general anesthesia include:

Accepted Answer

The answer of A cesarean section is ordered for the...

Quiz 25: Pain Management During Labor