A woman has requested an epidural for her pain.She is 5 cm dilated and 100% effaced.The baby is in a vertex position and is engaged.The nurse increases the woman's intravenous fluid for a preprocedural bolus.She reviews her laboratory values and notes that the woman's hemoglobin is 12 g/dL,hematocrit is 38%,platelets are 67,000,and white blood cells (WBCs)are 12,000/mm³.Which factor would contraindicate an epidural for the woman?

Question

Quizplus · Accepted Answer

The platelet count indicates a coagulopathy,specifically,thrombocytopenia (low platelets),which is a contraindication to epidural analgesia/anesthesia.Typically epidural analgesia/anesthesia is used in the laboring woman when a regular labor pattern has been achieved,as evidenced by progressive cervical change.The laboratory values show that the woman's hemoglobin and hematocrit are in the normal range and show a slight increase in the WBC count that is not uncommon in laboring women.

A Woman Has Requested an Epidural for Her Pain