A nurse is caring for a pregnant woman scheduled to have an epidural block.The nurse reviews the woman's admission laboratory results and finds the following: white blood count (WBC)6,500/ mm³,hemoglobin 14 mg/dL,hematocrit 38%,platelet count 98,000,and international normalized ratio (INR)4.2.What action by the nurse is best?

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Contraindications to spinal/epidural blocks include maternal refusal,local or systemic infection,coagulopathies,actual or anticipated maternal hemorrhage,allergy to a specific agent being used,or lack of trained staff.This woman's platelet count is low and her INR is high,leading to concern about coagulopathies.The nurse should notify the health-care provider immediately.Documentation should always be thorough,but further action is needed.A signed consent form should be in the chart for an invasive procedure; however,this is not the priority at this point.An IV will probably be needed prior to delivery (depending on institutional protocol),but,again,this is not the priority in the setting of a patient with abnormal laboratory results.

A Nurse Is Caring for a Pregnant Woman Scheduled to Have