ATI PHARMACOLOGICAL THERAPIES WEEK 4 Elaborations With Complete Solutions

ATI PHARMACOLOGICAL THERAPIES WEEK 4 Nursing care of client in labor: Assisting client who has epidural infusion. Nursing actions  Monitor for adverse effects. o Maternal hypotension o Fetal bradycardia o Inability to feel the urge to void o Loss of the bearing-down reflex  Monitor the client receiving a bolus of IV fluids to help offset maternal hypotension.  Help to position and steady the client into either a sitting or side-lying modified Sims’ position, with the client’s back curved to widen the intervertebral space for insertion of the epidural catheter.  Encourage the client to remain in the side-lying position after insertion of the epidural catheter to avoid supine hypotension syndrome with compression of the vena cava.  Coach the client in pushing efforts, and request an evaluation of epidural pain management by anesthesia if pushing efforts are ineffective.  Monitor maternal blood pressure and pulse. Observe for hypotension, respiratory depression, and oxygen saturations.  Monitor FHR patterns continuously.  Ensure oxygen and suction equipment is available.  Provide client safety such as raising the side rails of the bed. Do not allow the client to ambulate unassisted until all motor control has returned.  Check the maternal bladder for distention at frequent intervals and catheterize if necessary to assist with voiding.  Monitor for the return of sensation in the client’s legs after delivery but prior to standing. Assist the client with standing and walking for the first time after a delivery that included epidural anesthesia. Nursing care of labor: Effectiveness of Dinoprostone  Chemical agents consist of prostaglandin E1 (misoprostol [Cytotec]) and prostaglandin E2 (dinoprostone [Cervidil insert]), which are used to “ripen” (soften and thin) the cervix and to increase cervical readiness prior to the induction of labor. Nutrition during pregnancy: Teaching about oral ferrous sulfate. Ferrous sulfate (325 mg) iron supplements twice daily  Nursing Considerations and Client Education o Instruct