16. A client, who is postoperative, has the anesthetic bupivacaine infusing into an epidural catheter for pain control. On assessment, a nurse notes the client has decreased sensation and numbness in the lower abdomen. The pain level is 3/10. The nurse should:
. Record this expected finding.
. Increase the epidural infusion rate.
. Turn the epidural infusion off and raise the head of bed.
. Turn the epidural infusion off and lower the head of bed.
Test-Taking Tip
Know the normal level of numbness with an epidural. Select the only option that does not reequire an active intervention (e.g., "increase," "raise," "lower").
Content Area: Adult Health, Pain Control; Integrated Process: Nursing Process, Implementation; Cognitive Level: Application; Client Need/Subneed: Physiological Integrity/Pharmacological and Parenteral Therapies/Expected Effects/Outcomes
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Answer 1 is correct because bupivacaine blocks neuron transmission, numbing tissue and reducing pain. This is the desired effect and the data should be recorded. Answer 2 is incorrect because pain levels of 3/10 rarely require additional medication. Answer 3 is incorrect because the medication is working well and the client is not showing adverse effects. Raising the head of the bed may be helpful when too much medication has been administered, as gravity would help keep the medicine from anesthetizing nerves involved in breathing. Answer 4 is incorrect because the medication is working well and the client is not showing adverse effects. There is no reason to turn the infusion off. Lowering the head would facilitate movement of the medication to a higher spinal level. This is not needed for this client with good pain control.