Health Promotion and Maintenance
59. An anesthetist has just placed an epidural catheter dosed with bupivacaine hydrochloride (Marcaine) in a client in labor who is gravida 2, para 1 at 39 weeks' gestation. For which side effect should a nurse observe this client?
Test-Taking Tip
The question has "hypo-" and "hyper-" options for respirations and blood pressure. Think about the physiology behind these options and eliminate the three options that do not fit with epidural analgesia.
Content Area: Maternity, Intrapartum; Integrated Process: Nursing Process, Assessment; Cognitive Level: Application; Client Need/Subneed: Physiological Integrity/Pharmacological and Parenteral Therapies/Expected Effects/Outcomes
Health Promotion and Maintenance
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Answer 1 is correct because, with epidural anesthesia, the sympathetic nerves are also blocked by the medication, resulting in vasodilation and hypotension. Answer 2 is incorrect because hypertension is not a side effect of epidural anesthesia. Answer 3 is incorrect because hypoventilation does not occur when bupivacaine is used as the anesthetic agent. If epidural narcotics are used, hypoventilation can occur. Answer 4 is incorrect because hyperventilation is not a side effect of epidural anesthesia; it is more likely to occur during painful contractions. Epidural anesthesia helps to relieve contraction pain.
