7 a woman you are caring for in labor requests an

7. A woman you are caring for in labor requests an epidural for pain relief in labor. Included in
your preparation for epidural placement is a baseline set of vital signs. The most common vital
sign to change after epidural placement:a. Blood pressure, hypotension
b. Blood pressure, hypertension
c. Pulse, tachycardia
d. Pulse, bradycardia
ANS: a
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a. Blood pressure, hypotension, as up to 40% of
women may experience hypotension.
Hypotension is defined as systolic BP <100 mm
Hg or 20% decrease in BP from preanesthesia
levels. Intravenous bolus is typically given to
decrease the incidence of hypotension.
b. Blood pressure, hypertension is incorrect
because hypotension is the common
complication after epidural placement.
c. Pulse, tachycardia is incorrect because
hypotension is the common complication after
epidural placement.
d. Pulse, bradycardia is incorrect because
hypotension is the common complication after
epidural placement.
KEY: Integrated Process: Clinical Problem Solving | Cognitive Level: Application | Content
Area: Maternity | Client Need: Physiological Adaptation | Difficulty Level: Moderate
8. The labor patient you are caring for is ambulating in the hall. Her vaginal exam 1 hour ago
indicated she was 4/70/–1 station. She tells you she has fluid running down her leg. Your priority
nursing intervention is to:a. Assess the color, odor, and amount of fluid.b. Assist your patient to
the bathroom.c. Assess the fetal heart rate.d. Call the care provider.

with rupture of membranes.
d. Although you may call the care provider, the
priority nursing action is to assess the FHR
because of the risk of umbilical cord prolapse
with rupture of membranes.
KEY: Integrated Process: Clinical Problem Solving | Cognitive Level: Application | Content
Area: Maternity | Client Need: Reduction of Risk Potential | Difficulty Level: Moderate
9. You are in the process of admitting a multiparous woman to labor and delivery from the triage
area. One hour ago her vaginal exam was 4/70/0. While completing your review of her prenatal
record and completing the admission questionnaire, she tells you she has an urge to have a bowel
movement and feels like pushing. Your priority nursing intervention is to:a. Reassure the patient
and rapidly complete the admission.b. Assist your patient to the bathroom to have a bowel
movement.c. Assess the fetal heart rate and uterine contractions.d. Perform a vaginal exam.