Question

A 26 year-old primigravida is admitted to the L&D suite in active labor. Her contractions are occurring every 2 to 4 minutes, lasting 60 seconds with moderate intensity. The nurses' vaginal examination notes the cervix to be 5 cm, 100% effaced, at +1 station, the client is requesting an epidural for pain management. What are the advantages of regional anesthesia (an epidural)? What are the nursing responsibilities during administration of epidural anesthesia?

Answer 1

Answers

Epidural anesthesia in pregnancy

Epidural anesthesia is a procedure in which a local anesthetic is injecting around the spinal nerves of the lower back. The main purpose of administering this anesthetic is to relieve pain during labor contractions and delivery.

Advantages of epidural anesthesia

• Epidural anesthesia is one of the most effective methods to relieve pain during delivery.
• This method has a minimal side on both mother and baby.
• The patient will relieve from within 10-20 minutes after the administration of the epidural.
• Epidural will makes the mother stay alert and the mother will actively participate during the delivery.
• If the mother needs a cesarean section also, epidural will helps to remain the patient awake and comfortable.
• Epidural will helps to lower blood pressure. If the mother is suffering from high blood pressure, this will helps to maintain the blood pressure during delivery, thereby reducing the complications.

Nursing responsibilities during the administration of epidural anesthesia

• The nurse should obtain informed consent for the epidural anesthesia procedure with the patient signature before the anesthesia administration
• Before administration monitor the mother’s vital signs, level of consciousness, level of mobility, and pain level.
• Monitor the fetus status
• Epidural anesthesia should administer in a sterile technique.
• Maintain the competency of the epidural anesthesia infusion pump.
• To avoid interruption of the epidural analgesia, replace the empty medication syringe/bag in the epidural pump containing the same medication.
• The nurse should monitor the mother’s reaction and response to the medication during the administration.
• Monitor the sedation score and degree of motor and sensory nerve block
• Assess for any signs and symptoms of complications include hypotension, nausea, and vomiting, urinary retention.
• Administration of increased IV fluids if the patient experience hypotension
• The nurse should keep all the emergency equipment, medications, oxygen delivery readily available.
• Monitor blood pressure every 3 minutes during the procedure.
• Monitor the fetal heart rate during the procedure and inform if there were any abnormalities.
• Monitor the uterine contractions and maternal vital signs every 5 minutes for the first 15 minutes after the procedure.
• The nurse should document all the care providing to the patient during the epidural anesthesia.
• Document regarding the insertion site and condition of the catheter tip.