The nurse is caring for a pregnant client who is in labor and has a past medical history of heart failure. The client has dyspnea. Which of the following interventions would the nurse expect?
A) Hydrate with intravenous fluids.
B) Bearing down to relieve pain.
C) Epidural anesthesia.
D) General anesthesia.
Answer (2)
The most appropriate intervention for the pregnant client in labor with a history of heart failure and experiencing dyspnea is C) Epidural anesthesia. This option helps manage pain while allowing the client to relax, which can ease strain on the heart. Careful monitoring is important to ensure safety due to her medical history.
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When caring for a pregnant client with a history of heart failure who is in labor and experiencing dyspnea (difficulty breathing), the nurse needs to consider interventions that will minimize stress on both the mother and the fetus while also addressing the underlying heart condition.
Option A: Hydrate with intravenous fluids - This is generally not the preferred intervention for a patient with heart failure because administering excessive fluids can exacerbate the condition, leading to fluid overload and worsening of heart failure symptoms such as pulmonary edema.
Option B: Bearing down to relieve pain - Encouraging the client to bear down is not typically used to relieve pain and can increase intrathoracic pressure and workload on the heart, which may not be advisable given the client’s heart condition.
Option C: Epidural anesthesia - This option is often favorable in labor for patients with heart failure. It provides effective pain relief which can help to reduce stress and oxygen consumption, thus alleviating some of the strain on the heart. By achieving effective pain control, it helps manage dyspnea indirectly.
Option D: General anesthesia - This is less preferable because it can have more profound effects on cardiovascular and respiratory function compared to regional anesthesia like an epidural. General anesthesia may pose a higher risk to patients with heart failure unless it is absolutely necessary.
Therefore, the most suitable intervention for the nurse to expect in this scenario is Option C: Epidural anesthesia . This would provide effective pain management and may help to manage dyspnea by reducing the physiological stress associated with labor.
It is important for the healthcare team to closely monitor the cardiac status of the patient throughout labor and delivery to ensure the safety of both mother and child.
