Select the 3 findings that would require immediate action from the nurse while the laboring mother is receiving an epidural anesthesia.
Explanation & Rationale
A. Dizziness: Often an early symptom of hypotension caused by epidural-induced vasodilation. It should be assessed promptly but is not as immediately life-threatening as hypotension or respiratory compromise. B. Reports of pain: May indicate inadequate epidural coverage but is not life-threatening. Repositioning or additional dosing can typically address it without urgent intervention. C. Hypotension: A serious and common complication of epidural anesthesia. It reduces uteroplacental perfusion and can result in fetal hypoxia. Immediate fluid bolus and possible vasopressor administration are indicated. D. Nausea: Frequently accompanies hypotension but is not critical alone. It should prompt reassessment of blood pressure but does not necessitate emergency action unless combined with other symptoms. E. Fetal decelerations: Reflect compromised fetal oxygenation, often secondary to maternal hypotension. Immediate interventions like repositioning, oxygen administration, or discontinuing oxytocin may be needed. F. Difficulty breathing: Suggests high or total spinal anesthesia with ascending block affecting the diaphragm or intercostal muscles. This is a life-threatening emergency that requires immediate airway management and anesthesiology support.