epidural block for labor and delivery

J.C delivered a healthy male infant 2 hours ago.  She had a fourth-degree laceration.  This is her sixth pregnancy.  Before this delivery, she was para 4014.  She had an epidural block for her labor and delivery.  She is now admitted to the postpartum unit.

Hepatitis: neg

Rubella: non immune

HIV: neg

Bood type: A neg

EBL: 450ml

1.  What is important to note in the initial assessment?

The most important to note for this patient is that she had an epidural block. So, you want to check vitals like blood pressure because epidural can lower the blood pressure compare it to J.C baseline and continue to monitor until it returns back to normal. Since she also had a 4th degree laceration you want to assess the insicion to make sure proper healing and no signs of infection.

2.  You find a boggy fundus during your assessment.  What corrective measures can be initiated?

3.  J.C complains of pain and discomfort in her perineal area.  How will you respond?

4.  Three hours later, the nursing assistant assesses J.C. vital signs.  Which vital signs would be of concern at this time?

T – 99.9 (37.6C)

Pulse – 120 bpm

Blood pressure 90/50 mm Hg

Respirations 16 bpm

5.  What will you do next?