After undergoing a thoracotomy, a male client is receiving epidural analgesia. Which assessment finding indicates that the client has developed the most serious complication of epidural analgesia?
A. Heightened alertness
B. Increased heart rate
C. Numbness and tingling of the extremities
D. Respiratory depression
Correct Answer: D. Respiratory depression
Respiratory depression is the most serious complication of epidural analgesia. Other potential complications include hypotension, decreased sensation and movement of the extremities, allergic reactions, and urine retention. Typically, epidural analgesia causes central nervous system depression (indicated by drowsiness) as well as a decreased heart rate and blood pressure.
Option A: Adverse reactions or complications of epidural analgesia can be related to the medication used or to the epidural catheter itself. Adverse reactions to opioids administered epidurally include pruritus, nausea, vomiting, urinary retention, decreased level of consciousness, and respiratory depression.
Option B: Local anesthetics can cause sensory and motor deficits in dermatomes that aren’t meant to be blocked. They can also cause bradycardia and hypotension related to blocking the sympathetic nervous system.
Option C: Late-onset respiratory depression is a risk with hydrophilic opioids (morphine and hydromorphone). Urinary retention can occur with both opioids and local anesthetics, especially if they’re administered in the lumbar region. There’s a decreased risk of urinary retention when the epidural catheter is placed in the thoracic region.
No comments:
Post a Comment