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Exam (elaborations)

NUR 275 - EPIDURALS EXAM LATEST UPDATED

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NUR 275 - EPIDURALS EXAM LATEST UPDATED...

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  • August 22, 2024
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  • NUR 275 - EPIDURALS
  • NUR 275 - EPIDURALS
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NUR 275 - EPIDURALS EXAM LATEST UPDATED


State Board of Nursing (SC) - ANSWER RN may administer medication to the
epidural & intrathecal space and peripheral nerve with the use of an electronic
pump

RN may monitor, maintain, regulate, and/or terminate a continuous epidural,
intrathecal, or peripheral nerve infusion of medications

RN may remove epidural or peripheral nerve (NOT INTRATHECAL) catheters (as
long as it was an uncomplicated epidural)

What do I need to know about the spinal cord? - ANSWER Remember :

(3 layers called the meninges)

Dura mater- outermost layer, surrounds the spinal cord

Arachnoid membrane- between the dura & pia mater

Pia mater- innermost layer adheres to the surface of the spinal cord

Epidural space- lies between the dura mater and the wall of the vertebrae canal

Intrathecal space (CSF)- subarachnoid space. Lies beneath the arachnoid membrane
and is filled with CSF

Intrathecal & epidural meds affect my patient, how? - ANSWER Think about
where the medication is placed!!!!

Intrathecal delivery = profound numbness

Epidural delivery = little to no numbness

Epidural medication - ANSWER Injected into the epidural space into the lumbar
region or thoracic region side effects, no headache, pain relief without numbness
(injected into the meninges around the spinal cord.

, Intrathecal medication - ANSWER Medication that is intended for diffusion into
the cerebrospinal fluid (usually between the L4 & L5

Causes profound numbness

Where does the spinal cord end? - ANSWER Between L1 & L2

Where is the epidural usually injected? - ANSWER Between L3 & L4

Why is an epidural injected between L3 & L4? - ANSWER The location is below
the spinal cord to avoid paralysis



Epidural Analgesia - ANSWER Position in side-lying position w/legs flexed (fetal)

A catheter placed on the dermatome

End of catheter closed

Placement verified (test dose)

Contraindications - ANSWER •Anti-Coagulation (risk of hematoma)

•Systemic infection (risk of infection)

•Increased intracranial pressure (risk of cerebral herniation)

•Decreased LOC (cannot verbalize pain)

Low platelets (risk of bleeding/hematomas)



Epidural Continuous Infusion - ANSWER Usually placed by anesthetist prior to or
during surgery

Catheter placed at level of lumbar or thoracic vertebrae

Catheter placement site is dressed with clear sterile dressing

Catheter is taped to patient's back and brought up over patient's shoulder

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