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NUR 275 - EPIDURALS EXAM LATEST UPDATED
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NUR 275 - EPIDURALS EXAM LATEST UPDATED...
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NUR 275 - EPIDURALS EXAM LATEST UPDATEDState 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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