Epidural Catheter

Deborah Tibbs MSN, RN, BC, CCM

NSG 353
Fall 2012

Epidural Analgesia
A patient who had a small bowel resection this am has
been transported from the post anesthesia care unit
(PACU) to the medical surgical unit.
The patient has a nasogastric tube to low intermittent
suction, a Foley catheter, an IV of 0.9% normal saline
(NS) infusing at 50 milliliters (mL) per hour, and an
Epidural Catheter.
The patient has a midline abdominal incision with a small
amount of red drainage.

Ohio Board of Nursing

When can a registered nurse monitor and
manage the care of a patient with an
Epidural Infusion ?
Who is responsible for caring for the
Epidural Infusion?
What can the registered nurse do?
What can the student nurse do?
Can this be delegated to an LPN?

Safety
Where is the epidural catheter placed?
How would the nurse know if the catheter
was not in place?
Why should the infusion be preservative
free (PF)?
Why should the epidural infusion be on an
infusion pump?

Epidural Order Set

Continuous Epidural Infusion:
Discontinue all IV, IM, PO narcotics unless ordered by
anesthesia while epidural is infusing.
Discontinue all epidural medication orders after
catheter removed.
Label pump and tubing as Epidural
Epidural infusion of fentanyl (PF) SUBLIMAZE 1,250
mcg, bupivacaine (PF) MARCAINE O.5% (5 MG/ML)
62.5 mL in Na Cl 0.9% 162.5 mL.
Administer at 2-12 mL/hour, continuous starting
today until discontinued

Nursing Interventions
What are the priority nursing
interventions when caring for the
patient with a continuous epidural
infusion?

Priority Nursing Interventions

Monitor for Respiratory Depression

Prevent catheter displacement
Maintain catheter function
Prevent Infection
Maintain urinary and bowel function
Prevent undesirable complications