A postpartum nurse monitors a patient who had a subarachnoid (spinal) block for cesarean delivery. Which adverse effect is monitored?

A postpartum nurse monitors a patient who had a subarachnoid (spinal) block for cesarean delivery. Which adverse effect is monitored?

• A. Headache
• B. Pruritus
• C. Vomiting
• D. Hypertension

Answer: (A)

The main idea is that a spinal (subarachnoid) block can cause a post-dural puncture headache due to cerebrospinal fluid leakage at the puncture site. When the dura is breached, CSF can escape, lowering the intracranial pressure and pulling on the meninges, which produces a headache that is typically worse when upright and may improve when lying down. This often appears within hours to a couple of days after the procedure and is especially relevant in the postpartum patient who received a spinal block. Management is supportive—hydration, caffeine, rest, and analgesics—with escalation to an epidural blood patch if the headache is persistent or severe. While vomiting, pruritus, or transient hypotension can occur with spinal anesthesia, the most characteristic adverse effect to monitor in this setting is the post-dural puncture headache.

The main idea is that a spinal (subarachnoid) block can cause a post-dural puncture headache due to cerebrospinal fluid leakage at the puncture site. When the dura is breached, CSF can escape, lowering the intracranial pressure and pulling on the meninges, which produces a headache that is typically worse when upright and may improve when lying down. This often appears within hours to a couple of days after the procedure and is especially relevant in the postpartum patient who received a spinal block. Management is supportive—hydration, caffeine, rest, and analgesics—with escalation to an epidural blood patch if the headache is persistent or severe. While vomiting, pruritus, or transient hypotension can occur with spinal anesthesia, the most characteristic adverse effect to monitor in this setting is the post-dural puncture headache.