After a woman receives a subarachnoid spinal block for a cesarean delivery, which adverse effect should the nurse monitor for?

After a woman receives a subarachnoid spinal block for a cesarean delivery, monitoring for headache is particularly important due to the risk of a post-dural puncture headache. A subarachnoid spinal block involves the injection of anesthetic into the spinal fluid, and if the dura mater is inadvertently punctured, it can lead to a leak of cerebrospinal fluid. This leak may result in a decrease in intracranial pressure, leading to a headache that can be positional; typically worsening when the patient is upright and improving when lying down.

Headaches associated with spinal anesthesia are often characterized as severe and can be accompanied by other symptoms such as nausea and neck stiffness. Immediate recognition and management of this complication are essential in providing effective post-operative care for the patient.

Monitoring for other potential effects, such as vomiting, pruritus, or hypotension, is also relevant, but the most common and clinically significant adverse effect directly linked to spinal blocks is the post-dural puncture headache.