Nokea
A client is receiving methylergonovine (Methergine). After administering the drug, the nurse would be alert for which of the following?
- A. Chest pain
- B. Hypoglycemia
- C. Increase in blood pressure
- D. Diarrhea
- E. Water intoxication
Correct Answer: A,C,D
Rationale: Adverse reactions associated with methylergonovine include temporary chest pain, hypertension, diarrhea, nausea, vomiting, dizziness, and headache.
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A client is to receive indomethacin as tocolytic therapy. Which of the following laboratory tests would the nurse expect to be performed as a baseline?
- A. Complete blood count
- B. Serum creatinine level
- C. Liver function tests
- D. Amniotic fluid index
- E. Blood glucose level
Correct Answer: A,B,C,D
Rationale: Baseline laboratory testing includes a complete blood count, creatinine level, liver function tests, and amniotic fluid index. Blood glucose level may be done if diabetes is suspected or confirmed.
After administering an injection of oxytocin (Pitocin), the nurse continues to assess which of the following?
- A. Blood pressure
- B. Blood glucose
- C. Pulse
- D. Temperature
- E. Respiratory rate
Correct Answer: A,C,E
Rationale: After an injection of oxytocin (Pitocin), during ongoing assessment the nurse monitors the following: the client's blood pressure, pulse, and respiratory rate.
A 30-year-old pregnant woman has been prescribed oxytocin. When assessing the client's drug regimen, the nurse understands that the client is taking vasopressors. Which of the following risks is the client most susceptible to if oxytocin is administered along with vasopressors?
- A. Anaphylactic shock
- B. Hypertension
- C. Respiratory failure
- D. Heart attack
Correct Answer: B
Rationale: Combining oxytocin with vasopressor drugs increases the risk of severe hypertension. Combining oxytocin and vasopressors does not increase the risk of heart attack or respiratory failure. Anaphylactic shock is associated with a hypersensitivity reaction and does not occur with the interaction of vasopressors and oxytocin.
Before beginning an IV infusion of oxytocin (Pitocin) to induce labor, the nurse obtains an obstetric history that includes which of the following?
- A. Parity
- B. Stillbirths
- C. Abortions
- D. Previous obstetric problems
- E. Type of labor
Correct Answer: A,B,C,D,E
Rationale: Before beginning an IV infusion of oxytocin (Pitocin) to induce labor, the nurse obtains an obstetric history that includes parity, gravidity, previous obstetric problems, type of labor, stillbirths, abortions, and live-birth infant abnormalities.
A client has received a special formulation of oxytocin for intranasal use. The nurse understands that the rationale for using this formulation of the drug involves which effect?
- A. Antistimulating properties on the uterus
- B. Diuretic effect
- C. Stimulation of the milk ejection reflex
- D. Control of antepartum bleeding
Correct Answer: C
Rationale: Oxytocin, when administered intranasally, stimulates the milk ejection (milk letdown) reflex. Oxytocin has uterine-stimulating properties, not antistimulating properties, on the uterus. Tocolytics have an antistimulating effect on the uterus. Oxytocin has an antidiuretic effect, which might lead to a danger of excessive fluid volume (water intoxication), and not a diuretic effect. Oxytocin is given IM during the third stage of labor to produce uterine contractions and control postpartum, and not antepartum, bleeding and hemorrhage.