Nokea
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.
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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.
A nurse is administering magnesium to a client as part of therapy to halt preterm labor. The nurse is alert to the possibility of increased central nervous system depression if the client is also receiving which of the following?
- A. Fentanyl (Duragesic)
- B. Glyburide (DiaBeta)
- C. Lorazepam (Ativan)
- D. Meperidine (Demerol)
- E. Enalapril (Vasotec)
Correct Answer: A,C,D
Rationale: The administration of magnesium with the following drugs results in increased central nervous system depression: opioids (fentanyl and meperidine), sedatives (lorazepam), and analgesics.
A nurse suspects that a client receiving an oxytocic drug is developing water intoxication based on assessment of which of the following?
- A. Tachypnea
- B. Wheezing
- C. Confusion
- D. Hypoglycemia
- E. Hypotension
Correct Answer: A,B,C
Rationale: The nurse immediately reports any signs of water intoxication or fluid overload, which include drowsiness, confusion, headache, listlessness, wheezing, coughing, and tachypnea, to the physician.
A 32-year-old pregnant woman has been prescribed an IV infusion of oxytocin to induce labor. Which of the following interventions would be most appropriate for the nurse to implement before starting the IV infusion of oxytocin for the client?
- A. Ask the client to drink plenty of water
- B. Obtain an obstetric and general health history
- C. Examine for signs of water intoxication
- D. Place the client in an upright position
Correct Answer: B
Rationale: Before starting an IV infusion of oxytocin to induce labor, the nurse should obtain a complete obstetric history (e.g., parity, gravidity, previous obstetric problems, type of labor, stillbirths, abortions, live-birth infant abnormalities) and a general health history. Clients should not have water before labor, as the oxytocin may lead to water intoxication. The nurse should examine for any signs of water intoxication or fluid overload as a sign of an adverse reaction to the drug and need not assess this before administration of the medication. Placing the client in an upright position is advised when oxytocin is administered intranasally to facilitate the letdown of milk for breastfeeding.
A nurse should monitor a client for which of the following adverse reactions during the administration of tocolytic therapy to prevent uterine contractions?
- A. Fatigue
- B. Diaphoresis
- C. Diplopia
- D. Hypertension
- E. Prolonged vaginal bleeding
Correct Answer: A,B,C
Rationale: A nurse should monitor a client for the following adverse reactions during tocolytic therapy to prevent uterine contractions: fatigue, flushing, headache, diplopia, diaphoresis, hypotension, depressed reflexes, and flaccid paralysis.