Nokea
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.
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A nurse is preparing to administer a drug that is used to prevent uterine contractions. Which drug might the nurse be preparing to administer?
- A. Misoprostol (Cytotec)
- B. Indomethacin (Indocin)
- C. Terbutaline (Brethine)
- D. Oxytocin (Pitocin)
- E. Dinoprostone (Cervidil)
Correct Answer: B,C
Rationale: Tocolytics, like indomethacin (Indocin) and terbutaline (Brethine), are used to prevent uterine contractions. Misoprostol and oxytocin are uterine stimulants. Dinoprostone is used to ripen the cervix.
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.
When explaining the action of oxytocin to a client, the nurse integrates knowledge of which of the following about the drug?
- A. Secretion by the anterior pituitary gland
- B. Uterine-stimulating properties
- C. Diuretic effects
- D. Vasopressor effects
- E. Stimulation of milk ejection
Correct Answer: B,D,E
Rationale: Oxytocin is a hormone secreted by the posterior pituitary gland that has uterine-stimulating properties, exerts antichuretic and vasopressor effects, and stimulates milk ejection.
A nurse prepares to administer oxytocin (Pitocin) intramuscularly during the third stage of labor for which of the following reasons?
- A. Production of uterine contractions
- B. Stimulation of milk ejection
- C. Control of postpartum bleeding
- D. Initiation of labor
- E. Control of postpartum hemorrhage
Correct Answer: A,C,E
Rationale: Oxytocin (Pitocin) may be given intramuscularly during the third stage of labor to produce uterine contractions and control postpartum bleeding and hemorrhage.
Immediately before starting an IV infusion of oxytocin (Pitocin), the nurse assesses which of the following?
- A. Client's blood pressure
- B. Fetal heart rate
- C. Client's blood glucose
- D. Client's temperature
- E. Client's respiratory rate
Correct Answer: A,B,E
Rationale: Immediately before starting an IV infusion of oxytocin (Pitocin), the nurse assesses the fetal heart rate and the client's blood pressure, pulse, and respiratory rate.