Nokea
A nurse is caring for a pregnant client receiving oxytocin. The client is in the third stage of labor. The nurse would expect to administer oxytocin by which route?
- A. Intravenous
- B. Intramuscular
- C. Subcutaneous
- D. Intranasal
Correct Answer: B
Rationale: Oxytocin is given intramuscularly (IM) during the third stage of labor. It is the time period from when the neonate is expelled until the placenta is expelled. Oxytocin is given intramuscularly to produce uterine contractions and control postpartum bleeding and hemorrhage. Oxytocin is not given intravenously, subcutaneously, or intranasally during the third stage of labor.
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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 understands that methylergonovine (Methergine) should not be administered to which client because excessive vasoconstriction may result?
- A. Client who is a heavy smoker
- B. Client taking a diuretic
- C. Client receiving insulin
- D. Client taking an antihypertensive
- E. Client taking a vasopressor
Correct Answer: A,E
Rationale: When methylergonovine (Methergine) is administered concurrently with vasopressors or to clients who are heavy smokers, excessive vasoconstriction may result.
A client is receiving terbutaline for preterm labor. After administering the drug, the nurse would be alert for which of the following as an adverse reaction?
- A. Diplopia
- B. Nervousness
- C. Tremor
- D. Palpitations
- E. Heartburn
Correct Answer: B,C,D
Rationale: Adverse reactions associated with terbutaline include nervousness, restlessness, tremor, headache, anxiety, hypertension, palpitations, arrhythmias, hypokalemia, and pulmonary edema. Diplopia and heartburn are associated with indomethacin.
A client is admitted for tocolytic therapy for preterm labor. The client states, 'I'm so afraid that I'm so early. Is my baby okay? What if the drug doesn't help?' Based on the client's statement, the nurse would identify which nursing diagnosis as the priority?
- A. Anxiety
- B. Risk for Injury
- C. Impaired Gas Exchange
- D. Excess Fluid Volume
Correct Answer: A
Rationale: Based on the client's statements, the nurse would identify Anxiety as the priority nursing diagnosis because of the client's stated concern for her fetus and cessation of labor. Risk for Injury and Excess Fluid Volume would be more appropriate for a client receiving oxytocin. Impaired Gas Exchange would be appropriate if the client was experiencing adverse reactions related to the tocolytic.
The nurse is preparing to administer a prescribed drug to help prevent hemorrhage caused by uterine atony. Which drug would the nurse most likely administer?
- A. Carboprost (Hemabate)
- B. Indomethacin (Indocin)
- C. Methylergonovine (Methergine)
- D. Terbutaline (Brethine)
- E. Misoprostol (Cytotec)
Correct Answer: A,C,E
Rationale: Carboprost (Hemabate), methylergonovine (Methergine), misoprostol (Cytotec), and ergonovine (Ergotrate) are used postpartum to prevent hemorrhage caused by uterine atony. Indomethacin and terbutaline are used as tocolytics.