Nokea
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.
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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.
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.
A client who is receiving a tocolytic develops hypotension. The nurse would notify the primary health care provider and place the client in which position?
- A. Supine
- B. Lithotomy
- C. Left lateral
- D. Knee-chest
Correct Answer: C
Rationale: If a client develops hypotension while receiving a tocolytic drug, the nurse would notify the primary health care provider and place the client in the left lateral position to promote adequate fetal perfusion until the provider orders otherwise.
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.
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.