Nokea
A nurse is preparing to administer oxytocin (Pitocin) intravenously to a client based on the understanding that this drug is used for which of the following reasons?
- A. Gestational diabetes and a large fetus
- B. Rh problems
- C. Premature rupture of membranes
- D. Uterine inertia
- E. Pregnancy-induced hypertension
Correct Answer: A,B,C,D,E
Rationale: A nurse may be asked to administer oxytocin (Pitocin) intravenously to a client with the following: gestational diabetes and a large fetus, Rh problems, premature rupture of membranes, uterine inertia, or pregnancy-induced hypertension.
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A nurse administering oxytocin (Pitocin) to a client should monitor the client for which of the following?
- A. Water intoxication
- B. Diarrhea
- C. Uterine rupture
- D. Headache
- E. Cardiac arrhythmias
Correct Answer: A,C,E
Rationale: A nurse should monitor a client receiving oxytocin (Pitocin) for the following adverse reactions: fetal bradycardia, uterine rupture, uterine hypertonicity, nausea, vomiting, cardiac arrhythmias, and anaphylactic reactions. Serious water intoxication (fluid overload, fluid volume excess) may occur, particularly when the drug is administered by continuous infusion and the patient is receiving fluids by mouth.
A client receiving prescribed magnesium sulfate shows signs of dyspnea, tachycardia, and increased respiratory rate and rales. The nurse notices frothy sputum. Which of the following conditions should the nurse suspect?
- A. Pulmonary edema
- B. Water intoxication
- C. Renal failure
- D. Cardiac arrest
Correct Answer: A
Rationale: The client is most likely experiencing pulmonary edema. If there is an increase in respiratory rate of more than 20 respirations/min with the administration of magnesium sulfate, the nurse should assess the respiratory status for symptoms of pulmonary edema such as dyspnea, tachycardia, rales, and frothy sputum. In such cases, the primary health care provider is notified immediately because use of the drug may be discontinued or the dosage may be decreased. The danger of water intoxication is associated with oxytocin as it has an antidiuretic effect, and not with magnesium sulfate. Renal failure and cardiac arrest are not associated with magnesium sulfate.
After teaching a group of students about uterine drugs, the instructor determines that the teaching was successful when the students identify which of the following as oxytocic drugs?
- A. Oxytocin (Pitocin)
- B. Methylergonovine (Methergine)
- C. Estradiol (Estrace)
- D. Indomethacin (Indocin)
- E. Misoprostol (Cytotec)
Correct Answer: A,B,E
Rationale: Oxytocin (Pitocin), methylergonovine (Methergine), and misoprostol (Cytotec) are classified as oxytocic drugs. Indomethacin is a tocolytic. Estradiol is an estrogen.
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.
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.