Nokea
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.
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After administering an injection of oxytocin (Pitocin), the nurse continues to assess which of the following?
- A. Blood pressure
- B. Blood glucose
- C. Pulse
- D. Temperature
- E. Respiratory rate
Correct Answer: A,C,E
Rationale: After an injection of oxytocin (Pitocin), during ongoing assessment the nurse monitors the following: the client's blood pressure, pulse, and respiratory rate.
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.
Before beginning an IV infusion of oxytocin (Pitocin) to induce labor, the nurse obtains an obstetric history that includes which of the following?
- A. Parity
- B. Stillbirths
- C. Abortions
- D. Previous obstetric problems
- E. Type of labor
Correct Answer: A,B,C,D,E
Rationale: Before beginning an IV infusion of oxytocin (Pitocin) to induce labor, the nurse obtains an obstetric history that includes parity, gravidity, previous obstetric problems, type of labor, stillbirths, abortions, and live-birth infant abnormalities.
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.
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.