Nokea
After teaching a group of nursing students about drugs that affect the uterus, the instructor determines that the teaching was successful when the students identify which drug as being used for cervical ripening?
- A. Terbutaline
- B. Nifedipine
- C. Dinoprostone
- D. Misoprostol
Correct Answer: C
Rationale: Dinoprostone is a cervical ripening agent, Terbutaline and nifedipine are used for tocolysis. Misoprostol is used as a uterine stimulant.
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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.
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 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 32-year-old pregnant woman has been prescribed an IV infusion of oxytocin to induce labor. Which of the following interventions would be most appropriate for the nurse to implement before starting the IV infusion of oxytocin for the client?
- A. Ask the client to drink plenty of water
- B. Obtain an obstetric and general health history
- C. Examine for signs of water intoxication
- D. Place the client in an upright position
Correct Answer: B
Rationale: Before starting an IV infusion of oxytocin to induce labor, the nurse should obtain a complete obstetric history (e.g., parity, gravidity, previous obstetric problems, type of labor, stillbirths, abortions, live-birth infant abnormalities) and a general health history. Clients should not have water before labor, as the oxytocin may lead to water intoxication. The nurse should examine for any signs of water intoxication or fluid overload as a sign of an adverse reaction to the drug and need not assess this before administration of the medication. Placing the client in an upright position is advised when oxytocin is administered intranasally to facilitate the letdown of milk for breastfeeding.
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.