Nokea
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.
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A nurse should monitor a client for which of the following adverse reactions during the administration of tocolytic therapy to prevent uterine contractions?
- A. Fatigue
- B. Diaphoresis
- C. Diplopia
- D. Hypertension
- E. Prolonged vaginal bleeding
Correct Answer: A,B,C
Rationale: A nurse should monitor a client for the following adverse reactions during tocolytic therapy to prevent uterine contractions: fatigue, flushing, headache, diplopia, diaphoresis, hypotension, depressed reflexes, and flaccid paralysis.
A 31-year-old pregnant woman has been prescribed a tocolytic drug. The nurse understands that this drug is primarily indicated for which of the following?
- A. Antepartal hypertension
- B. Preterm labor
- C. Postpartum hemorrhage
- D. Protracted labor
Correct Answer: B
Rationale: Drugs used to prevent uterine contractions are called tocolytics. They are useful in the management of preterm labor. These drugs will decrease uterine activity and prolong the pregnancy to allow the fetus to develop more fully, thereby increasing the chance of neonatal survival. Oxytocic drugs are used antepartum (before birth of Dyson) to induce uterine contractions and initiate or augment labor. Tocolytics are not used for postpartum hemorrhage or protracted labor.
When monitoring uterine contractions of a client receiving an oxytocin infusion, the nurse should notify the primary health care provider immediately if which of the following occur?
- A. No palpable relaxation of the uterus
- B. Significant change in client's blood pressure
- C. Significant change in fetal heart rhythm
- D. Significant change in rhythm of uterine contractions
- E. Significant change in frequency of uterine contractions
Correct Answer: A,B,C,D,E
Rationale: When monitoring uterine contractions, the nurse should notify the physician immediately if any of the following occur: a significant change in fetal heart rate or rhythm; a marked change in the frequency, rate, or rhythm of uterine contractions; uterine contractions lasting longer than 60 seconds; contractions occurring more frequently than every 2 or 3 minutes; no palpable relaxation of the uterus; a marked increase or decrease in the client's blood pressure or pulse; or any significant change in the client's general condition.
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 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.