Nokea
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.
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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.
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.
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 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.
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.