Maternal Child- Pharmacology

A nurse is counseling a pregnant client with iron-deficiency anemia about when and how to take supplemental iron. What time of day is iron absorption most efficient?

Before breakfast Iron should be taken before breakfast, on an empty stomach, to permit maximal absorption. Iron should not be taken with or after meals or at bedtime

At 6 weeks' gestation a client is found to have gonorrhea. What medication does a nurse expect the primary healthcare provider to prescribe?

Ceftriaxone Ceftriaxone, a broad-spectrum antibiotic, is preferred during pregnancy. Levofloxacin, although listed as for unlabeled use against gonococcal infection, should not be prescribed during pregnancy. Sulfonamides may cause hemolysis in the fetus. Trimethoprim/sulfamethoxazole contains a sulfonamide and is contraindicated during pregnancy.

A client is taking fertility drugs for the first time. Which adverse effect of the drug should the nurse inform the client about?

Constipation Constipation is seen in the clients who are treated with fertility drugs for the first time. Fertility drugs do not cause vaginitis and swelling of joints. Deep vein thrombosis is an adverse effect of prolonged use of fertility drugs.

Which antihistamine is considered safe for a woman who plans to breast-feed?

Loratadine Loratadine does not get excreted in the breast milk. Therefore it is a safe drug for a lactating mother to take. Sertraline is an antidepressant that is safe for lactating women. Clemastine and bromocriptine are contraindicated in lactating women.

A 4-year-old child develops thrombocytopenia after vaccination. Which vaccination may be responsible?

Measles, mumps, and rubella virus vaccine (MMR) Measles, mumps, and rubella virus vaccine (MMR) may cause transient thrombocytopenia. It is generally benign and occurs only rarely. Rotavirus vaccine carries a small risk for intussusception. Varicella virus vaccine and human papillomavirus vaccine may cause mild effects such as fever and fainting.

Which drug may be used both for cervical ripening during labor and as a stomach protectant?

Misoprostol Misoprostol can be used for cervical ripening and as a stomach protectant. Raloxifene is used to prevent postmenopausal osteoporosis. Clomiphene is used for ovulation. Dinoprostone can be used for cervical ripening, but this drug does not act as a stomach protectant.

A nurse is counseling a pregnant client with iron-deficiency anemia about when and how to take supplemental iron. With what drink is iron absorption most efficient?

Orange Juice Iron should be taken before breakfast, on an empty stomach, to permit maximal absorption; the ascorbic acid in orange juice enhances the absorption of iron. Water does not provide the ascorbic acid necessary for absorption of iron. Iron should not be taken with milk or other dairy products, which may interfere with its absorption.

What are the actions of oxytocin? Select all that apply.

Promotes milk ejection during lactation Controls uterine bleeding after delivery Induces labor when uterine contractions are weak Oxytocin is a hormone supplement that is indicated for milk ejection during lactation because it promotes the movement of milk from the mammary glands to the nipples. Oxytocin also controls uterine bleeding after delivery. Oxytocin stimulates uterine contraction during childbirth, which induces labor when uterine contractions are weak. Oxytocin is contraindicated in uterine fibrosis. Hormones cannot prevent high-risk intrauterine fetal positions before delivery.

A married couple has been using oral contraceptives to delay pregnancy. When the wife misses her regular menstrual period, she decides to find out whether she is pregnant. She tells the nurse that pregnancy may have occurred because she missed her contraceptive pills for 1 week when she had the flu. How should the nurse respond?

"You may be correct. The effect of contraceptive pills depends on their being taken on a regular schedule." An oral contraceptive program requires the client to take one tablet daily from the fifth day of the cycle and continue taking tablets for 20 or 21 days. Interrupting the monthly dosage program may permit release of luteinizing hormone, resulting in ovulation and possibly pregnancy. Stating that people often forget to take oral contraceptive pills is judgmental; contraceptive practice is the client's choice. It is premature to discuss abortion. Oral contraceptives that are taken on an exact schedule have a very high rate of success.

What is the definition of a tocolytic?

A drug that inhibits labor and maintains a pregnancy Tocolytics are drugs used to inhibit labor and maintain a pregnancy. Abortifacients are drugs taken to terminate a pregnancy or induce an abortion. Oxytocics are used to stimulate the uterine contractions in pregnancy. Teratogens are drugs that cause harmful effects to the fetus.

The clinic nurse is planning care for a client found to have chlamydia. Which treatment should the nurse plan to implement?

Administration of 1 g of azithromycin orally in a single dose The treatment of choice for chlamydial infection is 1 g of azithromycin orally in a single dose. The one-dose course is preferred because of its ease of completion. Acyclovir may be prescribed in a 7-day course for a genital herpes outbreak. Administering 250 mg of ceftriaxone intramuscularly in a single dose is the drug therapy recommended for gonorrhea. Benzathine penicillin G given intramuscularly as a single 2.4 million unit dose is the treatment for primary, secondary, and early latent syphilis.

A primigravida has just given birth. The nurse is aware that the client has type AB Rh-negative blood. Her newborn's blood type is B positive. What should the plan of care include?

Obtaining a prescription to administer Rho(D) immune globulin to the mother Rho(D) immune globulin will prevent sensitization resulting from Rh incompatibility that may arise between an Rh-negative mother and an Rh-positive newborn. Determining the father's blood type is unnecessary because only the mother's and infant's Rh factors are relevant. Preparing for a maternal blood transfusion is unnecessary; if a transfusion were needed, it would be for the newborn, not the mother. There is no ABO incompatibility; incompatibility might occur if the mother were O positive and the newborn had type A, B, or AB blood.

A 10-year-old child is prescribed tetracycline. Which possible drug-related reactions are associated with this drug?

Staining of teeth Tetracycline causes staining or discoloration of developing teeth in children. Sulfonamides may cause kernicterus in neonates. Chloramphenicol may cause Gray syndrome in infants. Aspirin may cause Reye syndrome in pediatric clients with a history of chickenpox or influenza.

Which antiepileptic drug is used as the first-line treatment for absence seizures?

Valproic acid Valproic acid is used as the first-line treatment for absence seizures. Phenytoin is used to treat partial, secondary, and generalized tonic-clonic seizures. Diazepam is used to treat status epilepticus. Acetazolamide is used as an adjunct drug for the treatment of absence seizures

A newborn who is receiving drug therapy for an infection has developed jaundice. The newborn has poor sucking and extreme sleepiness. Which drug may be responsible for the newborn's condition?

Sulfonamide Jaundice, poor sucking, and extreme sleepiness are the clinical manifestations of kernicterus. Kernicterus is a condition seen in newborns due to deposition of bilirubin in the brain and is caused by sulfonamides. Tetracycline can cause staining of developing teeth in pediatric clients. Phenothiazine may cause sudden infant death syndrome. Chloramphenicol may cause Gray syndrome in pediatric clients.