Pharmacology Practice A&B

A nurse is caring for a client who has a magnesium level of 3.1 mEq/L. The nurse should expect to administer which of the following medications? - magnesium gluconate - cinacalcet - calcium gluconate - regular insulin

calcium gluconate administer IV calcium gluconate to the client and prepare to provide ventilatory support

A nurse is reviewing the medication list of a client who wants to begin taking oral contraceptives. The nurses should identify that which of the following client medications will interfere with the effectiveness of oral contraceptives? - carbamazepine - sumatriptan - atenolol - glipizide

carbamazepine causes an accelerated inactivation of oral contraceptives

A nurse is caring for a client who has acute acetaminophen toxicity. The nurse should anticipate administering which of the following medications? - vitamin K - acetylcysteine - benzotropine - physostigmine

acetylcysteine an antidote for acetaminophen toxicity

A nurse is caring for a client who is receiving haloperidol. The nurse should identify which of the following findings as an adverse effect of the medication? - akathisia - paresthesia - excess tear production - anxiety

akathisia an adverse effect of haloperidol is the development of extrapyramidal manifestations such as dystonia, pseudoparkinsonism, and akathisia

A nurse is reviewing the medical record of a client who has hypertension. The nurse should identify which of the following findings as a contraindication for receiving propranolol? - cholelithiasis - asthma - angina pectoris - tachycardia

asthma Propranolol is an adrenergic antagonist which blocks the beta2 receptors in the lungs, causing bronchoconstriction and leading to serious airway resistance and possibly respiratory arrest.

A nurse is an emergency department is caring for a client who has myasthenia gravis and is in a cholinergic crisis. Which of the following medications should the nurse plan to administer? - potassium iodide - glucagon - atropine - protamine

atropine an anticholinergic agent that can reverse cholinergic toxicity

A nurse is planning care for a client who is receiving mannitol via continuous IV infusion. The nurse should monitor the client for which of the following adverse effects? - weight loss - increased intraocular pressure - auditory hallucinations - bibasilar crackles

bibasilar crackles osmotic diuretics can precipitate heart failure and pulmonary edema

A nurse is preparing to mix and administer dantrolene via IV bolus to a client who has developed malignant hyperthermia during surgery. Which of the following actions should the nurse take? - administer the reconstituted medication slowly over 5 min - store the reconstituted medication in the refrigerator - use the reconstituted medication within 12 hr - reconstitute the initial dose with 60 ml of sterile water without a bacteriostatic agent

reconstitute the initial dose with 60 ml of sterile water without a bacteriostatic agent

A nurse is caring for a client who is taking acetazolamide for chronic open angle glaucoma. For which of the following adverse effects should the nurse instruct the client to monitor and report? - tingling of fingers - constipation - weight gain - oliguria

tingling of fingers an adverse effect of acetazolamide is paresthesia

A nurse in a clinic is caring for a client who is taking aspirin for the treatment of arthritis. The nurse should identify which of the following findings as an indication that the client is beginning to exhibit salicylism? - gastric distress - oliguria - excessive bruising - tinnitus

tinnitus a manifestation of aspirin toxicity, or salicylism; other manifestations are sweating, headache, and dizziness

A nurse at an urgent care clinic is collecting a history from a female client who has a UTI. The nurse anticipates a prescription for ciprofloxacin. The nurse should identify that which of the following client statements indicates a contraindication for administering this medication? - "I have tendonitis." - "I take a stool softener for chronic constipation." - "I take medicine for my thyroid." - "I am allergic to sulfa."

"I have tendonitis." ciprofloxacin can increase the risk of tendon rupture

A nurse is teaching a client who is to start taking famotidine for peptic ulcer disease. Which of the following client statements should the nurse identify as understand of the teaching? - "I will stop taking famotidine when my stomach pain is gone." - "I know smoking makes famotidine less effective." - "I will take famotidine anytime by stomach hurts." - "I know that famotidine with turn my stools black."

"I know smoking makes famotidine less effective." smoking decreases the effectiveness of famotidine by exacerbating the ulcer manifestations.

A nurse is teaching about a new prescription for ciprofloxacin to a client who has a urinary tract infection. The nurse should identify which of the following statements as an indication that the client understands the teaching? - "I will take this medication with an antacid to prevent GI upset." - "I will stop taking this medication when I no longer have pain upon urination." - "I will report any signs of tendon pain or swelling." - "I will take this medication with milk."

"I will report any signs of tendon pain or swelling." Ciprofloxacin, a fluoroquinolone, is associated with a risk of tendon rupture.

A nurse is instructing a client on the application of nitroglycerin transdermal patches. Which of the following statements by the client indicates an understanding of the teaching? - "I should apply a patch every 5 minutes if I develop chest pain." - "I will take the patch off right after my evening meal." - "I will leave the patch off at least one day each week." - "I should discard the used patch by flushing it down the toilet."

"I will take the patch off right after my evening meal." there should be 12-14 hr of medication free time to avoid developing a tolerance

A nurse is planning discharge teaching for a client who has a prescription for furosemide. The nurse should plan to include which of the following statements in the teaching? - "this medication increases your risk for hypertension." - "avoid potassium-rich foods in your diet." - "take each dose of medication in the evening before bed." - "drink a glass of milk with each dose of medication."

"drink a glass of milk with each dose of medication." to reduce gastric irritation

A nurse is providing teaching to a client who has a gastric ulcer and a new prescription for famotidine. Which of the following instructions should the nurse include? - "take the medication on an empty stomach for full effectiveness." - "you may discontinue this medication when stomach discomfort subsides." - "report yellowing of the skin." - "you will be taking this medication for 2 weeks."

"report yellowing of the skin." famotidine can be hepatotoxic and cause jaundice

A nurse is caring for the parent of a newborn. The parent asks the nurse when their newborn should receive the first diphtheria, tetanus, and pertussis vaccine (DTaP). The nurse should instruct the parent that their newborn should receive the immunization at which of the following ages? - at birth - 2 months - 6 months - 15 months

2 months

A nurse is preparing to teach a client who is to start a new prescription for extended release verapamil. Which of the following instruction should the nurse plan to include? - take the medication on an empty stomach - avoid crowds - discontinue the medication if palpitations occur - change positions slowly

change positions slowly to prevent orthostatic hypotension and syncope

A nurse is caring for a client who has hypocalcemia and is receiving calcium citrate. The nurse should identify that which of the following findings indicates a therapeutic response to the medication? - positive Chvostek's sign - decreased paresthesia - increased thirst - calcium level of 8.8 mg/dL

decreased paresthesia

A nurse is preparing to administer PO sodium polystyrene sulfonate to a client who has hyperkalemia. Which of the following actions should the nurse plan to take? - hold the client's oral medications for 8hr post administration - inform the client that this medication can turn stool a light tan color - keep the client's solution in the refrigerator for up to 72hr - monitor the client for constipation

monitor the client for constipation can lead to fecal compaction

A nurse is teaching a client about the use of risedronate for the treatment of osteoporosis. The nurse should identify which of the following statements as an indication that the client understands the teaching? - "I will drink a glass of milk when I take the risedronate." - "I will take the risedronate 15 min after my evening meal." - "I should take an antacid with the risedronate to avoid nausea." - "I should sit up for 30 min after taking the risedronate."

"I should sit up for 30 min after taking the risedronate." to reduce the adverse GI effects of esophagitis and dyspepsia

A nurse is providing teaching to a client who has depression and a new prescription for fluoxetine. Which of the following statements by the client indicates an understanding of the teaching? - "I should start to feel better within 24 hours of starting this medication." - "I will be sure to follow a strict diet to avoid foods with tyramine." - "I will continue to take St. John's Wort to increase the effects of the medication." - "I should take acetaminophen instead of ibuprofen for my headaches while taking this medication."

"I should take acetaminophen instead of ibuprofen for my headaches while taking this medication." Fluoxetine suppresses platelet aggregation, which increases the risk of bleeding when used concurrently with NSAIDs and anticoagulants.

A nurse is teaching about zolpidem to a client who has insomnia. The nurse should identify that which of the following client statements indicates an understanding of the teaching? - "I will need to get laboratory testing prior to a refill of this medication." - "I will use this medication for a short period of time." - "I will need to take this medication for 1 week before results are seen." - "I will need to change the medications to prevent building up a tolerance."

"I will use this medication for a short period of time." Zolpidem is used for short-term treatment of insomnia. Therefore, the provider should reassess the client before refilling the prescription.

A nurse is providing teaching to a client who has multiple sclerosis and a new prescription for methylprednisolone. Which of the following instructions should the nurse include? - blood glucose should be monitored during therapy - avoid contact with people who have known infections - take the medication 1hr before breakfast - decrease dietary intake of foods containing potassium - grapefruit juice can increase the effects of the medication

- blood glucose should be monitored during therapy - avoid contact with people who have known infections - grapefruit juice can increase the effects of the medication glucocorticoids can increase serum glucose levels glucocorticoids depress the immune system

A nurse is providing teaching to a client who has a prescription for ergotamine sublingual to treat migraine headaches. Which of the following information should the nurse include in the instructions? - "take one tablet three times a day before meals." - "take one tablet at onset of migraine." - "take up to eight tablets as needed within a 24hr period." - "take one tablet every 15 min until migraine subsides."

"take one tablet at onset of migraine."

A nurse is providing discharge instructions to a client who has heart failure and a new prescription for captopril. Which of the following client statements indicates an understanding of the teaching? - "I should take the medication with food." - "I should take naproxen if I develop joint pain." - "I should tell my provider if I develop a sore throat." - "I should expect the medication to cause my urine to look orange."

"I should tell my provider if I develop a sore throat." neutropenia is a serious adverse effect of captopril

A nurse is teaching a client about cyclobenzaprine. Which of the following client statements should indicate to the nurse that the teaching is effective? - "I will have increased saliva production." - "I will continue taking the medication until the rash disappears." - "I will taper off the medication before discontinuing it." - "I will report any urinary incontinence."

"I will taper off the medication before discontinuing it." prevent abstinence syndrome or rebound insomnia

A nurse is caring for a client who is receiving heparin therapy via continuous IV infusion to treat a pulmonary embolism. Which of the following findings should the nurse identify as an adverse effect of the medication and report to the provider? - vomiting - blood in the urine - positive Chvostek's sign - ringing in the ears

blood in the urine a manifestation of heparin toxicity; bruising, hematomas, hypotension, and tachycardia are also manifestations

A nurse is assessing a client who has received atropine eye drops during an eye examination. Which of the following findings should the nurse expect as an adverse effect of the medication? - difficulty seeing in the dark - pinpoint pupils - blurred vision - excessive tearing

blurred vision Blurred vision is an expected finding following the administration of atropine eye drops. This is due to the cycloplegic effects of the medication, which cause distant objects to appear blurry to the client.

A nurse is providing teaching to a client who is start taking sumatriptan. Which of the following adverse effects should the nurse instruct the client to monitor for and report to the provider? - chest pressure - white patches on the tongue - bruising - insomnia

chest pressure anti-migraine agents can cause coronary vasospasms, resulting in angina

A nurse is caring for a client who is taking atorvastatin for hyperlipidemia. Which of the following client laboratory values should the nurse monitor? - creatinine kinase - erythrocyte sedimentation rate - International normalized ratio - potassium

creatinine kinase an adverse effect of atorvastatin is rhabdomyolysis, which causes muscle weakness and can progress to myositis; CK levels rise in response to enzymes released with muscle injury

A nurse is planning to teach about inhalant medications to a client who has a new diagnosis of exercise-induced asthma. Which of the following medications should the nurse plan to instruct the client to use prior to physical activity? - cromolyn - beclomethasone - budesonide - tiotropium

cromolyn Cromolyn sodium stabilizes mast cells, which inhibit the release of histamine and other inflammatory mediators. The client should use cromolyn 10 to 15 min before planning to exercise to prevent bronchospasms.

A nurse is assessing a client after administering a second dose of cefazolin IV. The nurse notes the client has anxiety, hypotension, and dyspnea. Which of the following medications should the nurse administer first? - diphenhydramine - albuterol inhaler - epinephrine - prednisone

epinephrine induce vasoconstriction and bronchodilation during anaphylaxis

A nurse is administering baclofen for a client who has a spinal cord injury. Which of the following findings should the nurse document as a therapeutic outcome? - increase in seizure threshold - decrease in flexor and extensor spasticity - increase in cognitive function - decrease in paralysis of the extremities

decrease in flexor and extensor spasticity

A nurse is planning care for a client who has hypertension and is to start taking metoprolol. Which of the following intervention should the nurse include in the plan of care? - weigh the client weekly - determine the apical pulse prior to administering - administer the medication 30 prior to breakfast - monitor the client for jaundice

determine the apical pulse prior to administering life-threatening bradycardia is an adverse effect of this medication; if apical pulse is less than 60, hold the medication

A nurse is reviewing the medication administration record of a client who has hypocalcemia and a new prescription for IV calcium gluconate. The nurse should identify that which of the following medications can interact with calcium gluconate? - felodipine - guaifenesin - digoxin - regular insulin

digoxin calcium gluconate can cause hypercalcemia, which increases the risk for digoxin toxicity

A nurse is caring for a client who has developed hypomagnesemia due to long-term therapy with lansoprazole. The nurse should monitor the client for which of the following manifestations? - bradycardia - hypotension - muscle weakness - disorientation

disorientation manifestations of hypomagnesemia are disorientation, confusion, positive Chvostek's and Trousseau's signs

A nurse is an emergency department is caring for a client whose family reports the client has taken large amounts of diazepam. Which of the following medications should the nurse anticipate administering? - ondansetron - magnesium sulfate - flumazenil - protamine sulfate

flumazenil an antidote used to reverse benzodiazepines

A nurse is providing teaching to a client who has peptic ulcer disease and is to start a new prescription for sucralfate. Which of the following actions of sucralfate should the nurse include in the teaching? - decreases stomach acid secretion - neutralizes acids in the stomach - forms a protective barrier over ulcers - treats ulcers by eradicating H. pylori

forms a protective barrier over ulcers a mucosal protectant that forms a gel-like substance that coats the ulcers

A nurse is teaching a client who is to begin taking tamoxifen for the treatment of breast cancer. Which of the following adverse effects should the nurse include in the teaching? - hot flashes - urinary retention - constipation - bradycardia

hot flashes due to the estrogen receptor blocking action

A nurse is caring for a client who has heart failure and a prescription for enalapril. The nurse should monitor the client for which of the following findings as an adverse effect of the medication? - bradycardia - hyperkalemia - loss of smell - hypoglycemia

hyperkalemia due to potassium retention by the kidneys. ACE inhibitors have several cardiovascular adverse effects including hypotension, tachycardia, and dysrhythmias.

A nurse administered digoxin immune Fab to a client who received the incorrect dose of digoxin over a period of 3 days. The nurse should identify that which of the following findings indicates the antidote was effective? - normal sinus rhythm - digoxin level of 2.5 ng/mL - decrease in blood pressure - potassium level of 3.2 mEq/L

normal sinus rhythm Dysrhythmias are a life-threatening adverse effect of digoxin toxicity. The return of the heart to normal sinus rhythm indicates a therapeutic response to the antidote. Digoxin immune Fab is administered to a client who is experiencing severe digoxin toxicity. It binds with digoxin and works to reduce the client's blood digoxin level.

A nurse is caring for a client who reports lethargy and myalgia after taking clozapine for 6 months. Which of the following actions should the nurse plan to take? - infuse 0.9% NaCl liter bolus - schedule the client for an electroencephalogram - obtain WBC with absolute neutrophil count - place the client on a tyramine free diet

obtain WBC with absolute neutrophil count an adverse effect of clozapine is agranulocytosis which manifests as lethargy and myalgia

A nurse is planning to teach about the use of a spacer to a child who has a new prescription for a fluticasone inhaler to treat chronic asthma. The nurse should include that the spacer decreases the risk for which of the following adverse effects of the medication? - oral candidiasis - headache - joint pain - adrenal suppression

oral candidiasis inhaled corticosteroids can cause oral candidiasis; using a spacer and rinsing the mouth can prevent this

A nurse is caring for a 20 year old female client who has a prescription for isotretinoin for severe nodulocystic acne vulgaris. Before the client can obtain a refill, the nurse should advise the client that which of the following tests is required? - serum calcium - pregnancy test - 24hr urine collection for protein - aspartate aminotransferase level

pregnancy test isotretinoin has teratogenic effects

A nurse is reveiwing the ECG of a client who is receiving IV furosemide for heart failure. The nurse should identify which of the following findings as an indication of hypokalemia? - tall, tented T waves - presence of U waves - widened QRS complex - ST elevation

presence of U waves U waves are a manifestation of hypokalemia

A nurse is caring for a client who is experiencing acute alcohol withdrawal. For which of the following client outcomes should the nurse administer chlordiazepoxide? - minimize diaphoresis - maintain abstinence - lessen craving - prevent delirium tremens

prevent delirium tremens occurs during acute alcohol withdrawal

A nurse is planning care for a client who is prescribed metoclopramide following bowel surgery. For which of the following adverse effects should the nurse monitor? - muscle weakness - sedation - tinnitus - peripheral edema

sedation metoclopramide has CNS adverse effects including dizziness, fatigue, and sedation.

A nurse is providing discharge teaching to a client who has a new prescription for furosemide twice daily. The nurse should include which of the following instructions in the teaching? - "take the second dose at bedtime." - "increase intake of potassium rich foods." - "obtain your weight weekly." - "monitor for muscle weakness." - "dangle your legs from the side of the bed before standing."

"Increase intake of potassium rich foods." Loop diuretics, such as furosemide, act at the loop of Henle by blocking the resorption of sodium, water, and potassium. An adverse effect of the medication is the development of electrolyte imbalances such as hyponatremia, hypochloremia, and hypokalemia. To prevent hypokalemia, the client should increase intake of potassium-rich foods, such as potatoes, spinach, dried fruit, and nuts. "Monitor for muscle weakness." Furosemide, a loop diuretic, causes a loss of potassium, which can result in manifestations of hypokalemia such as difficulty concentrating, shallow respirations, hyporeflexia, and muscle weakness. The nurse should instruct the client to monitor for these manifestations and report them to the provider. "Dangle your legs from the side of the bed before standing." Loop diuretics, such as furosemide, reduce vascular tone and increase fluid excretion. These effects decrease blood return to the heart and can manifest as dizziness and lightheadedness when going from a lying to a standing position. The client should change positions slowly to minimize orthostatic hypotension.

A nurse is developing a teaching plan for a client who has a new prescription for simvastatin. Which of the following instructions should the nurse include in the teaching plan? - report muscle pain to the provider - avoid taking the medication with grapefruit juice - take the medication in the early morning - expect a flushing of the skin as a reaction to the medication - expect therapy with this medication to be lifelong

- report muscle pain to the provider - avoid taking the medication with grapefruit juice - expect therapy with this medication to be lifelong myopathy is an adverse effect of simvastatin that can lead to rhabdomyolysis when taken with grapefruit juice, there is an increased risk of muscle injury from elevations in CK

A nurse is assessing a client who is taking amitriptyline for depression. Which of the following findings should the nurse identify as an adverse effect of the medication? - muscle twitching - cough - urinary retention - increased libido

urinary retention an anticholinergic effect

A nurse is providing teaching to a client who is to start therapy with digoxin. For which of the following adverse effects should the nurse instruct the client to monitor and report to the provider? - dry cough - pedal edema - bruising - yellow-tinged vision

yellow-tinged vision a sign of digoxin toxicity; other s/sx are N/V, loss of appetite, and fatigue

A nurse is preparing to teach a client who is to start a new prescription for extended release verapamil. Which of the following instruction should the nurse plan to include? - plan to increase the dosage each week by 200mg increments - prolonged use of the medication can cause glaucoma - drink 2L of water daily - a fine red rash is transient and can be treated with antihistamines

drink 2L of water daily to prevent renal stone formation and kidney injury, because allopurinol is eliminated through the kidneys

A nurse is providing teaching to a client who has a prescription for trimethoprim/sulfamethoxazole. Which of the following instructions should the nurse include in the teaching? - take the medication with food - expect a fine, red rash as a transient effect - drink 8 to 10 glasses of water daily - store the medication in the refrigerator

drink 8 to 10 glasses of water daily to decrease the chance of kidney damage from crystallization

A nurse is assessing a client who is taking amitriptyline for depression. Which of the following findings should the nurse identify as an adverse effect of the medication? - tinnitus - urinary frequency - dry mouth - exopthalmos

dry mouth due to the blocking of acetylcholine receptors that cause anticholinergic responses

A nurse is providing teaching to a client who is begin taking oxybutynin for urinary incontinence. Which of the following adverse effects should the nurse include in the teaching? - dry mouth - tinnitus - blurred vision - bradycardia - dry eyes

dry mouth and dry eyes (anticholinergic effect) blurred vision (increases intraocular pressure)

A nurse is administering donepezil to a client who has Alzheimer's disease. Which of the following findings should the nurse report to the provider immediately? - dyspepsia - diarrhea - dizziness - dyspnea

dyspnea caused by bronchoconstriction due to increased acetylcholine

A nurse is administering diazepam to a client who is having a colonoscopy. Which of the following actions should the nurse take? - ensure flumazenil is available to administer for toxicity management - monitor the client for an increase in blood pressure - expect the client to become unconscious within 30 seconds - measure the capnography level every hour until the client is awake and oriented

ensure flumazenil is available to administer for toxicity management to reverse the effects of diazepam in the case of toxicity (respiratory depression & hypotension)

A nurse in a provider's office is assessing a client who has been taking aspirin daily for the past year. For which of the following findings should the nurse notify the provider immediately? - hyperventilation - heartburn - anorexia - swollen ankles

hyperventilation acute salicylate poisoning causes respiratory alkalosis in the early stages

A nurse is collecting a medication history from a client who has a new prescription for lithium. The nurse should identify that the client should discontinue which of the following over the counter medications? - aspirin - ibuprofen - famotidine - bisacodyl

ibuprofen NSAIDs can significantly increase lithium levels

A nurse is assessing a client who is taking propylthiouracil for the treatment of Graves' disease. Which of the following findings should the nurse identify as an indication that the medication has been effective? - decrease in WBC count - decrease in amount of time sleeping - increase in appetite - increase in ability to focus

increase in ability to focus propylthiouracil is a thyroid hormone antagonist

A nurse is caring for a client who has heart failure and is receiving an IV infusion of dopamine. Which of the following findings indicated that the medication is effective? - decreased blood pressure - increased heart rate - increased cardiac output - decreased serum potassium

increased cardiac output dopamine is an adrenergic that causes a receptor specificity effect, which increases cardiac output and improves perfusion

A nurse is caring for a client who is receiving filgrastim. Which of the following findings should the nurse document to indicate the effectiveness of the therapy? - increased neutrophil count - increased WBC count - decreased prothrombin time - decreased triglycerides

increased neutrophil count filgrastim stimulates bone marrow to produce neutrophils

A nurse is providing teaching to a client who is taking bupropion as an aid to quit smoking. Which of the following findings should the nurse identify as an adverse effect of the medication? - cough - joint pain - alopecia - insomnia

insomnia atypical antidepressants have stimulant properties

A nurse is teaching a client who has a new prescription for docusate sodium about the medication's mechanism of action. Which of the following information should the nurse include in the teaching? - it reduces the surface tension of the stools to change their consistency - it causes rectal contractions - it acts as a fiber agent, increasing bulk in the intestines - it stimulates the motility of the intestines

it reduces the surface tension of the stools to change their consistency docusate sodium is a surfactant that softens stool by reducing surface tension, allowing water to penetrate more easily into the stool

A nurse is assessing a client who is taking tamoxifen to treat breast cancer. Which of the following findings is the priority for the nurse report to the provider? - hot flashes - GI irritation - vaginal dryness - leg tenderness

leg tenderness an adverse effect of tamoxifen is thromboembolism

A nurse is assessing a client who has myasthenia gravis and is taking neostigmine. Which of the following findings should indicate to the nurse that the client is experiencing an adverse effect? - tachycardia - oliguria - xerostomia - miosis

miosis (pupillary constriction) excessive muscarinic stimulation causes difficulty with visual accomodation

A nurse on the acute care unit is caring for a client who is receiving gentamicin IV. The nurse should report which of the following findings to the provider as an adverse effect of the medication? - constipation - tinnitus - hypoglycemia - joint pain

tinnitus aminoglycosides are ototoxic

A nurse is reviewing the medical record of a client who has schizophrenia and prescription for clozapine. Which of the following laboratory tests should the nurse review before administering the medication? - troponin - total cholesterol - creatinine - thyroid stimulating hormone

total cholesterol clozapine can cause hyperlipidemia

A nurse is caring for a client who is in labor. The client is receiving oxytocin by continuous IV infusion with a maintenance IV solution. The external FHR monitor indicates late decelerations. Which of the following actions should the nurse take first? - turn the client to a side-lying position - disconnect the client's oxytocin from the maintenance IV - apply oxygen to the client by face mask - increase the client's maintenance IV infusion rate

turn the client to a side-lying position the greatest risk to the fetus experiencing late decelerations is injury from uteroplacental insufficiency