ATI Ch 32 Medications Affecting Labor and Delivery

1. A nurse is teaching a client about terbutaline. Which of the following statements by the client indicates understanding of the teaching? A. "This medication will stop my contractions." B. "This medication will prevent vaginal bleeding." C."This medication will promote blood ow to my baby." D."This medication will increase my prostaglandin production."

1. A. CORRECT: Terbutaline blocks beta2‐adrenergic receptors, which causes uterine smooth muscle relaxation. B. Terbutaline is used to suppress preterm labor and does not prevent bleeding. C. Terbutaline causes smooth muscle relaxation and does not promote placental blood ow. D. Terbutaline suppresses uterine contractions and does not increase prostaglandin production.

2. A nurse is caring for a client who has preeclampsia and is receiving magnesium sulfate IV continuous infusion. Which of the following ndings should the nurse report to the provider? A. 2+ deep tendon re exes B. 2+ pedal edema C. 24 mL/hr urinary output D. Respirations 12/min

2. A. This is an expected nding and does not need to be reported to the provider. B. This is an expected nding and does not need to be reported to the provider. C. CORRECT: Urine output less than 25 to 30 mL/hr is associated with magnesium sulfate toxicity and should be reported to the provider. D. A respiratory rate of 12/min is an expected nding and does not need to be reported to the provider.

3. A nurse is caring for a client who has a new prescription for oxytocin to stimulate uterine contractions. Which of the following interventions should the nurse make? (Select all that apply.) A. Use an infusion pump for medication administration. B. Obtain vital signs frequently and with every dosage change. C. Stop infusion if uterine contractions occur every 4 min and last 45 seconds. D. Increase medication infusion rate rapidly. E. monitor fetal heart rate continuously.

3. A. CORRECT: Oxytocin must be administered by an infusion pump to ensure precise dosage. B. CORRECT: Vital signs are monitored to assess for hypertension, an adverse effect of oxytocin. C. Infusion should not be stopped because therapeutic effect has not been achieved. D. Oxytocin rate is increased gradually to prevent hypertonic uterine contractions. E. CORRECT: Continuous FhR monitoring is required to assess for fetal distress.

4. A nurse is caring for a client who is in labor and receiving IV opioid analgesics. Which of the following actions should the nurse take? A. Instruct the client to self‐ambulate every 2 hr. B. Offer oral hygiene every 2 hr. C. Anticipate medication administration 2 hr prior to delivery. D. monitor fetal heart rate every 2 hr.

4. A. Clients should be assisted with ambulation due to the sedative effect of opioid analgesics. B. CORRECT: Oral hygiene should be offered on a regular basis to a client receiving opioid analgesics due to the adverse effects of dry mouth, nausea, and vomiting. C. Opioid analgesics should not be administered within 4 hr of delivery. D. Fetal heart rate should be monitored continuously in a client receiving opioid analgesics.

5. A nurse is reviewing a new prescription for terbutaline with a client who has a history of preterm labor. Which of the following client statements indicates understanding of the teaching? A. "I can increase my activity now that I've started on this medication." B. "I will increase my daily uid intake to 3 quarts." C."I will report increasing intensity of contractions to my doctor." D."I am glad this will prevent preterm labor."

5. A. The action of terbutaline is to relax uterine smooth muscle. Clients taking this medication are instructed to limit activity, which stimulates smooth muscle, to delay preterm labor. B. Fluid intake should be limited to 2,400 mL/day. C. CORRECT: The client should report increasing intensity, frequency, or duration of contractions to the provider because these are manifestations of preterm labor. D. Terbutaline delays preterm labor; it does not prevent it.