Pharm EAQ -

Normal Serum Magnesium Level

1.5 to 2.5 mEq/L or 1.8 to 3 mg/dL

Which drug is contraindicated during pregnancy but can be safely used by lactating mothers?

Carbamazepine

Stillbirth may occur due to

alcohol use.

Neural tube defects are due to

antiseizure drugs.

Lithium should not be given to

either pregnant or lactating mothers.

in the presomite period or preimplantation period, if a high dose of a teratogenic drug is administered, fetal death may occur;

if the dose is sublethal, the fetus is not affected.

A registered nurse teaches a nursing student about the effects of aspirin in pregnant women. Which statement made by the nursing student indicates a need for further teaching? "Aspirin may reduce a fever." "Aspirin may cause Reye syndrome. "Aspirin may increase the risk of bleeding." "Aspirin may suppress labor contractions."

"Aspirin may cause Reye syndrome

What is magnesium sulfate used for?

-Used to stop preterm labor by relaxing the smooth muscle of the uterus and suppresses contractions. -Also used to lower BP and depress the CNS if gestational HTN is present.

Respiratory distress or arrest may occur when the serum level of magnesium sulfate reaches 12 to 15 mg/dL. Deep tendon reflexes disappear when the serum level is.

10 to 12 mg/dL

All women, except those who are pregnant or lactating, should ingest between ________ of calcium daily;

1000 and 1300 mg

Respiratory distress or arrest may occur when the serum level of magnesium sulfate reaches

12 to 15 mg/dL.

magnesium sulfate is withheld in the absence of deep tendon reflexes. The therapeutic serum level of magnesium sulfate is

5 to 8 mg/dL

Thalidomide

A mild tranquilizer that, taken early in pregnancy, can produce a variety of malformations of the limbs, eyes, ears, and heart.

Phenytoin (Dilantin)

Anticonvulsant

indicated for female infertility in some clients.

Clomiphene used for ovulation

Which medication is indicated for evacuation in case of a miscarriage?

Dinoprostone

a prostaglandin E2 abortifacient and cervical ripening drug, which is indicated for uterine evacuation in cases of miscarriage.

Dinoprostone

Which teratogenic effect is seen due to lithium?

Ebstein anomaly

Clomiphene

Estrogen partial agonist: synthetic used in infertility to induce ovulation

A nurse withholds methylergonovine maleate from a postpartum client. What clinical finding supports the withholding of the medication?

HYPERTENSION

Category C constitutes drugs on which no studies have been done.

It also constitutes the drugs that have shown positive fetal risks in animal studies but with no studies conducted in humans.

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

Misoprostol

A breastfeeding mother requires treatment for depression. Which drug would be safe to use if the mother wishes to continue breastfeeding the newborn?

Paroxetine

Which cardiovascular adverse effect is associated with the use of clomiphene?

Tachycardia

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."

Vitamin C and glucosamine/chondroitin

cartilage and connective tissue integrity

Dinoprostone can be used for

cervical ripening * this drug does not act as a stomach protectant.

Category X constitutes

drugs that have shown risks of fetal abnormalities in both animal and human studies.

Category D constitutes

drugs that show a fetal risk in human studies but cannot be prohibited because of the safety of use.

Category B constitutes

drugs that show no fetal risk in animals; these drugs have not been involved in controlled studies in humans.

The fetus may develop gross malformations if exposed to teratogens during the .

embryonic stage

A nurse has just finished reviewing how anesthesia will be used during a vaginal birth for a client with class I heart disease. What type of anesthesia does the client discuss that indicates to the nurse that the teaching was effective?

epidural

Phenytoin may cause

fetal central nervous system defects.

Contractions lasting too long and occurring too frequently can lead to

fetal hypoxia; stopping the oxytocin infusion should stop the contractions, thereby increasing oxygen flow to the fetus.

The 32nd week of the gestational period is the fetal period during which

functional ability may be disrupted.

While a client is being given intravenous magnesium sulfate therapy for preeclampsia, it is essential for the nurse to monitor the client's deep tendon reflexes. What reason does the nurse give to the client to explain why this is done?

id's the potential for resp depress

Which anomaly may be observed when a fetus is exposed to a teratogen during the embryonic development?

improper growth of organs

Diethylstilbestrol cannot be given for pregnant clients and lactating mothers because

it may cause vaginal carcinoma and its level in the breast milk may be high

Heparin is safe to a fetus but

may cause osteoporosis in a pregnant woman.

During the final weeks of pregnancy, the prostaglandin concentration increases, which causes

mild myometrial contractions known as Braxton Hicks contractions.

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.

Clomiphene is used for

ovulation.

Interrupting the monthly dosage oral contraceptive program may

permit release of *luteinizing hormone*, resulting in ovulation and possibly pregnancy.

Raloxifene is used to prevent

postmenopausal osteoporosis.

Methylergonovine is used to treat

postpartum uterine atony and hemorrhage.

Tetracycline is contraindicated in

pregnant clients and in lactating clients.

During which period of pregnancy do teratogens act in an "all-or-nothing" fashion?

presomite period

Which chemical may be responsible for Braxton Hicks contractions occurring during the final weeks of pregnancy?

prostaglandin

Methylergonovine maleate can cause hypertension and

should not be given to a client with an increased blood pressure.

if the client is unable to ingest enough calcium in food,

supplements of calcium and vitamin D are recommended.

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.

Ebstein anomaly (cardiac defects) in the newborn occurs due to

taking lithium during pregnancy.

Shortened limbs may occur due to

thalidomide.

A client is taking a progesterone oral contraceptive (minipill). The nurse instructs the client to take one pill daily during which point in the monthly cycle?

the whole time

Oxytocin is administered when

there are weak contractions to induce labor.

Magnesium sulfate is used to

treat pregnancy-induced hypertension. Preclapsia

Carbamazepine may cause neural tube defects when

used during pregnancy but can be safely used by a lactating mother.

A thin 24-year-old woman who runs 10 miles each week asks the nurse for advice about preventing osteoporosis. Which vitamin and other dietary supplement should the nurse recommend?

vitamin D