Pharm EAQs

Which drug can be prescribed to a 30-week-pregnant woman to promote the maturity of the lungs in the fetus? 1 Methylergonovine 2 Clomiphene 3 Dinoprostone 4 Betamethasone

Correct: * 4 Betamethasone* may be prescribed to promote lung maturity in a fetus during the gestation period of 24 to 34 weeks. Methylergonovine is prescribed to reduce postpartum uterine hemorrhage. Clomiphene is prescribed to induce ovulation. Dinoprostone is prescribed to terminate a pregnancy.

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? 1 Water 2 A strawberry milkshake 3 Skim milk 4 Orange juice

Correct: 4 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.

Despite medication, a client's preterm labor continues, her cervix dilates, and birth appears inevitable. Which medication does the nurse anticipate will be prescribed to increase the chance of the newborn's survival? 1 Carboprost tromethamine 2 Misoprostol 3 Nalbuphine HCl 4 Betamethasone

*Correct: 4 Betamethasone* enhances fetal lung maturity when administered before a preterm birth. Carboprost tromethamine is a prostaglandin and nalbuphine HCl is a narcotic antagonist, neither of which is appropriate for administration in this case. Misoprostol is used for labor induction.

A client at 38 weeks' gestation is admitted for induction of labor. Her membranes ruptured 12 hours ago. There are no other signs of labor. Which medication does the nurse anticipate will be prescribed? 1 Oxytocin 2 Estrogen 3 Ergonovine 4 Progesterone

Correct: 1 *Oxytocin* is a small-polypeptide hormone synthesized in the hypothalamus and secreted from the neurohypophysis (posterior pituitary gland) during parturition or suckling; it promotes powerful uterine contractions and is therefore used to induce labor. Estrogen suppresses follicle-stimulating and luteinizing hormones, thereby helping maintain a pregnancy. Ergonovine can induce sustained contractions, which is contraindicated during labor; it may be prescribed in the postpartum period to promote or maintain a contracted uterus. Progesterone causes hyperplasia of the endometrium in preparation for implantation of the fertilized ovum; later it helps maintain the pregnancy.

An infusion of oxytocin is administered to a client for induction of labor. After several minutes the uterine monitor indicates contractions lasting 100 seconds with a frequency of 130 seconds. What is the next nursing action? 1 Discontinuing the infusion 2 Checking the fetal heart rate 3 Slowing the oxytocin flow rate 4 Turning the client on her left side

Correct: 1 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 fetal heart rate should be monitored, but this is not the priority. Oxytocin will continue to promote uterine contractions; this is unsafe because the prolonged, frequent contractions decrease oxygen flow to the fetus. Turning the client on her left side will promote placental perfusion, but it is not the priority at this time.

During a prenatal visit a nurse explains to a client who is Rh negative when Rho(D) immune globulin will be administered to her. When is the best time to administer Rho(D) immune globulin? 1 Within 72 hours of birth if the infant is Rh positive 2 Weekly during the ninth month if the mother is a multipara 3 Immediately after birth if the infant's Coombs test result is positive 4 Always during the second trimester

Correct: 1 Rho(D) immune globulin is given to an Rh-negative mother within 72 hours after birth if the infant is Rh positive and the mother was not previously sensitized. Rho(D) immune globulin is administered once after birth if the mother was not previously sensitized. The infant's Coombs test result does not influence the timing of administration. A small dose may be given prophylactically in the twenty-eighth week of gestation if there is a minimal increase in the antibody titer. If there is a significant increase in the antibody titer, amniocentesis is performed. Treatment of the fetus depends on the results of the amniocentesis.