Maternity and Newborn Medications Qestions
A nurse is monitoring a preterm labor client who is receiving magnesium sulfate intravenously. The nurse monitors for which adverse reactions of this medication? Select all that apply. 1. Flushing 2. Hypertension 3. Increased urine output 4. Depressed respirations 5. Extreme muscle weakness 6. Hyperactive deep tendon reflexes
1, 4, 5 magnesium sulfate is a central nervous system depressant, it relaxes muscle, including the uterus. It is used to prevent eclampsia and seizure, or halt preterm labor contractions. adverse effects are: flushing, depressed respirations, depressed deep tendon reflexes, hypotension, extreme muscle weakness, decreased urine output, pulmonary edema, and elevated serum magnesium levels.
A nursing instructor asks a nursing student to describe the procedure for administering erythromycin (0.5% Ilotycin) ointment to the eyes of a neonate. The instructor determines that the student needs to research this procedure further if the student states: 1. "I will flush the eyes after instilling the ointment." 2. "I will cleanse the neonate's eyes before instilling the ointment." 3. "The administration of the eye ointment is within 1 hour after delivery." 4. "I will instill the eye ointment into each of the neonate's conjunctival sacs."
1. The eyes should not be flushed after instilling the ointment, this will wash away the medication.
A 31-wwk preterm labor client dilated to 4 centimeters has been started on magnesium sulfate. Her contractions have stopped. If the client's labor can be inhibited for the next 48 hours, what medication does the nurse anticipate will be prescribed? 1. Betamethasone 2. Nalbuphine (Nubain) 3. Misoprostol (Cytotec) 4. Rh0(D) immune globulin (RhoGAM)
1. betamethasone is usually given if preterm labor that is between 28 to 32 weeks could be inhibited for more than 48 hours. betamethasone is a glucocorticoid that stimulates fetus lung maturation. Nalbuphine (Nubain) is an opioid analgesic. Misoprostol (Cytotec) is a prostaglandin that is given to ripen and soften the cervix and to stimulate uterine contractions.
A woman with preeclampsia is receiving magnesium sulfate. The nurse assigned to care for the client determines that the magnesium sulfate therapy is effective if: 1. Scotomas are present 2. Seizures do not occur 3. Ankle clonus is noted 4. The blood pressure decreases
2. For preeclampsia clients, Magnesium sulfate prevent eclampsia (seizures). Magnesium is not used as an antihypertensive in this circumstance. Although at the beginning the blood pressure may drop transiently, there is no huge blood pressure impact. Ankle clonus indicates hyperreflexia and may precede the onset of eclampsia. Scotomas are areas of complete or partial blindness. Visual disturbances like scotomas usually precede with eclampsia.
Methylergonovine (Methergine) is prescribed for a woman to treat postpartum hemorrhage. Before the admnistation of methylergonovine, the priority nursing assessment is to check the: 1. Uterine tone 2. Blood pressure 3. Amount of lochia 4. Deep tendon reflexes
2. Methylergonovine (Methergine), a ergot alkaloid, is used to control the postpartum bleeding by continuous uterine contraction. This may increase the client's blood pressure; therefore, before administer Methergine, the client's blood pressure needs to be assessed.
A nurse is caring for a client who is receiving oxytocin (Pitocin) to induce labor. The nurse discontinues the oxytocin infusion and notifies the registered nurse if which of the following is noted during the assessment of the client? 1. Fatigue 2. Drowsiness 3. Uterine hyperstimulation 4. Early decelerations of the fetal heart rate
3. an adverse effect of oxytocin (Pitocin) is hyperstimulation of the uterine. When signs of hyperstimulation occurs, oxytocin infusion must be stopped.
Epidural analgesia is administered to a woman for pain relief after a cesarean birth. The nurse assigned to care for the woman ensures that which medication is readily available if respiratory depression occurs? 1. Betamethasone 2. Morphine sulfate 3. Naloxone (Narcan) 4. Meperidine hydrocholoride (Demerol)
3. epidural analgesia are opioids. Narcan is the opioid antagonist. Betamethasone is corticosteroid that is administered to enhance fetal lung maturity.
A pregnant client is receiving magnesium sulfate for the management of preeclampsia. A nurse determines that the client is experiencing toxicity from the medication if which of the following is noted on assessment? 1. Proteinuria of 3+ 2. Presence of deep tendon reflexes 3. Serum magnesium level of 6 mEq/L 4. Respirations of 10 breaths per minute
4. magnesium sulfate toxicity signs and symptoms - central nerve system depressant effects: respiratory depression, loss of deep tendon reflexes, sudden drop in fetal heart rate, maternal heat rate and blood pressure. Therapeutic range of magnesium sulfate is 4 - 7.5 mEq/L Proteinuria of 3+ is likely in preeclampsia clients
Methylergonovine (Methergine) is prescribed for a client with postpartum hemorrhage. Before administering the medication, a nurse contacts the health care provider who prescribed the medication if which of the following conditions is documented in the client's medical history? 1. Hypotension 2. Hypothyroidism 3. Diabetes mellitus 4. Peripheral vascular disease
4. Methylergonovine (Methergine), an ergot alkaloid, has vasoconstrictive effects. It could not be used for patients who have cardiovascular, hypertension, eclampsia, preclampsia, or peripheral vascular diseases.
Rh0(D) immune globulin (RhoGAM) is prescribed for a woman after the delivery of a newborn infant, and the nurse provides information to the woman about the purpose of the medication. The user determines that the woman understands the purpose of the medication if the woman states that it will protect her next baby from which of the following? 1. Having Rh-positive blood 2. Developing a rubella infection 3. Developing physiological jaundice 4. Being affected by Rh incompatibility.
4. RhoGAM prevent mom from developing Rh positive immunity, which will protect a future Rh positive baby.
