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DAS VN OB/PEDS > Pharm Ch.39 Drugs Used In Obstetrics > Flashcards

Pharm Ch.39 Drugs Used In Obstetrics Flashcards

1
Q

Used to inhibit premature labor

A

Magnesium Sulfate

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2
Q

Used to induce labor at term

A

Oxytocin

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3
Q

Used to expel uterine contents

A

Dinoprostone

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4
Q

Used as an antidote for magnesium intoxication

A

Calcium Gluconate

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5
Q

Prevents vitamin K deficiency bleeding of the newborn

A

Phytonadione

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6
Q

Used to stimulate uterine contractions

A

Methylergonovine Maleate

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7
Q

Scenario #1: A 32-year-old gravida 1, para 0 was admitted after 38 weeks gestation to the local delivery unit in possible labor. After the initial assessment, the patient was noted to have high blood pressure, pedal edema, and hyper-reflexia. The patient was diagnosed with preeclampsia and was started on a magnesium sulfate infusion.

Objective: Identify appropriate nursing assessments during normal labor and delivery.

NCLEX item type: multiple response
Cognitive skill: application

The nurse needs to be aware of which potential obstetric complications in pregnant women? (Select all that apply.)

Infection
Preterm labor
Hypoglycemia
Gestational diabetes
Premature rupture of membranes

A

Infection
Preterm labor
Gestational diabetes
Premature rupture of membranes

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8
Q

NCLEX item type: multiple choice
Cognitive skill: knowledge

The nurse was discussing postpartum care with a new mother and knew that more teaching was needed after the mother made which statement?

  1. “I understand that my baby will gain about 1 ounce per dav until dav 5.’
  2. “I can take a mild analgesic 40 minutes before breastfeeding.”
  3. “I know I need to continue to eat a well-bal-anced diet when breastfeeding.”
  4. “If I note any foul odor from my vaginal dis-charge, I know to call my healthcare provider.”
A
  1. “I understand that my baby will gain about 1 ounce per dav until dav 5.’
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9
Q

NCLEX item type: multiple response
Cognitive skill: illustrate
What are routine nursing assessments performed on pregnant women no matter what trimester they are in? (Select all that apply.)

Weight
Blood pressure
Vaginal exams
Hemoglobin and hematocrit
Fundal height and fetal heart sounds

A

Weight
Blood pressure
Fundal height and fetal heart sounds

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10
Q

NCLEX item type: multiple response
Cognitive skill: evaluate

The nurse will perform an assessment of pregnant woman which includes obtaining an obstetric his-tory. What questions will the nurse ask? (Select all that apply.) (625)
“How many children do you have? And how many times have you been pregnant?”

  1. “How many children do you have? And how many times have you been pregnant?”
    2 “Have any of your previous deliveries been by cesarean?”
  2. “What medications are you currently taking?”
    4.”Have any of your children been premature at birth?”
  3. “Have you ever had a stillbirth? Or a spontaneous or therapeutic abortion?”
A

1 “How many children do you have? And how many times have you been pregnant?”
2 “Have any of your previous deliveries been by cesarean?”

4”Have any of your children been premature at birth?”
5 “Have you ever had a stillbirth? Or a spontaneous or therapeutic abortion?”

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11
Q

Objective: Discuss potential complications of preterm labor and when uterine relaxants and magnesium sulfate are used.
NCLEX item type: multiple response
Cognitive skill: application
11. The nurse reviewed the primary clinical indications for the use of uterine stimulants. Which situations warrant the use of uterine stimulants such as oxyto-cin? (Select all that apply.) (636)
1. Suppression of lactation
2. Induction of therapeutic abortion
3. Induction or augmentation of labor
4. Control of postsurgical hemorrhage
5. During preeclampsia to induce labor

A

3 Induction or augmentation of labor
4 Control of postsurgical hemorrhage
5 During preeclampsia to induce labor

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12
Q

NCLEX item type: multiple choice
Cognitive skill: compare
The nurse discusses with the patient in scenario #1 the reasons for the use of uterine relaxants on the pregnant uterus? (636-637)
1. Uterine relaxants are used to induce or augment labor.
2. Uterine relaxants are used to control postpartum hemorrhage.
3. Uterine relaxants are used to suppress the flow of colostrum.
4. Uterine relaxants are used to delay or prevent labor and delivery in selected patients.

A

4 Uterine relaxants are used to delay or prevent labor and delivery in selected patients.

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13
Q

NCLEX item type: multiple choice
Cognitive skill: interpret
13. Which assessment findings that the nurse obtained from the patient in scenario #1 would indicate that the magnesium sulfate infusion should be discontin-ued? (640-641)
1. Absence of deep tendon reflexes
2. Respiratory rate of 16 breaths/min
3.Urinary output of 45 mL during the past hour
4. Decrease in blood pressure from 180/100 to 150/90 mm Hg

A
  1. Absence of deep tendon reflexes
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14
Q

NCLEX item type: multiple choice
Cognitive skill: knowledge

The nurse knows to perform which interventionwhen a pregnant woman is in preterm labor? (630-631)

  1. Restrict fluids
  2. Position the patient on her back
  3. Administer uterine stimulants
  4. Administer uterine relaxants
A
  1. Administer uterine relaxants
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15
Q

NCLEX item type: multiple choice
Cognitive skill: comprehension

The nurse recognized the signs of fetal distress when monitoring a mother in labor. Which change in heart rate indicates the fetus is in distress? (638)

  1. Fetal heart rate 120-160 beats / min following
    any contraction
  2. Fetal heart rate > 160 beats / min lasting less than 10 seconds after contractions
  3. Fetal heart rate 140 beats/ min lasting longer than 15 seconds after contractions
  4. Fetal heart rate >160 followed by heart rate <120 occurring frequently following contractions
A
  1. Fetal heart rate >160 followed by heart rate <120 occurring frequently following contractions
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16
Q

Objective: Describe assessments needed for uterine stimulants administered for induction of labor, augmentation of labor, and postpartum atony and hemorrhage.
NCLEX item type: multiple response
Cognitive skill: application
The nurse assesses the patient in scenario #1 receiving an infusion of oxytocin (Pitocin) to induce labor and determines the infant is in distress. Which actions does the nurse take? (Select all that apply.)

  1. Notifies the healthcare provider immediately
  2. Administers oxygen by nasal cannula or facemask
    5.Reduces the oxytocin infusion to the slowest possible rate according to hospital policy
A
  1. Notifies the healthcare provider immediately
  2. Administers oxygen by nasal cannula or facemask
    5.Reduces the oxytocin infusion to the slowest possible rate according to hospital policy
17
Q

NCLEX item type: multiple choice
Cognitive skill: analyze
17. The nurse was performing a postpartum assessment on a mother who was receiving oxytocin (Pitocin) therapy for control of bleeding and found the uterus to be boggy. What is the nurse’s next action? (638)
1. Massage the uterus.
2.Administer magnesium sulfate.
3. Slow the rate of the infusion.
4. Call the healthcare provider immediately.

A

Massage the uterus.

18
Q

NCLEX item type: multiple choice
Cognitive skill: knowledge

When working with patients receiving oxytocin (Pi-tocin), the nurse must assess for the development of water intoxication because oxytocin therapy causes which effect? (638)

  1. Increased urine output
  2. Hyperalert state
  3. Extreme thirst in patients
  4. Stimulation of antidiuretic hormone
A
  1. Stimulation of antidiuretic hormone
19
Q

List in correct order the steps to take for managing patients in preterm labor. (628,630)

Determine contraindications to tocolysis (i.e., placenta previa, fetal distress)
2. Monitor contractions and determine estimated gestational age
3. Administer indomethacin, nifedipine, or magnesium sulfate

  1. Take vital signs of the mother and apply fetal monitoring
  2. Observe for cervical changes
A

3 Determine contraindications to tocolysis (i.e., placenta previa, fetal distress)
2 Monitor contractions and determine estimated gestational age
5 Administer indomethacin, nifedipine, or magnesium sulfate
1 Take vital signs of the mother and apply fetal monitoring
4 Observe for cervical changes

20
Q

NCLEX item type: multiple choice
Cognitive skill: classify

A patient is receiving magnesium sulfate to inhibit preterm labor. Which drug does the nurse have readily available if magnesium toxicity should oc-cur? (641)
1. atropine
2. epinephrine
3. calcium gluconate
4. potassium chloride

A
  1. calcium gluconate
21
Q

Objective: Discuss education needed for care of the neonate, including erythromycin ophthalmic ointment.

NCLEX item type: multiple response
Cognitive skill: application

The nurse caring for the neonate in scenario #2 estimates at 1 minute and 5 minutes after delivery using the Apgar rating system, which parameters of the newborn? (Select all that apply.) (629)

  1. Heart rate
  2. Blood pressure
  3. Muscle tone
  4. Reflex irritability
  5. Color of body and extremities
A
  1. Heart rate
  2. Muscle tone
  3. Reflex irritability
  4. Color of body and extremities
22
Q

NCLEX item type: multiple response
Cognitive skill: application

The nurse attends the delivery of a mother in labor and needs to complete which of the following procedures immediately after the birth of the newborn?
(Select all that apply.) (634)

  1. Breastfeeding
  2. Eye prophylaxis
  3. Clamping the umbilical cord
  4. Determining an Apgar score
  5. Airway suction with bulb syringe if needed
A
  1. Eye prophylaxis
  2. Clamping the umbilical cord
  3. Determining an Apgar score
  4. Airway suction with bulb syringe if needed
23
Q

NCLEX item type: multiple choice
Cognitive skill: relate

The nurse explains to the mother in scenario #2 that after birth all infants have prophylactic erythromy-in ointment applied to their eyes. What will this treatment prevent? (641)

  1. Wilms’ tumor
  2. Nearsightedness
  3. Pheochromocvtoma
  4. Ophthalmia neonatorum
A
  1. Ophthalmia neonatorum
24
Q

NCLEX item type: multiple choice
Cognitive skill: explain
24. A new mother in scenario #2 asks the nurse why her newborn needs a shot of vitamin K. Which is an appropriate statement by the nurse? (642)
1. “All babies get this to prevent ophthalmia neo-natorum.”
2. “The delivery may have caused an infection in your baby and this will take care of it.”
3. “This will help increase the amount of natural bacteria in your baby’s GI system.”
4. “Newborns are often deficient in vitamin K and we want to prevent any bleeding issues.

A

Newborns are often deficient in vitamin K and we want to prevent any bleeding issues.

DAS VN OB/PEDS (13 decks)

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