§ The nurse is monitoring a client who is receiving oxytocin to induce labor. Which assessment finding would cause the nurse to immediately discontinue the oxytocin infusion? 1. Fatigue 2. Drowsiness 3. Uterine hyperstimulation 4. Early decelerations of the fetal heart rate § A pregnant client is receiving magnesium sulfate for the management of preeclampsia. The nurse determines that the client is experiencing toxicity from the medication if which finding is noted on assessment? 1. Proteinuria of 3 + 2. Respirations of 10 breaths/minute 3. Presence of deep tendon reflexes 4. Serum magnesium level of 6 mEq/L § The nurse is monitoring a client in preterm labor who is receiving intravenous magnesium sulfate. The nurse should monitor for which adverse effects 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 § The nursing instructor asks a nursing student to describe the procedure for administering erythromycin ointment to the eyes of a newborn. Which student statement indicates that further teaching is needed? 1. "I will flush the eyes after instilling the ointment." 2. "I will clean the newborn's eyes before instilling ointment." 3. "I need to administer the eye ointment within 1 hour after delivery." 4. "I will instill the eye ointment into each of the newborn's conjunctival sacs." § A client in preterm labor (31 weeks) who is dilated to 4 cm has been started on magnesium sulfate and contractions have stopped. If the client's labor can be inhibited for the next 48 hours, the nurse anticipates a prescription for which medication? 1. Nalbuphine 2. Betamethasone 3. Rho(D) immune globulin 4. Dinoprostone § Methylergonovine is prescribed for a woman to treat postpartum hemorrhage. Before administration of methylergonovine, what is the priority nursing assessment? 1. Uterine tone 2. Blood pressure 3. Amount of lochia 4. Deep tendon reflexes § Rho(D) immune globulin is prescribed for a client after delivery and the nurse provides information to the client about the purpose of the medication. The nurse determines that the woman understands the purpose if the woman states that it will protect her next baby from which condition? 1. Having Rh-positive blood 2. Developing a rubella infection 3. Developing physiological jaundice 4. Being affected by Rh incompatibility § Methylergonovine is prescribed for a client with postpartum hemorrhage. Before administering the medication, the nurse contacts the health care provider who prescribed the medication if which condition is documented in the client's medical history? 1. Hypotension 2. Hypothyroidism 3. Diabetes mellitus 4. Peripheral vascular disease § Terbutaline is prescribed for a client with bronchitis. The nurse understands that this medication should be used with caution if which medical condition is present in the client? 1. Osteoarthritis 2. Hypothyroidism 3. Diabetes mellitus 4. Polycystic disease § For which reason will betamethasone IM be administered to the mother in premature labor? a. To stop uterine contractions b. To prevent precipitous labor c. To stimulate lung maturity in the fetus d. To stimulate prolactin to enhance breastfeeding § A 26-year-old patient with preeclampsia is receiving IV magnesium sulfate. The 1400 assessment includes: BP - 100/70 mm Hg Respiration - 10 Fetal heart tone - 100/min Urine output - 20 mL/hr Absent patellar reflex Which is the priority nursing action? a. Decrease IV magnesium sulfate to half the dose and reassess the patient and fetus in 15 minutes. b. Stop the IV magnesium sulfate and contact the health care provider. c. Place the patient on her left side and administer oxygen. d. Stop the IV magnesium sulfate and administer calcium gluconate 5 mEq IV over 3 minutes. § Which drug is administered after delivery to reduce the risk of postpartum hemorrhage after the placenta has been delivered? a. Oxytocin (Pitocin) b. Magnesium sulfate c. Vitamin K d. Dopamine § § A 36-week primigravida patient has been admitted to the unit with a blood pressure of 200/120 mm Hg, severe headache, and edema. Which medication does the nurse anticipate that the health care provider will order? a. Nifedipine (Procardia) b. Furosemide (Lasix) c. Magnesium sulfate d. Terbutaline (Brethine) § Which drug is administered when a patient is experiencing premature labor? a. Magnesium sulfate b. Oxytocin (Pitocin) c. Levonorgestrel (Mirena) d. Terbutaline (Brethine) § § A patient is a gravida 1, Rh-negative woman at a 28 weeks gestation. The father of her child is Rh positive. The mother is asking the nurse about the effect on her unborn child of RhoGAM that has been ordered. What is the nurses best reply? a. Your child will do well after birth once transfusions are administered. b. If the baby is Rh negative at birth, he or she will need RhoGAM also. c. RhoGAM kills antibodies you make, so your child will be protected. d. Your baby may be Rh positive and cause you to make antibodies. These wont affect this baby, but could affect future children if RhoGAM isnt given. § Which drug will the nurse administer to prevent neonatal conjunctivitis in the newborn? a. Silver nitrate b. Dexamethasone c. Erythromycin d. Vitamin K § Which emergency drug must be available when caring for a patient receiving magnesium sulfate? a. Naloxone b. Calcium gluconate c. Dextrose d. Dopamine § A patient at 33 weeks gestation is admitted to the obstetric unit in active labor with symptoms associated with pregnancy induced hypertension (PIH). Which action(s) will the nurse implement? (Select all that apply.) a. Vital signs hourly b. Administration of IV pitocin c. Administration of magnesium sulfate IV d. Fetal stress test e. Assessment of deep tendon reflexes § What will the nurse include when teaching a postpartum patient about expected adverse effects of Rho(D) immune globulin? (Select all that apply.) a. Nausea b. Constipation c. Fever d. Insomnia e. Aches f. Diarrhea g. Anorexia § . A patient at 26 weeks' gestation presents to the labor and delivery unit in preterm labor. The practitioner orders terbutaline to be administered subcutaneously. On initial assessment, the patient's blood pressure is 180/99 mm Hg, and a urine dipstick test indicates +3 protein. The patient is also reporting visual disturbances. Why should the nurse contact the practitioner to clarify whether terbutaline is appropriate for this patient? A. Terbutaline is contraindicated in pregnancies at 26 weeks' gestation. B. Terbutaline is contraindicated in patients with severe preeclampsia. C. Terbutaline is more effective as a maintenance tocolytic than as a first-line tocolytic. D. Terbutaline is limited to first-line tocolytics. § A patient at 32 weeks' gestation is admitted to the antepartum unit with significantly elevated blood glucose levels; the practitioner wants to rule out gestational diabetes. The patient recently received several doses of subcutaneous terbutaline for preterm contractions. What is one of the potential serious maternal adverse reactions to terbutaline? A. Seizures B. Hypoglycemia C. Hypoinsulinemia D. Hyperglycemia § A client who received intravenous magnesium sulfate for preeclampsia gives birth. What clinical finding in the newborn indicates to the nurse that magnesium sulfate toxicity may have occurred? 1 Pallor 2 Tremor 3 Hypotonia 4 Tachycardia
