Using the 5-digit system, determine the obstetric history in this situation: The client is 38 weeks into her fourth pregnancy. Her third pregnancy, a twin gestation, ended at 32 weeks with a live birth, her second pregnancy ended at 38 weeks with a live birth, and her first pregnancy ended at 18 weeks. A. G4, T2, P1, A1, L2 B. G4, T1, P2, A1, L1 C. G4, T1, P1, A1, L3 D. G4, T2, P1, A1, L1
A pregnant client has two children at home, the first born at 38 weeks' gestation and the second born at 34 weeks' gestation. She has also had one miscarriage, at 18 weeks, and an elective abortion. Which is the correct summary of her obstetric history using the GTPAL system? A. G5, T1, P1, A2, L2 B. G4, T2, P2, A1, L4 C. G2, T3, P3, A2, L1 D. G3, T2, P1, A3, L3 ANS: B Growth of the fetus, body changes, and nutritional guidance Rationale: A & D- Information on infant care, travel to the hospital, signs of labor, signs of preeclampsia, and relaxation breathing techniques are appropriate in the last trimester. C- Interventions for nausea and vomiting, urinary frequency, and anticipated care are appropriate for the first trimester. Recommended textbook solutions
 Pharmacology and the Nursing Process7th EditionJulie S Snyder, Linda Lilley, Shelly Collins 388 solutions
Integrated Electronic Health Records4th EditionAmy Ensign, M Beth Shanholtzer 485 solutions Gordis Epidemiology6th EditionDavid D Celentano, Moyses Szklo 123 solutions Pathophysiology for the Health Professions6th EditionKarin VanMeter, Robert Hubert 1,226 solutions The nurse is assessing a patient with gestational hypertension, who is prescribed magnesium sulfate therapy. Which would be a planning phase activity in this case? The nurse determines that the infusion will continue 24 hours postpartum. The nurse advises the patient to avoid exposure to infection. The nurse makes the resuscitation equipment available for emergency. The nurse uses the Z-track technique to administer the medication. The nurse determines that the infusion will continue 24 hours postpartum. he nurse should plan to administer the magnesium sulfate infusion at least 24 hours postpartum so the patient does not develop eclampsia. Advising the patient to avoid exposure to infection is an implementation phase activity when the nurse is teaching the patient. Having the resuscitation equipment available for emergency is also an implementation phase activity, because the intervention will counter any side effects of the therapy. Using the Z-track technique to administer the medication is an implementation phase activity. A pregnant patient is receiving magnesium sulfate to inhibit uterine contractions. The patient develops depressed reflexes and confusion. What is the nurse's priority action? Administer atropine IV. Administer calcium gluconate. Administer epinephrine. Administer protamine sulfate. Administer calcium gluconate. Calcium gluconate is the antidote when magnesium toxicity (maternal neurologic, respiratory, or cardiac depression) is evidenced. Atropine will not reverse magnesium toxicity; it is used for insecticide intoxication or slow heart rates. Epinephrine will not reverse magnesium toxicity; it is used for the treatment of anaphylactic reactions. Protamine sulfate will not reverse magnesium toxicity; it is the antidote for heparin overdose. What is the most important point that the nurse should explain when a pregnant patient is prescribed an enteric-coated drug along with an antacid? Why the drug prescription is necessary The prescribed dose of the drug Possible drug interactions The schedule for taking the drug Possible drug interactions The nurse is evaluating the prescriptions of a pregnant patient who is anemic. The patient is taking 60 mg of elemental iron per day, 600 mcg of folic acid daily, pyridoxine (B6) for nausea and vomiting, and acetaminophen (Tylenol) for headache. Which prescription does the nurse need to discuss with a primary health care provider? Elemental iron Folic acid Pyridoxine (B6) Acetaminophen (Tylenol) Elemental iron. The minimum supplemental iron requirement for a pregnant patient who is anemic is 120 mg per day. A prescription of 60 mg of elemental iron per day is helpful for nonanemic patients. The prescribed 600 mcg of folic acid is adequate for the patient. The use of pyridoxine (B6) for nausea and vomiting is safe to administer during pregnancy. The use of acetaminophen (Tylenol) for headache is also safe to administer during pregnancy. Which statement by a patient about the use of aspirin (Ecotrin) during pregnancy indicates a need for further learning? "Aspirin can be used to relieve pain during pregnancy." "Aspirin is most harmful when used late in pregnancy." "Aspirin can affect hemostasis in the newborn." "Aspirin can cause antepartum hemorrhage. "Aspirin can be used to relieve pain during pregnancy." Aspirin should not be used to relieve pain during pregnancy because it can affect uterine contractility. This may inhibit the initiation of labor and prolong labor. Aspirin is harmful when used late in pregnancy because it may increase maternal blood loss at the time of delivery. Aspirin can also affect hemostasis in the newborn if the mother uses aspirin during the last two months of pregnancy. Aspirin used late in pregnancy can cause antepartum hemorrhage. What is a common adverse reaction to iron supplements? Pruritus Erythema Epigastric pain Bronchospasm Epigastric pain. Epigastric pain is the common adverse reaction to iron supplements. Pruritus, erythema, and bronchospasm are the common adverse reactions of folic acid supplementation.Test-Taking Tip: Identify option components as correct or incorrect. This may help you identify a wrong answer. Which substance can cause intrauterine cerebral infarction in the fetus when taken during pregnancy? Heroin Cocaine Nicotine Caffeine Cocaine. Cocaine abuse can cause systemic and cerebral effects. It can also cause intrauterine cerebral infarction when abused during pregnancy, because it takes 4 to 5 days to clear via the urine of the newborn because of liver immaturity and the lack of cholinesterase. Heroin can cause neonatal meconium aspiration syndrome. Nicotine can lead to smaller head and arm circumferences. Excessive consumption of caffeine can be toxic for the embryo. What is the difference between dexamethasone (Decadron) and desoximetasone (Topicort)? Dexamethasone (Decadron) accelerates fetal lung maturity, whereas desoximetasone (Topicort) treats inflammation. Dexamethasone (Decadron) prevents respiratory distress in infants, whereas desoximetasone (Topicort) causes respiratory distress in infants. Dexamethasone (Decadron) is a corticosteroid, whereas desoximetasone (Topicort) is a beta2-adrenergic agonist. Dexamethasone (Decadron) is used for mild preeclampsia, whereas desoximetasone (Topicort) is used for severe preeclampsia Dexamethasone (Decadron) accelerates fetal lung maturity, whereas desoximetasone (Topicort) treats inflammation Dexamethasone (Decadron) is an antenatal corticosteroid that accelerates fetal lung maturity. Desoximetasone (Topicort) treats inflammation. Dexamethasone prevents respiratory distress in infants, but desoximetasone does not cause respiratory distress. Both dexamethasone and desoximetasone are corticosteroids. Neither medication is used for the treatment of preeclampsia. Which herbal preparation used during pregnancy decreases platelets? Sage Ginseng Kava kava Dong quai Kava kava Using kava kava during pregnancy can cause thrombocytopenia, leading to a decrease in the platelet count. Sage stimulates blood flow in the uterus. Ginseng decreases the action of anticoagulants when used during pregnancy. Dong quai increases bleeding when used with anticoagulants during pregnancy. Which corticosteroid drug is typically used for management of preterm labor? Betamethasone (Celestone) Prednisone (Deltasone) Fludrocortisone (Florinef) Methylprednisolone (Solu-Medrol) Betamethasone. Betamethasone (Celestone) is the drug of choice for patients experiencing premature labor. It helps to accelerate fetal lung maturation. Prednisone (Deltasone), fludrocortisone (Florinef), and methylprednisolone (Solu-Medrol) are all corticosteroid drugs, but they are not typically used during pregnancy. While most corticosteroid medications are pregnancy category C, studies have shown that betamethasone is safe for mother and baby, and the benefits to baby outweigh the risks associated with the drug. A patient delivers an infant at a low birth weight. The patient had been taking 325 mg/d of ferrous sulfate (Fer-In-Sol), prenatal vitamins, and 100 mcg of folic acid daily. What should the nurse conclude from this assessment? The patient consumed megadoses of vitamins during pregnancy. The patient has iron-deficiency anemia that caused the low birth weight in the infant. The patient had a folic acid deficiency that caused the low birth weight in the infant. The patient ingested iron supplements only in the third trimester of pregnancy. The patient had a folic acid deficiency that caused the low birth weight in the infant. Folic acid deficiency during pregnancy can lead to low birth weight in an infant. During pregnancy, the folic acid requirement is 600 mcg/d. The consumption of 100 mcg/d of folic acid in this patient most likely indicates a folic acid deficiency. The ingestion of megadoses of vitamins may have teratogenic effects in the infant. The patient does not have iron-deficiency anemia, because the patient has been taking 325 mg/d of ferrous sulfate. Iron supplements should begin in the second trimester of pregnancy; however, inadequate iron supplementation will not cause low birth weight in an infant, but will cause iron-deficiency anemia in the mother. Which medication can cause diarrhea in a pregnant woman? Meclizine (Antivert) Doxylamine (Unisom) Promethazine (Phenergan) Metoclopramide (Reglan) Metoclopramide (Reglan) Metoclopramide (Reglan) can cause diarrhea in pregnant woman. Meclizine (Antivert) causes dizziness. Doxylamine (Unisom) causes abdominal pain along with cramps as a side effect. Promethazine (Phenergan) causes fatigue as a side effect.
An infant demonstrates hypotonia and lethargy after birth. Which assessment finding will support this data? The mother received magnesium sulfate just before the delivery. The mother received hydralazine during the delivery. The mother had a high lecithin/sphingomyelin (L/S) ratio in the amniotic fluid. The mother used aspirin (Eotrin) in the last month of pregnancy The mother received magnesium sulfate just before the delivery. Hypotonia and lethargy are side effects of magnesium sulfate. Hydralazine, which is used for preeclampsia, has no direct effects on the fetus. A high lecithin/sphingomyelin (L/S) ratio in the amniotic fluid indicates an increase in the endogenous corticosteroid. It does not cause hypotonia nor lethargy in the infant after birth. The use of aspirin late in pregnancy increases maternal blood loss during delivery. A pregnant patient will begin an iron supplement regimen. The nurse finds that the patient is also taking aluminum hydroxide (Amphojel). What should the nurse tell the patient? "Take the iron supplement two hours before taking aluminum hydroxide." "Take the iron supplement and aluminum hyroxide with milk or coffee." "Take both the medications in the morning on an empty stomach with either juice or water." "Take a smaller dose of aluminum hydroxide when you begin taking the iron supplement." "Take the iron supplement two hours before taking aluminum hydroxide." Aluminum hydroxide (Amphojel) is an antacid that interferes with iron absorption; therefore, the nurse should instruct a patient to take the iron supplement two hours before taking aluminum hydroxide. The absorption of iron decreases if a patient takes the medication with milk or coffee; therefore, the nurse should instruct the patient to take the supplement with water or orange juice to increase its absorption. Both medications should not be taken together because they will not be absorbed effectively in the body. The nurse should not ask the patient to change the medication dose. Instead, the nurse should ask the patient to take the medication dose as prescribed by the primary health care provider. The nurse is caring for a patient who is pregnant who is expected to experience preterm labor. The laboratory reports indicate that the fetus's lungs are not completely developed. Which adrenal drug will the nurse expect to be most beneficial for the patient? Betamethasone (Celestone) Dexamethasone (Decadron) Aminoglutethimide (Cytadren) Methylprednisolone (Solu-Medrol) Betamethasone (Celestone) Betamethasone (Celestone) is a synthetic glucocorticoid and the drug of choice to enhance fetal lung maturation. This medication is given to patients who may experience preterm labor since it accelerates fetal lung maturation and prevents respiratory infections in newborns. Dexamethasone (Decadron) is also a synthetic glucocorticoid but is less beneficial than betamethasone (Celestone). Aminoglutethimide (Cytadren) is a pregnancy category D drug. It is an antiadrenal drug and may not be effective for enhancing fetal lung maturation. This medication may also cause teratogenic effects. Methylprednisolone (Solu-Medrol) is an injectable glucocorticoid drug. It is used to treat hyperemesis gravidarum and does not accelerate fetal lung maturation. A pregnant patient is prescribed ferrous sulfate (Feosol) in the second trimester. What should the nurse advise the patient with regard to this medication? "Avoid taking the medication on an empty stomach." "Lie down immediately after taking the medication." "Take the medication early in the morning." "Avoid taking the medication with milk or coffee." "Avoid taking the medication with milk or coffee." The absorption of ferrous sulfate, an iron supplement, decreases when taken with milk or coffee. A patient should take the supplement on an empty stomach with water to increase the absorption of iron. A patient should sit upright for 30 minutes after taking the medication to decrease reflux. A patient should take the medication at bedtime to prevent gastrointestinal upset. Vitamin C increases the absorption of iron and some primary health care providers suggest that drinking orange juice with the iron supplement is beneficial. Ideally, iron supplements should be taken with a full eight ounce glass of water. A pregnant patient is receiving betamethasone (Celestone) therapy. What should the nurse conclude from this prescription? The patient has developed preeclampsia. The patient is experiencing constipation. The patient is at risk for preterm delivery. The fetal lung maturity is normal The patient is at risk for preterm delivery. Betamethasone (Celestone) is an antenatal corticosteroid that will facilitate fetal lung maturation in a patient who is at risk for preterm delivery. Antenatal corticosteroids will not treat preeclampsia in a pregnant patient. The primary health care provider should prescribe a stool softener, such as docusate sodium (Colace), to relieve constipation. A prescription of an antenatal corticosteroid indicates that the fetal lung is not well developed. The nurse observes that a pregnant patient is receiving magnesium sulfate therapy for preterm labor. The patient shows fewer than 12 respirations per minute. What action should the nurse take? Anticipate administering a beta-sympathomimetic medication. Anticipate administering calcium gluconate. Initiate an increase of the dose immediately. Initiate fetal heart rate (FHR) monitoring immediately Anticipate administering calcium gluconate. Fewer than 12 respirations per minute in a pregnant patient who is receiving magnesium sulfate indicates respiratory depression because of magnesium toxicity or an overdose. Calcium gluconate is an antidote that counters the magnesium sulfate toxicity in the patient. The use of a beta-sympathomimetic medication is not useful in this case, because it is a tocolytic and is not an antidote for magnesium sulfate toxicity. Monitoring the fetal heart rate is secondary in this case, because it is more important to relieve respiratory depression in the mother. A pregnant patient reports general malaise and dark yellow urine. The nurse also finds erythema and a rash on the patient's skin. The patient is prescribed 325 mg of iron supplements per day and 600 mcg of folic acid daily. What might the nurse conclude from this finding? The patient did not take the iron supplements as prescribed. The patient did not consume folate-enriched foods. The patient is experiencing side effects of folic acid supplementation. The patient is experiencing a deficiency of folic acid The patient is experiencing side effects of folic acid supplementation. Symptoms such as general malaise, dark yellow urine, erythema, and a rash on the skin indicate that a patient is experiencing the side effects of folic acid supplementation. A patient is likely to develop iron-deficiency anemia if the patient does not take the iron supplements as prescribed. The folate from foods is not well absorbed and a patient still needs folic acid supplementation during pregnancy, because a deficiency of folic acid can cause birth defects or spontaneous abortion. A patient who is pregnant asks the nurse if it is safe to use herbal remedies for the treatment of problems experienced during pregnancy. What should the nurse tell the patient? Select all that apply. "Feverfew and sage are unsafe for the fetus." "Kava kava is a beneficial herb during pregnancy." "Gingko biloba can be taken with anticoagulants." "St. John's wort should be avoided during pregnancy." "Ginseng should not be taken with anticoagulants." "Feverfew and sage are unsafe for the fetus."\ "St. John's wort should be avoided during pregnancy." "Ginseng should not be taken with anticoagulants." The nurse should instruct the patient to avoid herbs such as feverfew and sage during pregnancy because they are emmenagogues, which stimulate blood flow in the uterus. The nurse should instruct the patient to avoid St. John's wort during pregnancy because the herb has mutagenic effects on fetal cells. Ginseng should not be taken with anticoagulants because it decreases the action of the medication. Kava kava is not a beneficial medication to take during pregnancy because it decreases the platelet count. Gingko biloba increases bleeding when used with anticoagulants and, therefore, is not safe. A pregnant patient is receiving magnesium sulfate therapy for preeclampsia. What would be an abnormal finding in the patient? The patient's urinary output is 30 mL per hour. The patient has more than 12 respirations per minute. The fetal heart rate (FHR) baseline is more than 180 beats per minute. The patient has 5 mEq/L of serum magnesium levels. The fetal heart rate (FHR) baseline is more than 180 beats per minute. The fetal heart rate (FHR) baseline should be between 110 to 160 beats per minute when a patient is receiving magnesium sulfate; therefore, a FHR baseline of more than 180 beats per minute indicates an abnormal finding, which should be promptly reported to a primary care provider. Urinary output of 30 mL per hour is a normal finding in a patient who is pregnant and who is on magnesium sulfate therapy. Less than 12 respirations per minute would indicate respiratory depression in a patient. Therapeutic serum magnesium levels in the patient should be between 4 to 7 mEq/L. Which medications have shorter half-lives during pregnancy? Hypnotics Analgesics Antiemetics Barbiturates Barbiturates Barbiturates have shorter half-lives during pregnancy. Certain factors such as late pregnancy and labor can alter the half-lives of barbiturates. Labor can actually increase the half-life of some medications including hypnotics and analgesics. Antiemetics are commonly administered during pregnancy; pregnancy or labor does not affect the half-lives of these drugs. A pregnant patient is receiving magnesium sulfate therapy for preeclampsia. What would be an abnormal finding in the patient? The patient's urinary output is 30 mL per hour. The patient has more than 12 respirations per minute. The fetal heart rate (FHR) baseline is more than 180 beats per minute. The patient has 5 mEq/L of serum magnesium levels. The fetal heart rate (FHR) baseline is more than 180 beats per minute. The fetal heart rate (FHR) baseline should be between 110 to 160 beats per minute when a patient is receiving magnesium sulfate; therefore, a FHR baseline of more than 180 beats per minute indicates an abnormal finding, which should be promptly reported to a primary care provider. Urinary output of 30 mL per hour is a normal finding in a patient who is pregnant and who is on magnesium sulfate therapy. Less than 12 respirations per minute would indicate respiratory depression in a patient. Therapeutic serum magnesium levels in the patient should be between 4 to 7 mEq/L. Which medication can cause diarrhea in a pregnant woman? Meclizine (Antivert) Doxylamine (Unisom) Promethazine (Phenergan) Metoclopramide (Reglan) Metoclopramide (Reglan) Metoclopramide (Reglan) can cause diarrhea in pregnant woman. Meclizine (Antivert) causes dizziness. Doxylamine (Unisom) causes abdominal pain along with cramps as a side effect. Promethazine (Phenergan) causes fatigue as a side effect. The nurse is counseling a patient who is in the sixth week of pregnancy. What is an important instruction for this patient to prevent any fetal abnormalities? "You need to start supplemental iron at once to prevent iron deficiency in the fetus." "Excess consumption of coffee is not likely to have any toxic effects after the fifth week." "Consult with the primary health care provider before taking over-the-counter (OTC) medications." "You must take 200 mcg of folic acid daily to prevent birth defects in the infant." "Consult with the primary health care provider before taking over-the-counter (OTC) medications." Over-the-Counter (OTC) medications may contain substances that are not safe for the fetus; therefore, the nurse should instruct the patient to consult with a primary health care provider before taking any OTC medications. The patient will be instructed to start supplemental iron during the second trimester of pregnancy when the fetus begins to store maternal iron. Excess consumption of coffee has toxic effects after the second week of pregnancy; therefore, caffeine intake during pregnancy should be restricted to 150-200 mg per day. The patient should take 600 mcg of folic acid daily to prevent birth defects in the infant. hich corticosteroid drug is typically used for management of preterm labor? Betamethasone (Celestone) Prednisone (Deltasone) Fludrocortisone (Florinef) Methylprednisolone (Solu-Medrol) Betamethasone (Celestone) Betamethasone (Celestone) is the drug of choice for patients experiencing premature labor. It helps to accelerate fetal lung maturation. Prednisone (Deltasone), fludrocortisone (Florinef), and methylprednisolone (Solu-Medrol) are all corticosteroid drugs, but they are not typically used during pregnancy. While most corticosteroid medications are pregnancy category C, studies have shown that betamethasone is safe for mother and baby, and the benefits to baby outweigh the risks associated with the drug. What is the difference between methylergonovine (Methergine) and terbutaline sulfate (Brethine)? Methylergonovine (Methergine) is used for preterm labor, whereas terbutaline sulfate (Brethine) is a postpartum medication. Methylergonovine (Methergine) facilitates fetal lung maturation, whereas terbutaline sulfate (Brethine) hinders fetal lung maturation. Methylergonovine (Methergine) is used for tocolytic therapy, whereas terbutaline sulfate (Brethine) is not used as a tocolytic. Methylergonovine (Methergine) stimulates uterine contractions, whereas terbutaline sulfate (Brethine) decreases uterine contractions. Methylergonovine (Methergine) stimulates uterine contractions, whereas terbutaline sulfate (Brethine) decreases uterine contractions. Methylergonovine (Methergine) stimulates uterine contractions to prevent postpartum bleeding and terbutaline sulfate (Brethine) decreases uterine contractions in preterm labor. Methylergonovine is not used for preterm labor, because it will not delay delivery. Terbutaline sulfate is an antepartum medication and is not used for postpartum patients. Neither medication affects fetal lung maturation. Antenatal corticosteroids facilitate fetal lung maturity. Methylergonovine is not a tocolytic. Terbutaline sulfate, an acute tocolytic, is limited to a single dose because it has adverse effects on the fetal and maternal cardiovascular systems. What is the difference between dexamethasone (Decadron) and desoximetasone (Topicort)? Dexamethasone (Decadron) accelerates fetal lung maturity, whereas desoximetasone (Topicort) treats inflammation. Dexamethasone (Decadron) prevents respiratory distress in infants, whereas desoximetasone (Topicort) causes respiratory distress in infants. Dexamethasone (Decadron) is a corticosteroid, whereas desoximetasone (Topicort) is a beta2-adrenergic agonist. Dexamethasone (Decadron) is used for mild preeclampsia, whereas desoximetasone (Topicort) is used for severe preeclampsia Dexamethasone (Decadron) accelerates fetal lung maturity, whereas desoximetasone (Topicort) treats inflammation. Dexamethasone (Decadron) is an antenatal corticosteroid that accelerates fetal lung maturity. Desoximetasone (Topicort) treats inflammation. Dexamethasone prevents respiratory distress in infants, but desoximetasone does not cause respiratory distress. Both dexamethasone and desoximetasone are corticosteroids. Neither medication is used for the treatment of preeclampsia. Which corticosteroids stimulate lung surfactant development in the fetus in utero? Select all that apply. Methylergonovine (Methergine) Betamethasone (Celestone) Dexamethasone (Decadron) Desoximetasone (Topicort) Terbutaline sulfate (Brethine Betamethasone (Celestone) Dexamethasone (Decadron) Betamethasone (Celestone) and Dexamethasone (Decadron) are antenatal corticosteroids that help in the lung surfactant development in the fetus in utero. Methylergonovine (Methergine) stimulates uterine contractions. Desoximetasone (Topicort) treats inflammation. Terbutaline sulfate (Brethine) inhibits uterine contractions during preterm labor. What is the most commonly ingested nonprescription drug during pregnancy? Cimetidine (Tagamet) Metamucil (Metamucil) Acetaminophen (Tylenol) Docusate sodium (Colace Acetaminophen (Tylenol) Acetaminophen (Tylenol) is the most commonly ingested nonprescription drug during pregnancy because it doesn't have any significant antiinflammatory effects. It is a para aminophenol analgesic that can be used in all trimesters of pregnancy in therapeutic doses on a short-term basis due to its analgesic and antipyretic effects. Cimetidine (Tagamet) is used to relieve heartburn during the early stage of pregnancy if prescribed by the primary health care provider. Metamucil is used for constipation in pregnancy only if it is prescribed by the primary health-care provider. Docusate sodium (Colace) is used as a stool softener in pregnancy only if severe constipation occurs. The nurse is teaching a patient who is in the early stage of pregnancy about nonpharmacologic comfort measures. Which statements should the nurse include in the teaching? Select all that apply. "Eat dry toast." "Limit the size of meals." "Eat small frequent meals." "Avoid highly seasoned foods." "Drink adequate fluids with meals." eat dry toast "Eat small frequent meals." Eating dry toast and small frequent meals are nonpharmacologic measures that can decrease morning sickness during the early stage of pregnancy. Limiting the size of meals and avoiding highly seasoned foods are nonpharmacologic measures preferred in the management of heartburn in the early stages of pregnancy. Drinking adequate fluids between meals, rather than with meals, helps to prevent morning sickness. Which medications are used in the management of nausea and vomiting during pregnancy? Select all that apply. Meclizine (Antivert) Promethazine (Phenergan) Metoclopramide (Reglan) Methylergonovine (Methergine) Desoximetasone (Topicor Meclizine (Antivert) Promethazine (Phenergan) Metoclopramide (Reglan) Meclizine (Antivert) is an antihistamine that blocks the chemoreceptor trigger zone that acts on the vomiting center. Promethazine (Phenergan) is a phenothiazine that blocks the postsynaptic mesolimbic dopaminergic receptors in the brain. This depresses the release of hypothalamic and hypophyseal hormones. Metoclopramide (Reglan) also blocks the dopamine receptors in the chemoreceptor trigger zone. It accelerates gastric emptying without stimulating secretions. Methylergonovine (Methergine) is used to stimulate uterine contractions, whereas desoximetasone (Topicort) is used for the treatment of inflammation. Neither methylergonovine (Methergine) nor desoximetasone (Topicort) should be prescribed for nausea and vomiting during pregnancy. A 5-months-pregnant patient enters the clinic and states, "I have no money for any kind of vitamins, and I have never taken any." What is the nurse's primary intervention? Refer the patient to social services. Check the patient's hemoglobin and hematocrit. Start the patient on folic acid. Screen the patient for fetal neural tube defects Screen the patient for fetal neural tube defects The development of neural tube defects occurs early in the pregnancy, so it would be appropriate to screen for this first. Folic acid ingestion improves the outcomes of pregnancy, because folic acid deficiency can lead to spontaneous abortion, neural tube defects, premature birth, low birth weight, and abruptio placentae. A pregnant patient complains of constipation and has not had a bowel movement in 5 days. What is the nurse's first intervention? Administer Metamucil. Administer docusate sodium. Assess the patient's fluid intake. Increase the patient's dietary fiber. Assess the patient's fluid intake. The pregnant patient is often nauseous and may not take in enough fluid, which can contribute to constipation. The nurse should first assess if this is the cause and increase fluid intake as appropriate. Which fetal side effects may be seen if a patient is taking terbutaline for preterm labor? Select all that apply. Tachycardia Diarrhea Hypoglycemia Hypokalemia Ketoacidosis Tachycardia Hypoglycemia Terbutaline causes an increase in hepatic glucose production (hyperglycemia) in the mother. The fetal response to this high level of glucose in mother's blood is an increased secretion of insulin (hyperinsulinemia). This results in fetal hypoglycemia. Another fetal side effect of terbutaline is tachycardia. Diarrhea and hypokalemia are both maternal side effects that occur because of the cross-reactivity of the medication with beta 1-adrenergic receptors. These symptoms do not occur in the fetus. Ketoacidosis is a more serious maternal adverse effect of terbutaline. The primary care provider has ordered a beta-sympathomimetic drug to treat preterm labor. For which side effects would the nurse monitor the patient? Select all that apply. Palpitations Hypokalemia Chest pain Dizziness Bradycardia Palpitations Which substances used during pregnancy can have a teratogenic effect on the fetus? Select all that apply. Alcohol Caffeine Heroin Methadone Barbiturates Alcohol Heroin Methadone Barbiturates Which are commonly used to treat nausea and vomiting associated with pregnancy? Select all that apply. Ginger Pyridoxine hydrochloride Doxylamine succinate Progesterone Magnesium hydroxide Ginger Pyridoxine hydrochloride Doxylamine succinate Ginger is an herbal remedy that can be used safely in moderation to treat nausea and vomiting associated with pregnancy. As with all herbs and supplements, the patient should consult with her primary health care provider prior to taking ginger as it can increase the risk of bleeding. Pyridoxine hydrochloride (vitamin B6) is the drug of choice for nausea and vomiting of pregnancy. Doxylamine succinate was recently approved by the U.S. Food and Drug Administration (FDA) for management of nausea and vomiting of pregnancy. Progesterone is a hormone increased during pregnancy that causes relaxation of smooth muscle contributing to heartburn and constipation. Magnesium hydroxide is an antiflatulent and neutralizes gastric acid. Which are contraindications for initiating an infusion of tocolytic therapy? Select all that apply. Leaking amniotic fluid Fetal decelerations Biophysical profile score of 4 Intact amniotic sac Cervical dilation of 6 cm Leaking amniotic fluid Fetal decelerations Biophysical profile score of 4 Cervical dilation of 6 cm Which statements by a student nurse about the effect of pregnancy on medication action indicate effective learning? Select all that apply. "The serum and tissue concentrations of the medications decrease during pregnancy." "There is a more rapid renal excretion of medications during pregnancy." "The maternal circulating blood volume does not dilute the medications." "There is increased gastrointestinal motility during pregnancy." "There is no effect on the liver's metabolism of the medications during pregnancy." "The serum and tissue concentrations of the medications decrease during pregnancy." "There is a more rapid renal excretion of medications during pregnancy." The serum and tissue concentrations of medications decrease during pregnancy because of an alteration in the clearance of the medications. There is also a more rapid excretion of medications during pregnancy due to an increased glomerular filtration rate and an increase in renal perfusion. The expanded maternal circulating blood volume during pregnancy results in the dilution of medications. There is reduced gastrointestinal motility due to the hormonal changes during pregnancy. The circulating steroid hormones affect the liver's metabolism of the medication during pregnancy. What is a common adverse reaction to iron supplements? Pruritus Erythema Epigastric pain Bronchospasm Epigastric pain Epigastric pain is the common adverse reaction to iron supplements. Pruritus, erythema, and bronchospasm are the common adverse reactions of folic acid supplementation. What should the nurse assess to understand the presence of preeclampsia in a patient who is pregnant? Select all that apply. Blood pressure 24-hour urine collection Complete blood count (CBC) reports Weight Methylergonovine (Methergine) use Blood pressure 24-hour urine collection Complete blood count (CBC) reports Weight The nurse should assess a patient's blood pressure to determine the presence of preeclampsia. An increase in blood pressure greater than 140 mm Hg systolic and/or greater than 90 mm Hg diastolic, but less than 160 mm Hg systolic indicates mild preeclampsia. The nurse should assess the results of a 24-hour urine collection to understand the presence of proteinuria. A complete blood count (CBC) report helps detect if preeclampsia is likely to progress further. An unusual increase in weight indicates the possibility of edema, also seen in preeclampsia. The nurse should not assess the use of methylergonovine (Methergine), because it stimulates uterine contractions, which is unrelated to preeclampsia. |
Which medication is safe to take during pregnancy Select all that apply quizlet
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