A client at 31 weeks gestation is admitted in preterm labor.
Which medication would the nurse provide education for?
An analgesic.
A corticosteroid.
A tocolytic.
An oxytocic.
Correct Answer : B,C
Choice A rationale
An analgesic like meperidine (Demerol) or butorphanol (Stadol) is typically used for pain management during labor but is not a primary therapeutic agent for addressing preterm labor (PTL) itself. While pain relief may be important, the essential interventions for PTL at 31 weeks gestation focus on stopping contractions and preparing the fetus for potential early delivery.
Choice B rationale
Corticosteroids, such as betamethasone or dexamethasone, are administered to the client in PTL between 24 and 34 weeks gestation. These medications promote fetal lung maturity by stimulating the production and release of surfactant and reduce the incidence and severity of respiratory distress syndrome (RDS), intraventricular hemorrhage, and neonatal mortality.
Choice C rationale
A tocolytic is a class of drugs used to suppress uterine contractions in an attempt to delay delivery, giving time for corticosteroids to take effect and for in-utero transfer if necessary. Examples include magnesium sulfate, nifedipine, or terbutaline, aiming to prolong the pregnancy by at least 48 hours to maximize steroid benefit.
Choice D rationale
An oxytocic medication, such as oxytocin (Pitocin) or methylergonovine, stimulates uterine contractions and is used for labor induction/augmentation or to prevent/treat postpartum hemorrhage. Providing an oxytocic to a client in preterm labor is contraindicated as it would accelerate delivery, which is the exact outcome one is attempting to prevent.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["100"]
Explanation
Step 1 is: Calculate the volume of the magnesium sulfate solution that contains the ordered dose. 500 mL÷30 g = 16.666. mL/g. 6 g/hr×16.666. mL/g = 100 mL/hr. The final calculated answer is 100 mL/hr.
Correct Answer is B
Explanation
Choice A rationale
While the amount of blood loss is critical for determining the severity of the hemorrhage and the need for immediate treatment, it is not the priority assessment before administering methylergonovine. The amount of blood loss determines the need for the drug, but the blood pressure determines its safety before administration. Methylergonovine is a potent vasoconstrictor and must be used cautiously in clients with elevated blood pressure to prevent hypertensive crisis or stroke.
Choice B rationale
Methylergonovine is an ergot alkaloid that acts as a potent vasoconstrictor and uterine stimulant. Its primary side effect and contraindication are hypertension and preeclampsia. Because the drug dramatically increases systemic vascular resistance, it can cause a sudden, severe elevation in blood pressure. Therefore, checking the blood pressure is the priority assessment to ensure the client's pressure is within safe limits before administration, preventing potential complications like stroke.
Choice C rationale
Although a change in the level of consciousness (LOC) could indicate hypovolemic shock from severe blood loss or a hypertensive emergency, it is a secondary finding. The primary, direct, and modifiable risk associated with methylergonovine administration is its potential to cause acute, severe hypertension. Checking the client's baseline blood pressure (Choice B) is the specific, essential safety check before administering this vasoconstrictive medication.
Choice D rationale
The uterine tone or atony is the indication for the medication; the client is already diagnosed with uterine atony (flaccid uterus) causing the hemorrhage. The medication's purpose is to contract the uterus (increase tone). The priority before administration, however, is to assess the client for contraindications or serious adverse reaction risks. The potent vasoconstrictive effect on peripheral arteries makes blood pressure (Choice B) the most critical pre-administration safety assessment.
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