A laboring client is requesting pain medicine and the nurse performs a vaginal exam. The client is 5/90/-2. The fetal heart rate is 145 with accelerations and moderate variability, uterine contractions are occurring q 3-4 minutes. The nurse received an order to administer Stadol 2mg IV push. Which nursing action describes safe administration of this medication?
Administer in the IV port farthest from the IV insertion site
Restart IV hydration rapidly after medication administration
Administering the medication during contractions
Administer IV push rapidly
The Correct Answer is A
A. Stadol (butorphanol) is an opioid agonist-antagonist that can cause respiratory depression in both mother and fetus if administered too rapidly or at the wrong time. Administering through the port farthest from the IV insertion site allows the medication to dilute in the bloodstream before reaching systemic circulation, reducing the risk of adverse effects.
B. Rapid IV fluid administration is not necessary and may cause fluid overload or exacerbate maternal hypotension. Standard IV maintenance rates are sufficient unless otherwise indicated.
C. Opioids should be administered between contractions, not during them, because giving the medication during a contraction can peak in the maternal bloodstream too quickly, increasing fetal exposure and risk of neonatal respiratory depression.
D. Stadol should be administered slowly over 3–5 minutes to prevent maternal adverse effects, including hypotension, respiratory depression, dizziness, and nausea. Rapid administration increases risk to both mother and fetus.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Abnormal uterine bleeding (AUB) refers to bleeding from the uterus that is irregular in volume, duration, or timing and is not related to normal menstruation. This definition makes “mostly irregular uterine bleeding” the most accurate description.
B. AUB originates from the uterus, not the ovaries. While ovarian dysfunction can contribute to AUB, the bleeding itself is classified based on uterine patterns, not ovarian activity.
C. AUB is irregular and does not follow the typical monthly menstrual cycle. It may occur unpredictably or with excessive or prolonged bleeding.
D. Steroids are not the primary treatment for AUB. Medical management usually includes hormonal therapies such as combined oral contraceptives, progestins, or tranexamic acid depending on the underlying cause.
Correct Answer is D
Explanation
A. Fetal hypoxia is typically indicated by abnormal FHR patterns, such as late decelerations, decreased or absent variability, bradycardia, or prolonged decelerations. In this scenario, the FHR shows a normal baseline, moderate variability, and accelerations, all of which suggest adequate oxygenation and fetal well-being.
B. Tachycardia is defined as a baseline FHR greater than 160 beats per minute. Causes of fetal tachycardia can include maternal fever, infection, medications, or fetal hypoxia, but this fetus has a baseline of 135 bpm, which is within the normal range of 110–160 bpm, so tachycardia is not present.
C. Bradycardia is defined as a baseline FHR less than 110 beats per minute. Causes of bradycardia can include prolonged cord compression, maternal hypotension, or congenital heart conditions, but this fetus has a baseline of 135 bpm, ruling out bradycardia.
D. This fetus exhibits a reassuring FHR pattern characterized by a normal baseline indicating adequate cardiac function, moderate variability reflecting an intact autonomic nervous system and good oxygenation, presence of accelerations demonstrating a responsive, well-oxygenated fetus, and absence of decelerations, indicating there is no evidence of uteroplacental compromise or cord compression.
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