A nurse is assisting with the care of a 30-year-old female client who is scheduled to receive a dose of dinoprostone in the maternal newborn unit.

Exhibits

For which of the following findings should the nurse anticipate a provider's prescription to withhold the dinoprostone? Select all that apply.

Breech presentation

Terbutaline administration

FHR (Fetal Heart Rate)

WBC count

Lesions noted

Answer and Explanation

Correct Answer : A,C,E

Choice A rationale:

Breech presentation is a contraindication for dinoprostone as it increases the risk of complications during labor and delivery. Using dinoprostone to induce labor in a non-vertex presentation can lead to issues such as cord prolapse or obstructed labor, which necessitate a cesarean section for safe delivery.

Choice B rationale:

Terbutaline administration is used to manage preterm labor by relaxing the uterus. While it is relevant in labor management, it does not directly contraindicate the use of dinoprostone. Terbutaline and dinoprostone can be used in conjunction if properly managed.

Choice C rationale:

Fetal heart rate (FHR) monitoring showing abnormalities is a potential reason to withhold dinoprostone. Dinoprostone can increase uterine contractions, potentially stressing the fetus. A stable FHR with moderate variability indicates fetal well-being; however, if there were concerns, the provider might withhold dinoprostone.

Choice D rationale:

A WBC count of 9,500/mm³ is within the normal range and does not indicate an infection or condition that would contraindicate dinoprostone use. Elevated WBC count could raise concerns, but in this case, it is normal and not a contraindication.

Choice E rationale:

Lesions noted on the vaginal introitus and labia majora, likely caused by Herpes simplex virus, are a contraindication for dinoprostone. Active genital herpes lesions increase the risk of neonatal herpes transmission, making vaginal delivery risky. In such cases, cesarean delivery is often preferred to prevent transmission.

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Correct Answer is B

Explanation

Choice A rationale

Elevating the client's legs is incorrect as an initial intervention. It is more important to address the potential cause of the late decelerations first.

Choice B rationale

Turning the client onto their side is correct. This intervention can improve blood flow to the fetus and reduce the pressure on the vena cava, potentially alleviating late decelerations.

Choice C rationale

Palpating the client's uterus is not the first action. It is essential to address maternal positioning and oxygenation issues first.

Choice D rationale

Increasing the client's IV fluid infusion rate may help, but it is not the initial action. Positioning changes can have an immediate effect on fetal oxygenation.

A. Insert the suppository 5 cm. B. Apply petroleum jelly to the suppository. C. Assist the client into a prone position. D. Insert the suppository along the posterior vaginal wall.

Correct Answer is D

Explanation

Choice A rationale

Inserting the suppository 5 cm is generally insufficient for proper placement. The suppository needs to be placed further along the vaginal canal to be effective.

Choice B rationale

Applying petroleum jelly to the suppository is not recommended because it can interfere with the absorption and effectiveness of the medication.

Choice C rationale

Assisting the client into a prone position is not appropriate for inserting a vaginal suppository. The client should be in a lithotomy or supine position with legs bent.

Choice D rationale

Inserting the suppository along the posterior vaginal wall ensures proper placement and maximizes the effectiveness of the medication by allowing it to dissolve and be absorbed where it is needed.

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A nurse is assisting with the care of a 30-year-old female client who is scheduled to receive a dose of dinoprostone in the maternal newborn unit. Exhibits For which of the following findings should the nurse anticipate a provider's prescription to withhold the dinoprostone? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is D

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