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A nurse is assisting with the care of a client who is scheduled to receive a dose of dinoprostone.

Exhibits

For which of the following findings should the nurse anticipate a provider's prescription to withhold the dinoprostone?

A.

Terbutaline

B.

FHR

C.

WBC count

D.

Lesions noted

E.

Breech presentation

Answer and Explanation

The Correct Answer is D

A. Terbutaline is typically used to manage preterm labor, not a contraindication for dinoprostone, which is used for labor induction.
B. FHR (Fetal Heart Rate) of 140/min with moderate variability is within normal limits and would not be a reason to withhold dinoprostone.
C. WBC count is within normal limits, indicating no infection, thus not a contraindication for dinoprostone.
D. Lesions noted on vaginal introitus and labia majora could indicate an active Herpes simplex virus infection, which is a contraindication for vaginal delivery due to the risk of neonatal infection.
E. Breech presentation is a concern for delivery method but does not contraindicate the use of dinoprostone for labor induction.
 


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Related Questions

Correct Answer is []

Explanation

- Potential Condition: Endometritis. The symptoms of malaise, chills, decreased appetite, elevated temperature, tachycardia, a boggy and tender uterus, and foul-smelling lochia are indicative of a postpartum infection, such as endometritis.

- Actions to Take:

- Monitor the lochia amount and odor: This will help assess the presence of infection and the effectiveness of treatment.

- Assist with the administration of prescribed antibiotics: Antibiotics are the primary treatment for endometritis.

- Parameters to Monitor:

- Temperature: Monitoring for fever can help assess the response to treatment and indicate if the infection is resolving or worsening.

- Heart rate: Tachycardia may be a sign of infection or other complications, so it's important to monitor changes in heart rate.

Correct Answer is []

Explanation

- Potential Condition: Hyperemesis Gravidarum

Actions to take

  1. Insert a peripheral venous access device:
  2. Monitor and manage electrolyte values:

Parameters to monitor

  1. Electrolyte values:
  2. Urine ketones:

Rationale

- Potential Condition: Hyperemesis Gravidarum

- This condition is characterized by severe nausea and vomiting, leading to dehydration and nutrient loss, which can affect both the mother and fetus.

- Actions to Take:

1. Insert a peripheral venous access device:

- This will allow for the administration of IV fluids and medications to treat dehydration and correct electrolyte imbalances.

2. Monitor and manage electrolyte values:

- Given the client's low potassium levels, it's crucial to monitor and manage electrolytes to prevent complications.

- Parameters to Monitor:

1. Electrolyte values:

- Monitoring electrolyte levels is essential to ensure they are within normal ranges and to adjust IV fluid composition as needed.

2. Urine ketones:

- Positive urine ketones indicate that the body is using fat for energy due to inadequate glucose utilization, which is common in Hyperemesis Gravidarum. Monitoring will help assess the effectiveness of treatment and nutritional status.

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