A nurse is planning care for a pre-term newborn who has a diagnosis of intraventricular hemorrhage (IVH).

Which of the following interventions should the nurse include in the plan?

Monitor vital signs and neurological status frequently

Administer antibiotics as prescribed

Elevate the head of the bed to 30 degrees

Provide supplemental oxygen as needed

Answer and Explanation

The Correct Answer is A

Monitor vital signs and neurological status frequently.

This is because intraventricular hemorrhage (IVH) is a common and serious complication of prematurity that can lead to hydrocephalus, cerebral palsy, and developmental delays. Monitoring vital signs and neurological status can help detect changes in intracranial pressure, bleeding, and infection.

Choice B is wrong because antibiotics are not indicated for IVH unless there is evidence of infection.

Choice C is wrong because elevating the head of the bed to 30 degrees can increase the risk of IVH by reducing cerebral perfusion pressure and causing venous congestion.

Choice D is wrong because supplemental oxygen is not recommended for IVH unless there is hypoxia or respiratory distress. Excessive oxygen can cause oxidative stress and vasoconstriction, which can worsen IVH.

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Correct Answer is B

Explanation

Indomethacin is a nonsteroidal anti-inflammatory drug (NSAID) that can cause renal impairment and elevated serum creatinine levels in both the mother and the fetus.This can lead to oligohydramnios, reduced fetal urine output, and fetal renal failure.

Therefore, the nurse should monitor the serum creatinine levels of the client and the fetus as a potential complication of indomethacin.

Choice A is wrong because indomethacin does not affect the platelet count.It may increase the risk of bleeding due to its antiplatelet effect, but it does not cause thrombocytopenia.

Choice C is wrong because indomethacin does not cause anemia or decrease the hematocrit.It may cause gastrointestinal bleeding or ulceration, which could lead to anemia, but this is not a common or direct effect of the medication.

Choice D is wrong because indomethacin does not cause hyperkalemia or increase the serum potassium levels.It may cause hyponatremia due to its effect on renal sodium excretion, but it does not affect potassium balance.

A. Avoid sexual intercourse until term B. Drink at least 3 L of fluids per day C. Report any increase in vaginal discharge to the provider D. Perform pelvic floor exercises daily

Correct Answer is C

Explanation

Report any increase in vaginal discharge to the provider.This is because an increase in vaginal discharge can indicate an infection, which can trigger preterm labor or cause complications for the mother and the baby.

Choice A is wrong because sexual intercourse is not contraindicated for women who have preterm labor that was successfully stopped with tocolytic therapy, unless they have other risk factors such as placenta previa or ruptured membranes.

Choice B is wrong because drinking at least 3 L of fluids per day is not necessary for women who have preterm labor that was successfully stopped with tocolytic therapy, unless they have dehydration or oligohydramnios.

Choice D is wrong because pelvic floor exercises are not recommended for women who have preterm labor that was successfully stopped with tocolytic therapy, as they can increase uterine activity and cause contractions.

Tocolytic therapy is the use of drugs to delay delivery for a short time (up to 48 hours) if a woman begins labor too early in her pregnancy.

The purpose of tocolytic therapy is to allow time for the administration of corticosteroids or other medicine.

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A nurse is planning care for a pre-term newborn who has a diagnosis of intraventricular hemorrhage (IVH). Which of the following interventions should the nurse include in the plan?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing the laboratory results of a client who is in pre-term labor and has received indomethacin. Which of the following findings should the nurse monitor for as a potential complication of the medication?

Correct Answer is B

Explanation

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Correct Answer is C

Explanation

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A nurse is planning care for a pre-term newborn who has a diagnosis of intraventricular hemorrhage (IVH).

Which of the following interventions should the nurse include in the plan?