A woman with a history of asthma comes to the clinic for evaluation for pregnancy. The woman's pregnancy test is positive. When reviewing the woman's medication therapy regimen for asthma, which medication would the nurse identify as problematic for the woman now that she is pregnant?

ipratropium

albuterol

salmeterol

Prednisone

Answer and Explanation

The Correct Answer is C

A. Ipratropium:

Ipratropium is an anticholinergic bronchodilator used to relieve bronchospasm associated with asthma and chronic obstructive pulmonary disease (COPD). It works by relaxing the muscles around the airways to improve breathing. In pregnant women with asthma, ipratropium is generally considered safe for use when the benefits of controlling asthma symptoms outweigh the potential risks to the fetus. It is minimally absorbed systemically, reducing the risk of systemic side effects for both the mother and the fetus.

B. Albuterol:

Albuterol is a short-acting beta agonist (SABA) commonly used as a rescue inhaler for acute asthma symptoms. It works by relaxing the muscles in the airways, making it easier to breathe. Albuterol is considered safe for use during pregnancy, and it is often recommended as needed to relieve bronchospasm in pregnant women with asthma. Controlling asthma symptoms with albuterol can help improve maternal oxygenation and prevent complications associated with poorly controlled asthma during pregnancy.

C. Salmeterol:

Salmeterol is a long-acting beta agonist (LABA) used for the long-term control of asthma symptoms. It works similarly to albuterol but has a longer duration of action. Salmeterol is generally not recommended as the sole therapy for asthma during pregnancy due to limited safety data. While animal studies have shown adverse effects on fetal development, there are no adequate and well-controlled studies in pregnant women. Therefore, the risks versus benefits of using salmeterol during pregnancy should be carefully considered, and alternative treatments may be preferred.

D. Prednisone:

Prednisone is a corticosteroid medication used to reduce inflammation and suppress immune responses in conditions such as asthma. It is often prescribed to manage asthma exacerbations during pregnancy. While corticosteroids are generally considered safe for short-term use during pregnancy to control asthma symptoms, they may have risks associated with long-term or high-dose use, especially if used during the first trimester. Potential risks include fetal growth restriction and cleft palate. However, the benefits of controlling asthma symptoms and preventing exacerbations often outweigh the potential risks of corticosteroid use during pregnancy. Therefore, prednisone may be prescribed judiciously during pregnancy, and the dose should be tailored to the individual's needs while considering potential risks to the fetus.

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Correct Answer is C

Explanation

A. Disseminated intravascular coagulation (DIC):

DIC is a serious condition characterized by abnormal clotting throughout the body's blood vessels, leading to both bleeding and clotting simultaneously. While it can occur in severe cases of HELLP syndrome, it is not a specific finding used to diagnose HELLP syndrome. Instead, it's a complication that can develop due to various underlying conditions, including HELLP syndrome.

B. Elevated platelet count:

In HELLP syndrome, platelet count is typically decreased, not elevated. HELLP syndrome stands for Hemolysis, Elevated Liver enzymes, and Low Platelets. The low platelet count is a key diagnostic feature of HELLP syndrome and contributes to the risk of bleeding complications.

C. Elevated liver enzymes:

Elevated liver enzymes, particularly elevated levels of AST (aspartate aminotransferase) and ALT (alanine aminotransferase), are hallmark features of HELLP syndrome. Liver involvement is a significant component of this syndrome, and elevated liver enzymes are part of the diagnostic criteria.

D. Hyperglycemia:

While hyperglycemia can occur in various conditions, it is not a characteristic finding of HELLP syndrome. HELLP syndrome primarily affects the liver, blood clotting factors, and platelets, leading to features such as elevated liver enzymes, low platelet count, and hemolysis (destruction of red blood cells).

A. alcohol B. heroin C. marijuana D. cocaine

Correct Answer is D

Explanation

A. Alcohol:

Alcohol consumption during pregnancy can lead to a range of adverse effects on the fetus, collectively known as fetal alcohol spectrum disorders (FASDs). However, the symptoms described in the scenario—tachycardia, hypertension, and evidence suggesting vasoconstriction—are not typical of alcohol use. While alcohol can lead to hypertension in chronic heavy drinkers, it is not commonly associated with tachycardia and vasoconstriction in the same way that stimulant drugs like cocaine are.

B. Heroin:

Heroin is an opioid drug that depresses the central nervous system, leading to effects such as respiratory depression, sedation, and decreased heart rate. While heroin use during pregnancy can have serious consequences for both the mother and the fetus, including neonatal withdrawal syndrome (neonatal abstinence syndrome), it is not typically associated with tachycardia, hypertension, and vasoconstriction. Therefore, heroin is less likely to be the substance causing the symptoms described in the scenario.

C. Marijuana:

Marijuana use during pregnancy has been associated with various adverse outcomes, including low birth weight and neurodevelopmental issues in children. However, the symptoms described—tachycardia, hypertension, and evidence suggesting vasoconstriction—are not typical of marijuana use. Marijuana is more commonly associated with effects such as relaxation, increased heart rate (tachycardia), and vasodilation (not vasoconstriction). Therefore, marijuana is less likely to be the substance causing the symptoms described in the scenario.

D. Cocaine:

Cocaine is a potent stimulant drug that acts on the central nervous system and cardiovascular system, leading to effects such as tachycardia, hypertension, and vasoconstriction. These symptoms are consistent with acute cocaine intoxication. Cocaine use during pregnancy can have serious adverse effects on both the mother and the fetus, including increased risk of miscarriage, preterm labor, placental abruption, and fetal growth restriction. Therefore, given the symptoms described in the scenario, cocaine is the substance that the nurse would question the woman about.

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A woman with a history of asthma comes to the clinic for evaluation for pregnancy. The woman's pregnancy test is positive. When reviewing the woman's medication therapy regimen for asthma, which medication would the nurse identify as problematic for the woman now that she is pregnant?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse suspects that a client is developing HELLP syndrome. The nurse notifies the health care provider based on which finding?

Correct Answer is C

Explanation

Assessment of a pregnant woman and her fetus reveals tachycardia and hypertension. There is also evidence suggesting vasoconstriction. The nurse would question the woman about use of which substance?

Correct Answer is D

Explanation

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