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 ["A","B","C","D","E","F"]

Explanation

A. Hypertonicity: Neonates experiencing withdrawal from heroin may exhibit increased muscle tone, leading to stiffness or rigidity. This is often observed as hypertonicity in their limbs or overall body.

B. Excessive sneezing: Nasal congestion and sneezing are common symptoms in neonates undergoing withdrawal. These symptoms can occur due to the irritant effects of withdrawal on the respiratory system.

C. Low whimpering cry: Infants with neonatal abstinence syndrome (NAS) may have a weak or high-pitched cry, which may sound like whimpering. This cry can be indicative of the discomfort and distress they are experiencing.

D. Overly vigorous sucking: Neonates with NAS may display exaggerated sucking behaviors, often characterized by frantic or overly vigorous sucking during feeding or when provided with a pacifier. This behavior is a manifestation of their heightened agitation and irritability.

E. Lethargy: Some neonates experiencing NAS may appear excessively drowsy, fatigued, or have decreased responsiveness. Lethargy is a common symptom associated with withdrawal from heroin or other opioids.

F. Tremors: Tremors or shaking movements, especially when the neonate is disturbed or agitated, are hallmark signs of NAS. These tremors can be mild to severe and may affect various parts of the body, such as the arms, legs, or jaw.

A. "Your membranes may rupture earlier than normal." B. "It will not have any effect on your pregnancy." C. "Your newborn can be infected during birth." D. "Your newborn may have eye infections from this infection." E. "Your newborn is protected from this infection."

Correct Answer is ["C","D"]

Explanation

A. "Your membranes may rupture earlier than normal." - This statement is not directly associated with chlamydia infection during pregnancy. Premature rupture of membranes (PROM) can occur due to various factors, but chlamydia infection is not a direct cause.

B. "It will not have any effect on your pregnancy." - This statement is incorrect. Chlamydia infection during pregnancy can have implications for both the mother and the baby, so it is not accurate to say it will not have any effect.

C. "Your newborn can be infected during birth." - This is an accurate statement. Chlamydia can be transmitted from the mother to the newborn during vaginal childbirth, leading to neonatal chlamydial infection.

D. "Your newborn may have eye infections from this infection." - This is also correct. Neonatal chlamydial infection can cause conjunctivitis (eye infection) in newborns if they are exposed to the bacteria during delivery.

E. "Your newborn is protected from this infection." - This statement is incorrect. Newborns are not inherently protected from chlamydial infection if the mother is infected. Without appropriate treatment and preventive measures, the newborn can contract the infection during birth.

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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?

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