The nurse is caring for a client with preterm labor whose provider orders tocolytic therapy.
Which clinical findings indicate a desired outcome from tocolytic therapy?

Contractions occurring occasionally and lasting for 30 seconds every 2 minutes.

Fetal Heart Rate (FHR) 170 beats per minute (bpm) with a decrease from moderate to minimal variability.

FHR 140 bpm with minimal variability with late decelerations.

Contractions slowing with a fetal heart rate of 130 bpm and moderate variability.

Answer and Explanation

The Correct Answer is D

Choice A rationale

Contractions occurring occasionally and lasting for 30 seconds every 2 minutes still represent a persistent pattern of uterine activity. The primary goal of tocolytic therapy is to inhibit or suppress uterine contractions in preterm labor. Therefore, contractions occurring every two minutes, even if occasional and short, do not fully demonstrate the desired outcome of effectively stopping or significantly spacing out the labor process.

Choice B rationale

A Fetal Heart Rate (FHR) of 170 bpm is a concerning fetal tachycardia (normal range is 110-160 bpm). Additionally, a decrease from moderate to minimal variability indicates a reduction in the healthy push-pull of the fetal autonomic nervous system, suggesting potential fetal distress or compromise. Neither fetal tachycardia nor decreased variability is a desired outcome from tocolytic therapy, which aims to improve the fetal environment.

Choice C rationale

A FHR of 140 bpm is within the normal range, but minimal variability suggests reduced fetal reserve or a drug effect, and the presence of late decelerations is a non-reassuring sign, indicative of uteroplacental insufficiency (a drop in FHR after the peak of a contraction). These findings collectively suggest fetal compromise and are not a desired outcome after initiating a tocolytic medication intended to prolong gestation.

Choice D rationale

Contractions slowing is the direct desired therapeutic effect of tocolytic agents like magnesium sulfate or nifedipine, as it prevents preterm birth. A fetal heart rate of 130 bpm is within the normal range (110-160 bpm), and moderate variability (6 to 25 beats per minute amplitude) is the most favorable and reassuring sign of adequate fetal oxygenation and a healthy central nervous system. This combination reflects a stable maternal-fetal status. .

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Free Nursing Study Resources

Correct Answer is ["6.7"]

Explanation

Step 1 is: Calculate the total oxytocin in mU:. 20 units × (1000 mU ÷ 1 unit) = 20000 mU.

Step 2 is: Calculate the concentration of the oxytocin solution in mU/mL:. 20000 mU ÷ 500 mL = 40 mU/mL.

Step 3 is: Calculate the total mU of oxytocin infused per hour:. 10 mL/hr × 40 mU/mL = 400 mU/hr.

Step 4 is: Convert the infusion rate from mU/hr to mU/min:. 400 mU/hr ÷ 60 min/hr = 6.666. mU/min.

Step 5 is: Round to the nearest tenths place:. 6.7 mU/min.

A. Risk for infection during insertion. B. Delay of return to fertility. C. Ectopic pregnancy. D. Risk for perforation of the uterus.

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

Explanation

Choice A rationale

The insertion of any foreign object into the uterus, such as an intrauterine device (IUD), carries a risk of introducing pathogenic microorganisms, potentially leading to pelvic inflammatory disease (PID) or endometritis, particularly in the first few weeks after insertion. Strict aseptic technique is mandatory to minimize this transient risk, which stems from the passage of the device through the cervix.

Choice B rationale

One of the major benefits of IUDs is their immediate reversibility. Upon removal of the device, fertility returns quickly, often within the first menstrual cycle. This is a point of education that contrasts with hormonal methods, such as the injectable depot medroxyprogesterone acetate (DMPA), which can cause a delay in the return to fertility.

Choice C rationale

An intrauterine device prevents uterine implantation, but it does not prevent fertilization. If pregnancy occurs with an IUD in place, there is a significantly increased risk that the fertilized ovum will implant outside the uterus, most commonly in the fallopian tube, resulting in a potentially life-threatening ectopic pregnancy for the woman.

Choice D rationale

Uterine perforation is a rare but serious complication, occurring most often at the time of insertion when the sound or the IUD itself punctures the uterine wall, which can lead to intra-abdominal placement or damage to adjacent organs. Risk factors include a recently postpartum or lactating uterus, which is softer and more pliable.

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The nurse is caring for a client with preterm labor whose provider orders tocolytic therapy. Which clinical findings indicate a desired outcome from tocolytic therapy?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["6.7"]

Explanation

Which risk factors associated with an intrauterine device (IUD) use would the nurse include in the discussion of an IUD with a client based on the information in the history and physical? Select all that apply.

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

Explanation

When providing instructions to a pregnant client regarding an amniocentesis, which information would the nurse include? Select all that apply.

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The nurse is giving report to a student about a newborn they suspect has toxoplasmosis. Which statement by the student on how and when the infection was transmitted to the newborn does not require further teaching?

The fetal monitor demonstrates a pattern that reflects uteroplacental insufficiency. What is the priority action by the labor nurse?

A pregnant client is planning travel to a foreign country as part of a work assignment and needs immunizations. What would the nurse instruct the client about immunizations while pregnant?

The nurse is caring for a client with preterm labor whose provider orders tocolytic therapy.
Which clinical findings indicate a desired outcome from tocolytic therapy?