To assist with an induction of labor which of these medications can be used? Select all that apply

Pitocin

Methergine

Misoprostol

Magnesium Sulfate

Betamethasone

Answer and Explanation

Correct Answer : A,C

A. Pitocin. Pitocin (oxytocin) is the primary medication used for labor induction. It stimulates uterine contractions to initiate or augment labor. It is given intravenously (IV) and carefully titrated to avoid complications like uterine tachysystole and fetal distress.

B. Methergine. Methergine (methylergonovine) is not used for labor induction. It is a uterotonic medication used postpartum to prevent or treat postpartum hemorrhage by causing sustained uterine contractions. It is contraindicated in pregnancy due to the risk of excessive uterine contractions and hypertension.

C. Misoprostol. Misoprostol (Cytotec) is a prostaglandin used for cervical ripening and labor induction. It is administered vaginally or orally to soften the cervix and stimulate contractions before starting Pitocin. It is commonly used in women with an unfavorable cervix.

D. Magnesium Sulfate. Magnesium sulfate is not used for labor induction. It is primarily used for seizure prevention in preeclampsia/eclampsia and to stop preterm labor (tocolysis). It actually relaxes the uterus, which is the opposite of what is needed for induction.

E. Betamethasone. Betamethasone is a corticosteroid used to accelerate fetal lung maturity in preterm labor (before 34 weeks). It has no role in labor induction.

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Correct Answer is A

Explanation

A. The patient's blood pressure dropped from 160/120 to 130/90. Hydralazine is an antihypertensive medication used to lower blood pressure in conditions such as eclampsia. A reduction in blood pressure indicates that the medication is achieving its intended effect of controlling hypertension, reducing the risk of complications like stroke or organ damage.

B. The patient states that her headache is gone. While headaches are a symptom of severe hypertension, their resolution does not directly confirm the effectiveness of hydralazine. Other factors, such as pain relief or improved postpartum recovery, could contribute to headache relief.

C. The patient's postoperative weight has dropped from 155 to 144 pounds. Postpartum weight loss is expected due to fluid shifts and loss of pregnancy-related fluids, but it is not a direct measure of hydralazine’s effectiveness. The medication does not act as a diuretic or weight-loss agent.

D. The patient has had no seizures since delivery. While hydralazine helps lower blood pressure, preventing seizures in eclamptic patients is primarily managed with magnesium sulfate, not hydralazine. The absence of seizures is important but does not indicate the specific effectiveness of this antihypertensive medication.

A. Induction of labor with intravenous oxytocin. B. An emergency cesarean section C. In-hospital fetal monitoring for 48 hours D. Discharge home on strict bed rest

Correct Answer is B

Explanation

A. Induction of labor with intravenous oxytocin. Induction is contraindicated in cases of abruptio placentae with a Category III fetal heart rate tracing, as labor induction can worsen fetal distress and maternal bleeding. An immediate cesarean section is the safest intervention to prevent fetal and maternal complications.

B. An emergency cesarean section. A Category III fetal heart rate tracing with minimal variability and a prolonged deceleration indicates severe fetal distress, requiring immediate delivery. Partial abruptio placentae can cause fetal hypoxia, maternal hemorrhage, and potential fetal demise. The priority is an emergency cesarean section to ensure the best outcome for both mother and baby.

C. In-hospital fetal monitoring for 48 hours. Continuous monitoring is essential in cases of mild abruptio placentae without fetal distress, but in this case, a Category III tracing indicates an immediate threat to the fetus, making waiting inappropriate.

D. Discharge home on strict bed rest. Abruptio placentae is a serious obstetric emergency, and home management is never appropriate when fetal distress is present. Immediate intervention is necessary to prevent fetal and maternal complications.

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To assist with an induction of labor which of these medications can be used? Select all that apply

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient is 3 days post c-section delivery for eclampsia. The client is receiving hydralazine (Apresoline). Which of the following would indicate that the medication is effective?

Correct Answer is A

Explanation

A client at 35 weeks' gestation is admitted with a partial abruptio placenta and a Category III fetal heart rate tracing with minimal variability and a prolonged deceleration. The nurse anticipates a plan of care for this client that includes most importantly:

Correct Answer is B

Explanation

When working with a woman who has just experienced a fetal demise you should offer supportive care, give her the opportunity to grieve, and provide for a chaplain to come in if the patient wants one. You know that the Chaplain is non-denominational and can also provide comforting words.

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