Which of the following practices reflect safe administration of oxytocin (Pitocin)?
Attach IV line to distal port
Customize concentration
Two RN verification
Titrate to gravity
The Correct Answer is C
Choice A rationale:
Attaching the IV line to the distal port is not a safe practice for oxytocin administration. This is because oxytocin is a high-alert medication that can have serious adverse effects if administered incorrectly. Attaching the IV line to the distal port increases the risk of the medication being infused too quickly, which can lead to uterine hyperstimulation, fetal distress, or even uterine rupture. The safest practice is to attach the IV line to the proximal port, which is closer to the patient's body and allows for slower infusion rates.
Choice B rationale:
Customizing the concentration of oxytocin is not a recommended practice. Oxytocin is available in a premixed solution of 10 units/mL, and this concentration should not be altered. Altering the concentration can lead to dosing errors and increase the risk of adverse effects.
Choice D rationale:
Titrating oxytocin to gravity is not a safe practice. Oxytocin should be administered using an infusion pump that can accurately control the infusion rate. Infusion pumps are necessary to ensure that the medication is administered at the correct dose and rate. Gravity-based infusions are less accurate and can lead to over- or under-infusion of the medication.
Choice C rationale:
Two RN verification is a safe practice for oxytocin administration. This practice involves having two registered nurses independently verify the medication, dose, and infusion rate before administration. This helps to prevent errors and ensure that the medication is administered safely.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale:
Incorrect. The quad screen test does not examine fetal DNA to determine gender. That is the role of other tests, such as amniocentesis or chorionic villus sampling (CVS).
Gender determination is not a primary objective of the quad screen test.
Focusing on gender unnecessarily narrows the scope of the test's potential findings.
Choice B rationale:
Incorrect. The quad screen test does not use fetal tissue. It is a non-invasive blood test that measures levels of four substances in the mother's blood: alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), unconjugated estriol (uE3), and inhibin A.
Fetal tissue sampling is more invasive and carries risks, while the quad screen is a safer alternative.
Clarifying the non-invasive nature of the test is crucial for informed consent and patient understanding.
Choice C rationale:
Incorrect. While AFP levels can be affected by maternal liver function, that is not the primary focus of the quad screen test.
Liver function tests are specifically designed to assess liver health, and they are not part of the quad screen panel.
Distinguishing between liver function assessment and AFP's role in screening for fetal anomalies is essential for accurate interpretation.
Choice D rationale:
Correct. The quad screen test measures levels of AFP, hCG, uE3, and inhibin A in the mother's blood. These substances can provide information about the risk of certain fetal chromosomal abnormalities and neural tube defects.
Elevated AFP levels can indicate an increased risk for neural tube defects such as spina bifida or anencephaly.
Low AFP levels can be associated with Down syndrome or other chromosomal abnormalities.
Understanding the specific disorders that can be indicated by AFP levels is crucial for patient counseling and further testing decisions.
Correct Answer is A
Explanation
Choice A rationale:
Trisomy 21, also known as Down syndrome, is a genetic condition caused by the presence of an extra copy of chromosome 21.
The nuchal translucency test (NT) is a non-invasive ultrasound screening test that measures the thickness of the fluid-filled space at the back of a developing baby's neck.
Evidence suggests that fetuses with Down syndrome tend to have increased fluid accumulation in this area, resulting in a larger-than-average nuchal translucency measurement.
Therefore, an increased NT measurement can be a marker for an increased risk of Down syndrome.
It's important to emphasize that the NT test is a screening tool, not a diagnostic test.
This means it can only indicate an increased risk of Down syndrome; it cannot definitively diagnose the condition.
To confirm a diagnosis, further testing, such as chorionic villus sampling (CVS) or amniocentesis, is required.
Choice B rationale:
Neural tube defects (NTDs) are birth defects that affect the brain, spine, or spinal cord.
The most common NTDs are spina bifida and anencephaly.
The NT test is not a diagnostic test for NTDs, although it might detect some cases of open spina bifida.
However, it's not specifically designed for this purpose, and other tests, such as alpha-fetoprotein (AFP) screening or detailed ultrasound, are more reliable for diagnosing NTDs.
Choice C rationale:
The NT test is typically performed in the first trimester of pregnancy, between 11 and 14 weeks gestation.
It's not available in the second trimester because the nuchal translucency measurement becomes less reliable after this point in pregnancy.
Choice D rationale:
A nuchal translucency measurement of 3mm or less is generally considered normal.
Measurements greater than 3mm are associated with an increased risk of Down syndrome and other chromosomal abnormalities.
The higher the measurement, the greater the risk.
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