Chapter 64: Drugs That Affect Uterine Function

Chapter 64: Drugs That Affect Uterine Function

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A patient is admitted to the obstetric unit in preterm labor at 36 weeks’ gestation. The prescriber orders a tocolytic agent. When teaching the patient about this medication, the nurse will tell her that tocolytics:

a.	are given until term to reduce fetal mortality.
b.	are used to help the fetal lungs mature.
c.	help delay delivery while glucocorticoids are given.
d.	help treat the infections that cause preterm labor.

 

 

ANS:  C

Tocolytic agents are used to postpone premature labor and, on average, for only 48 hours. During this time, glucocorticoids are given to help the fetal lungs mature. Tocolytic agents do not suppress labor long term. They do not directly help the fetal lungs to mature; they help by allowing time for glucocorticoids to be given. They do not treat infection.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 777-778

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

2. A patient is in preterm labor, and the prescriber orders magnesium sulfate for its neuroprotective effect on the fetus. The order calls for 4 gm given as an intravenous bolus over 20 minutes, followed by a maintenance infusion of 2 gm/hr. What will the nurse do?

a.	Administer the drug as ordered.
b.	Question the bolus amount.
c.	Question the bolus rate.
d.	Question the maintenance amount.

 

 

ANS:  D

For fetal neuroprotective uses, magnesium sulfate should be given using a low-dose protocol, which is a 4-gm IV loading bolus over 20 minutes, followed by a maintenance infusion of 1 gm/hr. A high-dose protocol would have a maintenance infusion of 2 to 3 gm/hr. The nurse should question the maintenance amount. The bolus amount and rate are correct.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 780

TOP:   Nursing Process: Planning

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential

 

3. A patient who is having her sixth child has gone beyond term, and her labor is being induced with oxytocin [Pitocin]. The patient is having increased frequency, duration, and intensity of contractions. The nurse will interrupt the oxytocin infusion if what occurs?

a.	Contractions occur every 2 to 3 minutes.
b.	Individual contractions last 2 minutes.
c.	Mild to moderate pain occurs with uterine contractions.
d.	Resting intrauterine pressure is greater than 10 to 15 mm Hg.

 

 

ANS:  B

Induction of labor in patients of high parity (five or more pregnancies) carries a high risk of uterine rupture, and oxytocin should be used with great caution. Oxytocin infusions should be interrupted for contractions that last longer than 1 minute. Contractions that occur more often than every 2 to 3 minutes are a concern. Mild to moderate pain is normal with contractions. A resting intrauterine pressure greater than 15 to 20 mm Hg is a concern.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 783

TOP:   Nursing Process: Evaluation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential

 

4. A patient who has experienced preterm births with her previous two pregnancies will begin receiving hydroxyprogesterone caproate [Makena] to prevent preterm delivery with her current pregnancy. Which statement by the patient indicates a need for further teaching about this drug?

a.	“I should report any calf pain immediately.”
b.	“I will eventually learn to administer the injections of this drug myself.”
c.	“This drug may cause fluid retention and glucose intolerance.”
d.	“This medication must be given once a week until 37 weeks’ gestation.”

 

 

ANS:  B

Hydroxyprogesterone caproate is given IM and must be given by a healthcare provider and not by the patient. Although serious side effects are rare, thrombosis and thromboembolism may occur, so the patient should report signs of thrombosis immediately. Fluid retention and glucose intolerance may occur. The medication is given weekly from 16 to 21 weeks’ gestation up to 37 weeks or delivery of the baby.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 780-781

TOP:   Nursing Process: Planning

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies