Question 1

The nurse is caring for a patient after the third stage of labor,and the provider orders 20 mg of oxytocin to be given intramuscularly.The nurse will explain to the patient that this drug for which purpose?

Accepted Answer

After delivery of the infant,oxytocin is given to help the uterus stay contracted and prevent uterine atony.It may be given intravenously or intramuscularly.It does not constrict the cervix.Intranasal oxytocin may be given later to enhance letdown of breast milk.Oxytocin does not suppress lactation.

Question 2

The nurse is caring for an infant who is 2 days postpartum and notes that the infant has a poor sucking response.The nurse reviews the delivery record and will likely note that which drug was given to the mother during labor?

Accepted Answer

Sedative-hypnotic drugs,such as secobarbital,can cause neonatal respiratory depression,hypotonia,and a poor sucking response up to 4 days.Butorphanol tartrate,fentanyl,and nalbuphine do not have prolonged effects.

Question 3

The nurse is caring for a woman who is in active labor and wants to receive a drug for severe pain immediately.Her intravenous line has just infiltrated.The nurse will perform which action?

Accepted Answer

Meperidine may be given IM and is the most commonly used opioid during labor. Fentanyl is best given intravenously.Promethazine is given in combination with opioids during active labor to potentiate the analgesic action of the opioids and minimize emesis.Hydroxyzine is given for nausea.

Question 4

The nurse prepares to assist with beractant (Survanta)administration to an infant who is intubated and mechanically ventilated.After removing the drug from the refrigerator,the nurse will perform which action?

Accepted Answer

Beractant (Survanta)should be given at room temperature and should be out of the refrigerator for 20 minutes to warm up or warmed in the nurse's hand for 8 minutes.The drug should not be artificially warmed.The drug should not be shaken.The nurse may give off-white to light-brown product.

Question 5

The nurse is caring for a multipara woman during labor who has requested an epidural block.The nurse will tell the patient that the epidural block will be given when her cervix is dilated

Accepted Answer

In a multipara woman,an epidural block is given when the cervix is dilated 3 to 4 cm.In a primipara woman,the block is given at 5 to 6 cm.

Question 6

The nurse administers meperidine (Demerol)to a woman who is in early labor.Immediately after the drug is given,the woman's labor progresses quickly,and she delivers her infant.The nurse will monitor the infant closely for which condition?

Accepted Answer

Narcotic analgesics cause respiratory depression in the infant if given shortly before delivery.The nurse should monitor the infant closely and prepare to give naloxone (Narcan)if this occurs.Opioid withdrawal occurs with prolonged exposure to opioids. Orthostatic hypotension and tachycardia are not common effects.

Question 7

The nurse is caring for a woman who is in early labor.The woman wants to avoid pain medications as long as possible.What will the nurse tell her?

Accepted Answer

Breathing and relaxation techniques are often used as nonpharmacologic measures to control pain during labor.Sedatives are often used to decrease maternal anxiety during false labor,latent labor,or with ruptured membranes without true labor.Fentanyl is generally not given until active labor.Ibuprofen can cause premature closure of the ductus arteriosis.

Question 8

The nurse is caring for a woman who is in labor.The woman is anxious and reports increasing nausea after receiving an opioid analgesic medication.The nurse will contact the provider and request an order for which intravenous medication?

Accepted Answer

Phenergan is used as an adjunct to narcotic analgesics to potentiate pain relief,control anxiety,and reduce nausea.Hydroxyzine may have similar effects but is not given intravenously.Pentobarbital and secobarbital are used for anxiety only.

Question 9

The nurse examines a primipara woman who has received an epidural block.The woman's cervix has been dilated at 5 cm for an hour after having shown steady progression earlier.The nurse will notify the provider and anticipate a need for

Accepted Answer

Regional anesthetics may slow labor,and therefore the patient may need to be administered a drug to enhance uterine contractions.Intravenous oxytocin is given to stimulate contractions.If oxytocin is not effective,the other measures may be necessary.

Question 10

The nurse is preparing a woman who is in labor for a lumbar epidural and explains that she will receive a continuous infusion of epidural anesthesia.She asks what will happen if that isn't effective.What response by the nurse is correct?

Accepted Answer

Continuous epidural anesthesia provides a consistent drug level and more effective pain relief than with intermittent epidural anesthesia.Patients may have rescue doses as needed.Postdural headache occurs with accidental puncture of the dura with epidural anesthesia.

Question 11

The nurse is assisting with placement of epidural anesthesia for a woman who is in labor.To help prevent maternal hypotension,which is the nurse's initial action?

Accepted Answer

To decrease maternal hypotension before epidural placement,an IV bolus of 500 to 1000 mL of crystalloid solution is given.When hypotension develops,the woman should be turned to her left side and administered a rapid bolus of crystalloid solution.Phenylephrine is given if hypotension does not improve.Blood pressure should be monitored throughout the procedure.

Quiz 54: Female Reproductive Cycle II: Labor, Delivery, and Preterm Neonatal Drugs