Question 1

Which are physiologic changes during pregnancy that affect drug absorption,metabolism,distribution,and excretion?

Accepted Answer

Steroid hormones,decreased GI motility,and increased blood volume all affect maternal drug effectiveness.Renal perfusion is increased during pregnancy.Poor sleep does not alter drug effectiveness.Rapid respiratory rate does not necessarily occur.

Question 2

A woman who is experiencing preeclampsia asks what changes she has to make to her routine to minimize the risk of worsening her condition.The nurse will explain that she should

Accepted Answer

Nonpharmacologic treatments for preeclampsia include activity reduction,lying on left side,drinking six to eight 8-ounce glasses of water a day.There is no need for hospitalization if the condition can be controlled.

Question 3

A pregnant woman who has morning sickness asks the nurse what she can do to decrease her symptoms.The nurse will counsel her to take which action?

Accepted Answer

Avoiding fatty foods is a nonpharmacologic measure to reduce nausea and vomiting.Patients should drink fluids between and not with meals.Taking iron in the morning is not recommended.The pregnant woman should eat small,frequent meals.

Question 4

A pregnant woman reports having constipation and has tried dietary changes without success.What will the nurse recommend?

Accepted Answer

Bulk-forming laxatives,like psyllium,should be tried first because they are not systemically absorbed.Bisacodyl and senna have systemic effects.Mineral oil can reduce the absorption of fat-soluble vitamins.

Question 5

A woman who is experiencing premature labor is being given betamethasone (Celestone).She asks the nurse why this drug is being given.The nurse will explain that betamethasone is given for which reason?

Accepted Answer

The medication is given to accelerate lung maturation and lung surfactant development in the fetus in utero.It does not lower maternal blood pressure,stop maternal contractions,or prevent closure of the fetal ductus arteriosus.

Question 6

The nurse is caring for a woman who is experiencing premature labor.The provider has ordered intravenous terbutaline (Brethine)to be given.The nurse will explain that this medication will have which action?

Accepted Answer

Terbutaline is given to relax the smooth muscle of the uterus and decrease contractions in order to stop premature labor.It does not affect fetal lung development or fetal blood supply and does not lower maternal blood pressure.

Question 7

The nurse is caring for a patient who is 6-7 weeks pregnant and has moderate to severe vomiting.The provider has ordered doxylamine (Unisom)and intravenous fluids.The patient reports a history of asthma and type 2 diabetes mellitus.The nurse will hold the drug and contact the provider because doxylamine should not be given to patients who

Accepted Answer

Doxylamine is used for nausea and vomiting during pregnancy.It should not be given to patients who have asthma.It may be given to pregnant women in their first trimester.Diabetes is not a contraindication.

Question 8

The nurse is teaching a woman who is pregnant about iron supplementation.Which statement by the woman indicates understanding of the teaching?

Accepted Answer

Orange juice helps to improve absorption.Antacids and milk interfere with absorption.Black,tarry stools are an expected side effect and do not warrant stopping the supplement.

Question 9

A patient who has just delivered her baby asks the nurse if she needs to continue taking her iron supplement.What instruction will the nurse provide to the patient?

Accepted Answer

Women should continue taking an iron supplement for 6 weeks after delivery.It is not necessary to take iron for the duration of nursing.

Question 10

The nurse is caring for a woman who is in labor and has a blood pressure of 180/98 mm Hg with proteinuria of 400 mg/24 h.The woman is receiving magnesium sulfate.The woman becomes lethargic with slurring of her speech and decreased muscle tone.Her serum magnesium sulfate level is 11 mEq/L.The nurse recognizes which condition in this patient?

Accepted Answer

Patients receiving magnesium sulfate can develop toxicity,evidenced by lethargy,slurred speech,and decreased muscle tone.A level greater than 10 mEq/L indicates toxicity.An elevated blood pressure and proteinuria are expected findings in a patient with pre-eclampsia.Patients with eclampsia will have marked elevation of blood pressure and seizures.

Question 11

A woman who is 4 weeks pregnant is worried that a medication she took until 3 weeks ago may cause birth defects.The nurse will tell her that

Accepted Answer

During the first 2 weeks,the embryo is not susceptible to teratogenesis.There is no need for an ultrasound.

Question 12

A pregnant woman asks the nurse about whether a medication is safe to take during pregnancy.The nurse notes that the drug has a low-molecular weight.Based on this drug characteristic,the nurse understands that this drug

Accepted Answer

Low-molecular-weight drugs are more likely to cross the placental barrier.This characteristic does not contribute to increased GI distress or toxicity because of reduced renal elimination.Drugs with low-molecular weight are not more sensitive to metabolism by maternal hormones.

Question 13

A young woman who is contemplating pregnancy asks the nurse what she can do to get healthy in preparation for pregnancy.The nurse will recommend which dietary supplement?

Accepted Answer

Folic acid can help prevent neural tube defects.All women of childbearing age should take folic acid supplements.The other supplements may be given during pregnancy but are not recommended prior to getting pregnant.

Question 14

The nurse is caring for a woman who is in her third trimester of pregnancy.The patient has a blood pressure of 165/95 mm Hg with proteinuria of 350 mg/24 h and has been diagnosed with preeclampsia.The nurse recognizes which conditions as risk factors for this condition?

Accepted Answer

Maternal infection,age younger than 19 and older than 35 years,and preexisting renal disease are all predisposing factors for preeclampsia.Additional risk factors include African American,obesity; primigravida; history of preeclampsia; multifetal gestation; family history of preeclampsia,pregestational diabetes mellitus; and preexisting hypertension,vascular,or renal disease.

Question 15

A woman who is in her third trimester of pregnancy asks the nurse why she cannot take ibuprofen instead of acetaminophen for headaches.The nurse will explain that NSAIDs

Accepted Answer

Ibuprofen can cause premature closure of the ductus arteriosus in the fetus if taken late in the pregnancy.Aspirin can induce premature labor and prolong labor.

Question 16

Which statement by the nurse is accurate regarding iron supplementation during pregnancy?

Accepted Answer

Iron supplements generally are not necessary until the second trimester when the fetus begins to store iron.Iron supplements are given to prevent maternal iron deficiency,not to supply the fetus.The greatest demand occurs in the third trimester.

Question 17

A woman who is pregnant tells the nurse she has frequent heartburn in spite of eating small meals slowly; avoiding greasy,gas-forming foods; and remaining upright for 30 min after eating.The nurse will recommend which over-the-counter product?

Accepted Answer

If a pregnant patient does not respond to nonpharmacologic therapy,antacids are first-line therapy,and patients should choose a nonsystemic low-sodium product such as hydroxymagnesium aluminate (Magaldrate).Alka-Seltzer contains baking soda and can be harmful during pregnancy.A histamine₂ receptor antagonist,such as Pepcid,may be used,but only if recommended by the provider.TUMS contain calcium,which can be constipating during pregnancy.

Question 18

A pregnant woman asks the nurse if she must give up caffeinated coffee while pregnant.How will the nurse advise the patient?

Accepted Answer

Two cups of coffee per day increase epinephrine and decrease intervillous blood flow with a potential for spontaneous abortion.Although an amount greater than 6-8 cups per day is likely to be toxic to the embryo,there is no evidence that caffeine is teratogenic.The risk is consistent throughout the pregnancy.

Quiz 49: Pregnancy and Preterm Labor