A nurse is caring for a client who has preeclampsia and is experiencing a postpartum hemorrhage. The nurse should expect the provider to prescribe which of the following medications?
Methylergonovine
Carboprost
Nifedipine
Oxytocin
The Correct Answer is D
A. Methylergonovine: While effective for postpartum hemorrhage, it causes vasoconstriction and can raise blood pressure significantly. It is contraindicated in clients with preeclampsia or hypertension due to the risk of stroke or hypertensive crisis.
B. Carboprost: Carboprost is used to treat postpartum hemorrhage, but it may increase blood pressure and is used cautiously in clients with preeclampsia. It is not typically the first-line treatment in hypertensive patients.
C. Nifedipine: Nifedipine is a calcium channel blocker used for managing hypertension and preterm labor, not for controlling postpartum bleeding. It does not cause uterine contraction and is not effective for hemorrhage.
D. Oxytocin: Oxytocin stimulates uterine contractions and is the first-line medication for managing postpartum hemorrhage. It does not raise blood pressure, making it safe and effective for clients with preeclampsia.
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Related Questions
Correct Answer is B
Explanation
A. Ibuprofen: This NSAID can irritate the gastric lining and increase the risk of bleeding, making it inappropriate for clients with a history of peptic ulcers.
B. Acetaminophen: It is not an NSAID and does not affect the gastrointestinal lining, making it a safer option for pain relief in clients with peptic ulcer disease.
C. Ketorolac: Like other NSAIDs, ketorolac increases the risk of gastric bleeding and should be avoided in clients with peptic ulcers.
D. Aspirin: Aspirin is an NSAID and antiplatelet agent that can worsen peptic ulcers and increase bleeding risk, so it should not be used in this client.
Correct Answer is B
Explanation
A. Decreased temperature: Vomiting and diarrhea usually cause dehydration, but they do not typically lower body temperature. Infants may have a normal or slightly elevated temperature if an infection is present.
B. Oliguria: Oliguria, or reduced urine output, is a key sign of dehydration in infants. Fluid loss from vomiting and diarrhea leads to decreased kidney perfusion, causing the kidneys to conserve water and produce less urine.
C. Bulging anterior fontanel: A bulging anterior fontanel indicates increased intracranial pressure and is not a sign of dehydration. In contrast, dehydration often causes a sunken fontanel due to decreased fluid volume.
D. Hypertension: Dehydration usually causes low blood pressure in infants because of decreased circulating blood volume. Hypertension is not expected in this situation and would suggest a different underlying issue.
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