A nurse is caring for a client who is at 35 weeks of gestation and has pre-term labor with intact membranes and no signs of infection.
The provider prescribes indomethacin to inhibit prostaglandin synthesis and suppress uterine contractions.
Which of the following laboratory tests should the nurse monitor while the client is receiving this medication?
Platelet count
Creatinine clearance
Liver function tests
Blood glucose levels
The Correct Answer is B
Creatinine clearance.
Indomethacin is a nonsteroidal anti-inflammatory drug (NSAID) that inhibits prostaglandin synthesis and suppresses uterine contractions. However, it can also cause renal failure in the fetus and the mother by reducing renal blood flow and glomerular filtration rate.
Therefore, the nurse should monitor the creatinine clearance, which is a measure of renal function, while the client is receiving this medication.
Choice A is wrong because indomethacin does not affect platelet count or coagulation.
Choice C is wrong because indomethacin does not affect liver function tests.
Choice D is wrong because indomethacin does not affect blood glucose levels.
Normal ranges for creatinine clearance are 88-128 mL/min for women and 97-137 mL/min for men. Normal ranges for platelet count are 150,000-450,000 cells/mm3.
Normal ranges for liver function tests vary depending on the specific test, but some common ones are: alanine aminotransferase (ALT) 7-55 U/L, aspartate aminotransferase (AST) 8-48 U/L, alkaline phosphatase (ALP) 45-115 U/L, total bilirubin 0.1-1.2 mg/dL.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Assess the client’s vital signs.
The nurse should first assess the client’s vital signs to determine the severity of the situation and identify any signs of infection, bleeding, or shock.
The nurse should also monitor the fetal heart rate to assess fetal well-being.
Choice B is wrong because a sterile vaginal exam is not indicated for a client who reports lower abdominal cramping and may increase the risk of infection or rupture of membranes.
Choice C is wrong because administering tocolytic medication is not the first action the nurse should take.
Tocolytic medication may be used to inhibit uterine contractions and prolong pregnancy, but only after assessing the client’s and fetus’s condition and obtaining a prescription from the provider.
Choice D is wrong because monitoring the fetal heart rate is not the first action the nurse should take.
Monitoring the fetal heart rate is important to assess fetal well-being, but it does not take priority over assessing the client’s vital signs.
Correct Answer is C
Explanation
This is because assessing fetal heart rate is the most important action to take first when a client has prelabor rupture of membranes (PROM) at 34 weeks of gestation and oligohydramnios.Fetal heart rate can indicate fetal well-being, distress, or infection.Oligohydramnios can increase the risk of umbilical cord compression and fetal hypoxia.
Choice A is wrong because administering IV fluids is not the first priority in this situation.IV fluids may be given to prevent dehydration, enhance uterine blood flow, or augment labor, but they are not as urgent as assessing fetal heart rate.
Choice B is wrong because obtaining a urine specimen is not the first priority in this situation.A urine specimen may be obtained to check for infection, proteinuria, or glucose levels, but they are not as urgent as assessing fetal heart rate.
Choice D is wrong because inserting an indwelling urinary catheter is not the first priority in this situation.An indwelling urinary catheter may be inserted to monitor fluid balance, prevent bladder distension, or reduce the risk of infection, but they are not as urgent as assessing fetal heart rate.
Normal ranges for fetal heart rate are 110 to 160 beats per minute.Oligohydramnios is defined as an amniotic fluid index of less than 5 cm.
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