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
“This medication can cause premature closure of your baby’s ductus arteriosus.”
Indomethacin is a NSAID that can prevent the synthesis of prostaglandins, which are involved in preterm contractions.However, it can also cause constrictive effects on the fetal ductus arteriosus, which can lead to cardiac complications and oligohydramnios.The dosage and duration of indomethacin treatment should be carefully monitored.
Choice B is wrong because indomethacin does not increase the risk of postpartum hemorrhage.In fact, it may reduce the risk of bleeding by inhibiting platelet aggregation.
Choice C is wrong because indomethacin does not cause jaundice in the baby.
Jaundice is caused by high levels of bilirubin in the blood, which can be due to various factors such as blood group incompatibility, infection, or liver problems.
Choice D is wrong because indomethacin does not increase blood pressure during labor.It may actually lower blood pressure by dilating blood vessels.
Normal ranges for indomethacin dosage are 25 to 50 mg orally every 6 hours or 100 mg rectally every 12 hours for up to 48 hours.
Normal ranges for fetal ductus arteriosus diameter are 1.5 to 4 mm before 28 weeks of gestation and 1 to 3 mm after 28 weeks of gestation.
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.
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