A nurse is caring for a pre-term newborn who has a patent ductus arteriosus (PDA).
Which of the following medications should the nurse expect to administer to close the ductus arteriosus?
Indomethacin
Prostaglandin E1
Furosemide
Digoxin
The Correct Answer is A
Indomethacin is a nonsteroidal anti-inflammatory drug (NSAID) that helps close the ductus arteriosus, a blood vessel connecting two arteries of the heart (aorta and pulmonary artery) in fetus. This drug is effective only among premature babies.
Choice B. Prostaglandin E1 is wrong because it is used to keep the ductus arteriosus open in some congenital heart defects that require surgery.
Choice C. Furosemide is wrong because it is a diuretic that reduces fluid retention and blood pressure, but does not affect the ductus arteriosus.
Choice D. Digoxin is wrong because it is a cardiac glycoside that strengthens the heart muscle contractions and regulates the heart rhythm, but does not affect the ductus arteriosus.
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Correct Answer is C
Explanation
Indomethacin is contraindicated for this client because it is a nonsteroidal anti-inflammatory drug (NSAID) that can irritate or inflame the lining of the stomach and small intestine.This can worsen the client’s peptic ulcer disease, which is a condition where open sores develop on the inner surface of the stomach or small intestine due to acid erosion.
Indomethacin can also interact with other medications that the client may be taking for pre-term labor or peptic ulcer disease.
Choice A is wrong because magnesium sulfate is not contraindicated for this client.It is a medication that can relax the smooth muscles of the uterus and prevent pre-term labor contractions.
Choice B is wrong because betamethasone is not contraindicated for this client.It is a corticosteroid that can help mature the fetal lungs and reduce the risk of respiratory distress syndrome in pre-term infants.
Choice D is wrong because terbutaline is not contraindicated for this client.
Correct Answer is A
Explanation
Assess fetal heart rate and activity.
The nurse should identify that a client who reports a sudden gush of fluid from her vagina is at risk forpremature rupture of membranes (PROM), which can lead toinfection,cord prolapse, andfetal distress.Therefore, the priority action is to assess the fetal heart rate and activity to monitor for signs of hypoxia or distress.
Choice B is wrong because performing a nitrazine test on the fluid is not the first action.A nitrazine test can confirm the presence of amniotic fluid by detecting its alkaline pH, but it is not as urgent as assessing the fetal well-being.
Choice C is wrong because administering oxytocin (Pitocin) IV infusion is contraindicated in this situation.Oxytocin is used to induce or augment labor, but it can causeuterine hyperstimulation,fetal distress, andplacental abruptionif given to a client who has PROM.
Choice D is wrong because placing the client in Trendelenburg position is not recommended for a client who has PROM.Trendelenburg position can increase the risk ofcord prolapseandaspirationin this situation.
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