A nurse is providing education to a client who had pre-term labor and was prescribed indomethacin.
Which of the following information should the nurse include in the teaching?
“This medication can cause premature closure of your baby’s ductus arteriosus.”
“This medication can increase your risk of postpartum hemorrhage.”
“This medication can cause your baby to have jaundice after birth.”
“This medication can increase your blood pressure during labor.”
The Correct Answer is A
“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.
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Correct Answer is B
Explanation
Indomethacin is a nonsteroidal anti-inflammatory drug (NSAID) that can cause renal impairment and elevated serum creatinine levels in both the mother and the fetus.This can lead to oligohydramnios, reduced fetal urine output, and fetal renal failure.
Therefore, the nurse should monitor the serum creatinine levels of the client and the fetus as a potential complication of indomethacin.
Choice A is wrong because indomethacin does not affect the platelet count.It may increase the risk of bleeding due to its antiplatelet effect, but it does not cause thrombocytopenia.
Choice C is wrong because indomethacin does not cause anemia or decrease the hematocrit.It may cause gastrointestinal bleeding or ulceration, which could lead to anemia, but this is not a common or direct effect of the medication.
Choice D is wrong because indomethacin does not cause hyperkalemia or increase the serum potassium levels.It may cause hyponatremia due to its effect on renal sodium excretion, but it does not affect potassium balance.
Correct Answer is B
Explanation
Tocolytics are a category of drugs used to delay the labor process.These may be used in situations when a pregnant person begins showing signs of preterm labor —which is any time before 37 weeks of completed pregnancy.Tocolytics may help delay labor by two to seven days.
Some possible explanations for the other choices are:
• Choice A. Administering intravenous fluids.
This is not a correct answer because intravenous fluids are not effective in suppressing uterine contractions.They may be used to correct dehydration or electrolyte imbalance, which can sometimes trigger preterm labor, but they are not a primary intervention for preterm labor.
• Choice C. Administering corticosteroids.
This is not a correct answer because corticosteroids are not tocolytics.They do not stop or slow down uterine contractions, but they help accelerate fetal lung maturity and reduce the risk of neonatal respiratory distress syndrome and other complications of prematurity.
Corticosteroids are often given along with tocolytics, but they have a different function and mechanism of action.
• Choice D. Administering antibiotics.
This is not a correct answer because antibiotics are not tocolytics.They may be used to treat infections that can cause or complicate preterm labor, such as chorioamnionitis or group B streptococcus, but they do not directly affect uterine contractions.
Antibiotics may be given along with tocolytics, but they have a different function.
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