A nurse is reviewing the medication history of a client who is in pre-term labor and has a history of peptic ulcer disease.
The nurse should recognize that which of the following medications is contraindicated for this client?
Magnesium sulfate
Betamethasone
Indomethacin
Terbutaline
The Correct Answer is C
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.
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Correct Answer is B
Explanation
Prepare for an emergency cesarean section.This is because the client has pre-term labor that has not responded to tocolytic therapy, which are drugs that are used to delay delivery for a short time.The client’s cervix is dilated to 4 cm and she is experiencing regular contractions every 3 minutes, which are signs of active labor.The baby is at 33 weeks of gestation, which is premature and may have complications such as respiratory distress syndrome or bleeding in the brain.
Therefore, the client needs an emergency cesarean section to deliver the baby as soon as possible and prevent further risks.
Choice A is wrong because administering magnesium sulfate intravenously is a type of tocolytic therapy that the client has already failed.Magnesium sulfate may also have side effects such as nausea, vomiting, flushing, headache, and muscle weakness.
Choice C is wrong because placing the client in Trendelenburg position, which is lying on the back with the feet elevated above the head, is not recommended for preterm labor.This position may increase the risk of aspiration, decrease cardiac output, and impair gas exchange.
Choice D is wrong because administering antibiotics prophylactically is not indicated for preterm labor unless there is evidence of infection in the uterus or membranes.
Antibiotics may also cause allergic reactions or bacterial resistance
Correct Answer is B
Explanation
Drinking enough water can help prevent dehydration, which can trigger preterm labor contractions.Dehydration can also cause low amniotic fluid levels, which can affect fetal growth and development.
Choice A is wrong because avoiding sexual intercourse until term is not necessary for most women at risk for preterm labor.Sexual activity does not cause preterm labor unless there are other complications, such as placenta previa or cervical insufficiency.
Choice C is wrong because lying down when feeling contractions may not stop preterm labor.If a woman has regular contractions that cause cervical change, she should seek medical attention as soon as possible.Lying down may also reduce blood flow to the uterus and placenta, which can affect fetal oxygenation.
Choice D is wrong because taking aspirin for pelvic pain is not recommended for pregnant women.Aspirin can increase the risk of bleeding and affect fetal blood circulation.
Pelvic pain may be a sign of preterm labor or other complications, so it should be evaluated by a health care provider
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