A patient is 3 days post c-section delivery for eclampsia. The client is receiving hydralazine (Apresoline). Which of the following would indicate that the medication is effective?

The patient's blood pressure dropped from 160/120 to 130/90

The patient states that her headache is gone

The patient's postoperative weight has dropped from 155 to 144 pounds

The patient has had no seizures since delivery

Answer and Explanation

The Correct Answer is A

A. The patient's blood pressure dropped from 160/120 to 130/90. Hydralazine is an antihypertensive medication used to lower blood pressure in conditions such as eclampsia. A reduction in blood pressure indicates that the medication is achieving its intended effect of controlling hypertension, reducing the risk of complications like stroke or organ damage.

B. The patient states that her headache is gone. While headaches are a symptom of severe hypertension, their resolution does not directly confirm the effectiveness of hydralazine. Other factors, such as pain relief or improved postpartum recovery, could contribute to headache relief.

C. The patient's postoperative weight has dropped from 155 to 144 pounds. Postpartum weight loss is expected due to fluid shifts and loss of pregnancy-related fluids, but it is not a direct measure of hydralazine’s effectiveness. The medication does not act as a diuretic or weight-loss agent.

D. The patient has had no seizures since delivery. While hydralazine helps lower blood pressure, preventing seizures in eclamptic patients is primarily managed with magnesium sulfate, not hydralazine. The absence of seizures is important but does not indicate the specific effectiveness of this antihypertensive medication.

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Correct Answer is B

Explanation

A. Uterine prolapse. Uterine prolapse occurs when the uterus descends into or outside the vagina, usually postpartum due to weakened pelvic support. It does not present with sudden, severe pain or fetal heart rate abnormalities during labor.

B. Uterine rupture. A tearing sensation, sudden severe pain, fetal heart rate abnormalities, pallor, and diaphoresis are hallmark signs of uterine rupture. This is a life-threatening emergency where the uterine wall tears, often due to prior cesarean scars, excessive oxytocin use, or grand multiparity. Immediate intervention, including emergency surgery, is required to prevent maternal and fetal death.

C. Precipitous labor. Precipitous labor is rapid labor and delivery within three hours and is not associated with severe, tearing pain. While it can cause fetal distress, it does not typically involve uterine rupture symptoms.

D. Amniotic fluid embolus. An amniotic fluid embolus presents with sudden respiratory distress, hypotension, and cardiovascular collapse due to amniotic fluid entering the maternal circulation. It does not typically cause localized severe abdominal pain or fetal distress due to uterine rupture.

A. The cervix is effacing and dilated to 2 cm B. Irregular, mild uterine contractions are occurring every 15-30 minutes C. Estriol is not found in maternal saliva D. Fetal fibronectin is present in vaginal secretions

Correct Answer is A

Explanation

A. The cervix is effacing and dilated to 2 cm. Cervical changes, including effacement and dilation, are the most definitive signs of preterm labor. Uterine contractions alone do not confirm preterm labor unless they result in cervical dilation, indicating that labor is progressing.

B. Irregular, mild uterine contractions are occurring every 15-30 minutes. Irregular contractions, known as Braxton Hicks contractions, can be common in pregnancy and do not necessarily indicate preterm labor. True preterm labor involves regular contractions that lead to cervical changes.

C. Estriol is not found in maternal saliva. The absence of estriol in maternal saliva does not confirm or rule out preterm labor. Salivary estriol testing is not a widely used or reliable diagnostic tool for determining the onset of preterm labor.

D. Fetal fibronectin is present in vaginal secretion. Fetal fibronectin (fFN) is a protein found in vaginal secretions between 22-34 weeks of pregnancy and can indicate a risk of preterm labor, but its presence alone does not confirm that labor is actively occurring. A positive fFN test means the patient may be at increased risk for preterm labor, but cervical changes remain the best indicator of actual labor.

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A patient is 3 days post c-section delivery for eclampsia. The client is receiving hydralazine (Apresoline). Which of the following would indicate that the medication is effective?

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