A postpartum client has a fourth-degree perineal laceration. The nurse would expect which of the following medications to be ordered?
Select one:
Docusate sodium (Colace).
Bromocriptine (Parlodel).
Ferrous sulfate (Feosol).
Methylergonovine (Methergine).
The Correct Answer is A
Choice A Reason: Docusate sodium (Colace). This is because docusate sodium is a stool softener that can prevent constipation and straining during defecation, which can aggravate or impair the healing of a perineal laceration. A fourth-degree perineal laceration is a severe tear that extends through the skin, muscles, perineal body, and anal sphincter into the rectal mucosa. It can occur during vaginal delivery due to factors such as fetal macrosomia, forceps use, or episiotomy.
Choice B Reason: Bromocriptine (Parlodel). This is an inappropriate medication for a postpartum client with a fourth- degree perineal laceration, as it has no effect on wound healing or pain relief. Bromocriptine is a dopamine agonist that can suppress lactation by inhibiting prolactin secretion. It is used for women who do not wish to breastfeed or who have medical contraindications to breastfeeding.
Choice C Reason: Ferrous sulfate (Feosol). This is an unnecessary medication for a postpartum client with a fourth- degree perineal laceration, unless she has iron deficiency anemia. Ferrous sulfate is an iron supplement that can treat or prevent anemia by increasing hemoglobin production and oxygen-carrying capacity. Anemia can occur in the postpartum period due to blood loss during delivery or poor nutritional intake during pregnancy.
Choice D Reason: Methylergonovine (Methergine). This is an irrelevant medication for a postpartum client with a fourth-degree perineal laceration, as it does not affect wound healing or pain relief. Methylergonovine is an ergot alkaloid that can stimulate uterine contractions and reduce postpartum bleeding. It is used for women who have uterine atony or hemorrhage.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A Reason: Late decelerations. This is an incorrect answer that refers to a different type of fetal heart rate patern that indicates uteroplacental insufficiency, which can reduce blood flow and oxygen delivery to the fetus. Late decelerations are characterized by gradual decreases in fetal heart rate that begin after the peak of uterine contractions and return to baseline after the end of contractions. Amnioinfusion is not effective for late decelerations, as it does not address the underlying cause of uteroplacental insufficiency, which may be due to maternal hypertension, diabetes, preeclampsia, or placental abruption.
Choice B Reason: Moderate decelerations. This is an incorrect answer that refers to a non-existent type of fetal heart rate patern, as there is no such term as moderate decelerations. The term moderate refers to the category of fetal heart rate variability, which is a measure of the fluctuations in fetal heart rate around the baseline. Moderate variability indicates normal fetal oxygenation and well-being, while absent or minimal variability indicates fetal hypoxia or distress.
Choice C Reason: Variable decelerations. This is because variable decelerations are a type of fetal heart rate patern that indicates cord compression, which can reduce blood flow and oxygen delivery to the fetus. Variable decelerations are characterized by abrupt decreases in fetal heart rate that vary in onset, depth, and duration, and do not have a consistent relationship with uterine contractions. Amnioinfusion is a procedure that involves infusing saline or lactated Ringer's solution into the amniotic cavity through a transcervical catheter, which can relieve cord compression by increasing the volume of amniotic fluid and cushioning the cord. Amnioinfusion can improve fetal oxygenation and reduce variable decelerations.
Choice D Reason: Early decelerations. This is an incorrect answer that refers to a different type of fetal heart rate patern that indicates head compression, which can stimulate the vagus nerve and slow down the fetal heart rate. Early decelerations are characterized by gradual decreases in fetal heart rate that begin with the onset of uterine contractions and return to baseline with the end of contractions. Early decelerations are benign and do not require intervention, as they reflect normal fetal head descent and progress of labor. Amnioinfusion is not indicated for early decelerations, as it does not affect head compression or vagal stimulation.
Correct Answer is A
Explanation
Choice A Reason: Fetal movements are an indicator of fetal well-being. You should count twice a day, and you should feel ten fetal movements in 2 hours. This is because this response provides accurate and clear instructions on how to perform kick counts, which are a simple and non-invasive method of monitoring fetal activity and health. Kick counts can help detect changes in fetal movement paterns that may indicate fetal distress or hypoxia.
Choice B Reason: Here is a computer printed information packet on how to do kick counts. This is an insufficient answer that does not address the patient's question or demonstrate effective communication skills. Providing writen information alone may not ensure the patient's understanding or compliance with kick counts.
Choice C Reason: Fetal kick counts are not a reliable indicator of fetal well-being in the third trimester. This is an incorrect answer that contradicts the evidence and guidelines on kick counts. Kick counts are recommended for all pregnant women, especially in the third trimester, when fetal movements are more noticeable and consistent.
Choice D Reason: It is not important to do kick counts because you have a low-risk pregnancy. This is an incorrect answer that discourages the patient from performing kick counts and may give her a false sense of security. Kick counts are important for all pregnant women, regardless of their risk status, as they can help identify potential problems that may require further evaluation or intervention.
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