A number of factors influence drug transfer into breastmilk. Which of the following is INCORRECT?

Correct Answer: B

Rationale: In this question, the correct answer is B) Larger breast size leads to greater protein binding. This statement is incorrect because breast size does not impact protein binding in breastmilk. A) The molecular size of the drug is a relevant factor affecting drug transfer into breastmilk. Smaller molecules are more likely to pass into breastmilk. C) The pH of breast milk being slightly more acidic than maternal plasma is correct. This difference in pH can affect drug solubility and hence transfer into breastmilk. D) Lipophilicity of the drug is another important factor influencing drug transfer into breastmilk. Lipophilic drugs are more likely to pass into breastmilk due to their ability to dissolve in fats. Educationally, understanding factors influencing drug transfer into breastmilk is crucial for healthcare professionals when advising breastfeeding mothers on safe medication use during early pregnancy. It highlights the importance of considering various pharmacokinetic factors to ensure the safety of both the mother and the infant.

Correct Answer: A

Rationale: In early pregnancy, many women experience nausea and vomiting, commonly known as morning sickness. Ginger has been traditionally used as an antiemetic due to its ability to alleviate these symptoms. Ginger contains compounds that can help calm the stomach and reduce nausea, making it a safe and effective option for pregnant women. Garlic, Ginkgo biloba, and Green tea are not commonly used as antiemetics in pregnancy and may even have adverse effects. Garlic is more commonly known for its culinary uses and potential blood-thinning properties. Ginkgo biloba is an herb primarily used for cognitive function and is not recommended during pregnancy due to its potential effects on circulation. Green tea contains caffeine, which should be limited during pregnancy. In an educational context, it is important for healthcare providers and pregnant women to be aware of safe and effective options for managing common pregnancy symptoms. Understanding the properties of different herbal agents can help in making informed decisions regarding their use during pregnancy, ensuring the health and well-being of both the mother and the developing fetus.

Correct Answer: C

Rationale: In early pregnancy, administering IV magnesium sulfate is often used to prevent seizures in conditions like preeclampsia. The desired outcome related to magnesium sulfate administration is to decrease blood pressure. This is because magnesium sulfate acts as a vasodilator, relaxing blood vessels and reducing blood pressure, thus helping to prevent complications like eclampsia. Option A, increased contractions, is incorrect because magnesium sulfate is actually used to reduce contractions in conditions like preterm labor. Option B, respiratory rate above 18, is incorrect as it is not a direct desired outcome of administering magnesium sulfate. Monitoring respiratory rate is important due to potential side effects like respiratory depression, but it is not a primary goal of magnesium sulfate administration. Option D, increased uterine tone, is incorrect because magnesium sulfate is a tocolytic agent, meaning it is used to reduce uterine activity and tone to prevent preterm labor, rather than increase it. Educationally, understanding the pharmacological actions and desired outcomes of medications used in early pregnancy is crucial for healthcare providers to ensure safe and effective care for pregnant individuals. Knowing the specific effects of magnesium sulfate helps in providing appropriate management and preventing complications in pregnancy.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Calcium gluconate. When a patient shows signs of hypermagnesemia due to magnesium sulfate infusion, calcium gluconate is administered as the antidote. Calcium competes with magnesium for binding sites and can help counteract the effects of excess magnesium in the body. Metoprolol (A) is a beta-blocker used for conditions like hypertension and cardiac issues, not for treating hypermagnesemia. Potassium chloride (C) is used to treat or prevent low potassium levels, not magnesium toxicity. Furosemide (D) is a diuretic used to remove excess fluid and salt from the body, not indicated for hypermagnesemia. Educationally, understanding the antidotes for medication complications is crucial for nurses and healthcare providers to ensure patient safety. It is vital to know the appropriate interventions to manage adverse drug reactions promptly and effectively. This knowledge can prevent further complications and improve patient outcomes in clinical settings.

Correct Answer: D

Rationale: Terbutaline sulfate (Brethine) is a beta-adrenergic agent that inhibits uterine contractions by reducing intracellular calcium levels. Adverse effects may include hyperkalemia, hyperglycemia, cardiac dysrhythmias, hypotension, and pulmonary edema. Women commonly experience hand tremors, palpitations, and shortness of breath with chest tightness.