A woman who began labor several hours ago is to be administered oxytocin. What is the goal of oxytocin therapy?

Correct Answer: C

Rationale: Use of this manufactured hormone induces labor or augments weak, irregular uterine contractions during labor. It is not used in the labor phase to prevent bleeding. It is not administered to decrease fetal hyperactivity. The administration of oxytocin should allow for adequate periods of relaxation between contractions.

Correct Answer: B

Rationale: When administering magnesium sulfate, it is crucial for the nurse to assess for respiratory depression. Magnesium sulfate is a central nervous system depressant that can lead to respiratory depression, especially if given in high doses or too rapidly. This can result in decreased respiratory rate, shallow breathing, and even respiratory arrest. Therefore, monitoring the patient's respiratory status is essential to prevent any potential complications. Dry, pale skin (choice A) is not a common side effect or assessment finding associated with magnesium sulfate administration. Instead, magnesium sulfate may cause flushing or warmth of the skin due to vasodilation. Agitation (choice C) is also not a typical assessment finding related to magnesium sulfate administration. In fact, magnesium sulfate is often used to treat agitation in conditions such as pre-eclampsia or eclampsia by exerting a calming effect on the central nervous system. Tachycardia (choice D) is not a common side effect of magnesium sulfate. In fact, magnesium sulfate is known to have a negative chronotropic effect, meaning it can slow down the heart rate. Therefore, monitoring for bradycardia rather than tachycardia would be more appropriate when administering magnesium sulfate.

Correct Answer: C

Rationale: Gastroesophageal reflux is a common issue during pregnancy due to hormonal changes and increased intra-abdominal pressure. Ranitidine (Zantac) is the most highly recommended medication for a pregnant woman experiencing GERD. A: Terbutaline (Brethine) is a bronchodilator used to relax smooth muscles in the airways, not to treat GERD. It is not recommended for this condition during pregnancy. B: Diphenoxylate (Lomotil) is an antidiarrheal medication used to treat diarrhea, not GERD. It is not appropriate for managing GERD symptoms in a pregnant woman. D: Chlorothiazide (Diuril) is a diuretic medication used to treat high blood pressure and edema by increasing urine output. It has no direct effect on GERD symptoms and is not recommended for pregnant women with GERD. Ranitidine (Zantac) is a histamine-2 blocker that reduces stomach acid production, providing relief from GERD symptoms. It is considered safe for use during pregnancy and is commonly recommended for pregnant women experiencing gastroesophageal reflux. It helps alleviate symptoms without posing significant risks to the developing fetus.

Correct Answer: D

Rationale: Dinoprostone (Cervidil) is the correct answer for promoting cervical ripening in a woman at 42 weeks of gestation. Dinoprostone is a prostaglandin E2 analog that helps soften and dilate the cervix, making it more favorable for labor induction. It can be administered intravaginally, leading to cervical ripening within hours. This medication is commonly used in post-term pregnancies to initiate labor and reduce the risk of complications associated with prolonged gestation. A: Calcium gluconate is not used for cervical ripening. Calcium gluconate is a mineral supplement used to treat calcium deficiencies or to prevent complications of hyperkalemia or hypermagnesemia. It is not indicated for labor induction or cervical ripening. B: Magnesium sulfate is a tocolytic agent used to prevent preterm labor by relaxing uterine smooth muscle. It is not used for cervical ripening in post-term pregnancies. Magnesium sulfate is commonly used to prevent seizures in preeclampsia or to reduce uterine contractions in preterm labor. C: Terbutaline (Brethine) is a beta-agonist medication used to relax uterine smooth muscle and inhibit uterine contractions. It is primarily used as a tocolytic agent to delay preterm labor. Terbutaline is not indicated for cervical ripening in post-term pregnancies.

Correct Answer: A

Rationale: A: The correct answer is A. Four hours must elapse after the last dose of misoprostol before administering oxytocin. Misoprostol is a prostaglandin E1 analog used to ripen the cervix and induce labor. Oxytocin, on the other hand, is a hormone that stimulates uterine contractions. The care team must wait at least four hours after administering misoprostol to avoid the risk of uterine hyperstimulation when oxytocin is subsequently administered. This timing ensures that the uterus has had time to recover from the effects of misoprostol, reducing the likelihood of complications during labor induction. B: The incorrect answer is B. The woman having a type and cross-match performed is not a necessary step prior to administering oxytocin. Type and cross-match are typically done to determine the patient's blood type and screen for any antibodies that may cause transfusion reactions. While it is important to know the patient's blood type in case a blood transfusion is needed during labor, it is not directly related to the administration of oxytocin. C: The incorrect answer is C. The woman receiving a bolus of 500-mL normal saline is not a required step before administering oxytocin. Normal saline may be used during labor to maintain hydration and electrolyte balance, but it is not specifically needed before starting oxytocin. It is essential to monitor the woman's fluid status and provide hydration as needed, but a bolus of normal saline is not a prerequisite for oxytocin administration. D: The incorrect answer is D. The woman having her electrolytes measured is not a mandatory step before administering oxytocin. While monitoring electrolyte levels is important during labor, especially if oxytocin is being used, checking electrolytes before starting oxytocin is not a standard requirement. It is crucial to monitor electrolytes throughout labor to ensure proper hydration and prevent complications, but it does not need to be done immediately before oxytocin administration.