SAUNDERS ATI PHARMACOLOGY STUDY GUIDE

SAUNDERS ATI PHARMACOLOGY
STUDY GUIDE
Week 1: Chapter 35 “Maternity and Newborn Medications”
Questio Answers and Rationales
ns
1. The nurse is monitoring a client who 1. Fatigue
is receiving oxytocin (Pitocin) to 2. Drowsiness
induce labor. Which assessment 3.Uterine hyperstimulation
finding would cause the nurse to 4.Early decelerations of the fetal heart rate
immediately discontinue the
oxytocin infusion? Rationale: Often used to induce labor. High doses are
often used for uterine hyperstimulation & C/S births.
ADVERSE EFFECTS: Hyperstimulation of uterine
contractions & non-reassuring fetal HR DISCONTINUE
2. A pregnant client is receiving 1. Proteinuria of 3 +
magnesium sulfate for the 2.Respirations of 10 breaths/ minute
management of preeclampsia. The 3.Presence of deep tendon reflexes
nurse determines that the client is 4.Serum magnesium level of 6 mEq/ L
experiencing toxicity from the
medication if which finding is noted Rationale: Mg TOXICITY RESP. DEPRESSION, LOSS OF
on assessment? TENDON REFLEXES & SUDDEN DECLINE IN FETAL HR,
MATERNAL HR, &
BP caused by Mg tx. Must remain within therapeutic
serum levels 4–7.5 mEq/L. Proteinuria 3+ is expected
in a pt w/ preeclampsia.
3. The nurse is monitoring a client in 1. Flushing
preterm labor who is receiving 2. Hypertension
intravenous magnesium sulfate. 3.Increased urine
The nurse should monitor for which output 4. Depressed
adverse effects of this respirations
medication? Select all that apply. 5.Extreme muscle weakness
6.Hyperactive deep tendon reflexes

Rationale: Mg sulfate is a CNS depressant that
relaxes smooth muscles like the uterus. It’s used to
STOP preterm labor contractions and for
preeclampsia pts. to PREVENT SEIZURES. ADVERSE
EFFECTS:
 Flushing
 Depressed respirations
 Depressed deep tendon reflexes
 Hypotension
 Extreme muscle weakness
 Decreased urine output
 Pulmonary Edema
 Elevated Mg serum levels
4. The nurse instructor asks a nursing 1. “I will flush the eyes after instilling the
student to describe the procedure for ointment?”
administering erythromycin ointment
to the eyes of a newborn. Which 2. “I will clean the newborn’s eyes before instilling
student statement indicates that ointment.”
further teaching is needed?
3.“I need to administer the eye ointment within
1 hr. after delivery.”

4.“I will instill the eye ointment into each of the NB’s
conjunctiva sacs.”

,Rationale: Eye prophylaxis protects the NB against
Neisseria gonorrhea & Chlamydia trachomatis. The
eyes are NOT FLUSHED AFTER INSTILLATION of med
because the flush would WASH AWAY the
administered medication.

,5. A client in preterm labor (31 1. Nalbuphine (Nubain)
weeks) who is dilated to 4 cm has 2.Betamethasone (Celestone)
been started on magnesium sulfate 3.Rho(D) immune globulin (RhoGAM)
and contractions have 4.Dinoprostone (Cervidil vaginal insert)
stopped. If the client’s labor can be
inhibited for the next 48 hours, the Rationale: Betamethasone, a glucocorticoid
nurse anticipates a prescription for increases the production of surfactant to stimulate
which medication? fetal lung maturation. It is administered to clients in
preterm labor at 28 to 32 weeks of gestation if the
labor can be inhibited for 48 hours.

Nalbuphine (Nubain) is an opioid analgesic.

Rho(D) immune globulin (RhoGAM) is given to Rh-
negative clients to prevent immunological
condition aka Rh disease (hemolytic disease of
NB); it takes out the + cells that were transported
from maternal blood stream  fetal circulation.

Dinoprostone (Cervidil vaginal insert) is a prostaglandin
given to ripen and soften the cervix and to stimulate
uterine contractions.
6. Methylergonovine (Methergine) is 1. Uterine tone
prescribed for a woman to treat 2.Blood pressure  ABC!!!
postpartum hemorrhage. Before 3.Amount of lochia
administration of 4.Deep tendon reflexes
methylergonovine, what is the
priority nursing assessment? Rationale: Methylergonovine is an ERGOT ALKALOID
prevents or controls postpartum hemorrhage by
contracting the uterus. This med  continuous uterine
contractions and can elevate BP CHECK BP  report to
MD if HTN is present



7. The nurse is preparing to administer 1.
beractant (Survanta) to a Intradermal
premature infant who has 2.
respiratory distress syndrome. Intratracheal
The nurse plans to administer the 3.Subcutaneous
medication by which route? 4.Intramuscular

Rationale: Respiratory distress syndrome is a serious
lung disorder caused by immaturity and the inability
to produce surfactant hypoxia and acidosis. It is
common in premature infants and may be due to
lung immaturity as a result of surfactant deficiency.
The mainstay of tx=exogenous surfactant, which is
administered by the intratracheal route.

* Note relationship that question states
“respiratory distress syndrome” Intratracheal

8. An opioid analgesic is 1. Naloxone  Antidote!
administered to a client in labor. 2. Morphine sulfate
The nurse assigned to care for the 3.Betamethasone (Celestone)
client ensures that which medication 4.Meperidine hydrochloride (Demerol)
is readily available if respiratory
depression occurs?

, 9. Rho(D) immune globulin (RhoGAM) is 1. Having Rh-positive blood
prescribed for a client after delivery 2. Developing a rubella infection
and the nurse provides information to 3.Developing physiological jaundice
the client about the purpose of the 4.Being affected by Rh incompatibility
medication. The nurse determines
that the woman understands the Rationale: Rh incompatibility can occur when an Rh-
purpose if the woman states that it negative mother becomes sensitized to Rh antigen.
will protect her next baby from which Sensitization may occur when an Rh-negative woman
condition? becomes pregnant with a fetus who is positive
maternal circulation mother’s immune system to form
antibodies against Rh+ blood. This medication
prevents mothers from developing antibodies against
Rh+ blood by providing passive antibody protection
against Rh antigen.
10. Methylergonovine (Methergine) is 1. Hypotension
prescribed for a client with 2. Hypothyroidism
postpartum hemorrhage. Before 3.Diabetes mellitus
administering the medication, the 4.Peripheral vascular disease
nurse contacts the health care
provider who prescribed the Rationale: Ergot alkaloids are contraindicated in
medication if which condition is clients with significant cardiovascular disease,
documented in the client’s medical peripheral vascular disease, hypertension,
history? preeclampsia, or eclampsia. The vasoconstrictive
effects of the ergot alkaloids worsen these
conditions.

Chapter 49: “Pediatric Med. Administration and Calculations”
Questio Answers and Rationales
ns
1. The nurse is providing medication 1. “I should cuddle my child after giving the
instructions to a parent. Which medication.”
statement by the parent indicates 2. “I can give my child a frozen juice bar after
a need for further instruction? he swallows the medication.”
3.“I should mix the medication in the baby food and
give it when I feed my child.”
4.“If my child does not like the taste of the medicine, I
should encourage him to pinch his nose and drink the
medication through a straw.”

Rationale: It may give an unpleasant taste to the food,
and the child may refuse to accept the same food in
the future. In addition, the child may not consume the
entire serving and would not receive the required
medication dosage.
2. A health care provider’s 1. 1.1 mL
prescription reads “ampicillin 2. 0.54 mL
sodium 125 mg IV every 6 3. 7.425 mL
hours.” The medication label reads 4. 0.925 mL
“1 g and reconstitute with 7.4 mL of
bacteriostatic water.” The nurse Rationale: 1 g= 1000 mg
prepares to draw up how many mL
to administer one dose?