A woman has been diagnosed with hypertonic labor. She has an ...

[Marty]

A woman has been diagnosed with hypertonic labor. She has an order for hydromorphone (Dilaudid). The student is preparing the medication and asks the labor nurse the rationale for using it. What response by the nurse is best?
 
  A.
  It is to induce prescribed rest and relax the uterus.
  B.
  It's for the pain associated with those strong contractions.
  C.
  The patient must be allergic to other pain meds.
  D.
  This is the best medication for labor and birth.

Question 2

The perinatal nurse is providing care to a 17-year-old G2 TPAL 0010 patient at 32 weeks' gestation. An ultrasound examination confirms that she is experiencing an abruptio placentae. The patient's vital signs are as follows:
 
  BP: 110/66 mm Hg, P: 92 beats/minute, R: 18 breaths/minute, fetal heart rate: 156 beats/minute. What assessment should the nurse include in this patient's plan of care as a priority?
  A.
  Hourly vital signs
  B.
  Intake and output every 8 hours
  C.
  Blood draw for complete blood count (CBC), prothrombin time (PT), and electrolytes
  D.
  Checks for perineal bleeding every 15 minutes

[pikon]

Answer to Question 1

ANS: A
Rest, hydration, and sedation often are prescribed in hypertonic labor to reduce the irritability of the uterus and help diminish the ineffective contractions. Medications given include hydromorphone (Dilaudid), meperidine (Demerol), and morphine sulfate (Morphine). The other answers are not accurate.

Answer to Question 2

ANS: C
The nurse should review baseline and ongoing laboratory data, including complete blood count, clotting studies, serum electrolytes, and renal function tests. This baseline information is used to alert the care providers to changes in the patient's condition as additional laboratory tests are obtained.
Assessment of vital signs is dependent on the patient's condition. Intake and output may need to be monitored more frequently. Checks for bleeding every 15 minutes are not necessary.

[Marty]

Excellent

[yeungji]

Thanks for the timely response, appreciate it