A client at 25 weeks' gestation has experienced a fetal demise. ...

[fnuegbu]

A client at 25 weeks' gestation has experienced a fetal demise. What medication is most likely to be used first to induce labor in this client?
 
  1. Dinoprostone (Cervidil)
  2. Methylergonovine (Ergotrate)
  3. Parenteral oxytocin (Pitocin)
  4. Carboprost (Hemabate)

Question 2

Which outcome statement indicates that a client has effectively been treated with conjugated estrogen (Premarin) for severe and frequent hot flashes?
 
  1. The client is able to sleep 45 hours every night.
  2. The client reports one to two hot flashes per day.
  3. The client reports experiencing headaches while taking this drug.
  4. The client reports an improvement in mood.

[Hikerman221]

Answer to Question 1

Correct Answer: 1
Rationale 1: Dinoprostone is approved to prepare the cervix for labor or to abort a fetus that has died.
Rationale 2: This medication is not used to induce labor.
Rationale 3: Parenteral oxytocin would not be the first drug used in this client. At 25 weeks, the cervix has not ripened, so it is not wise to begin giving a medication for uterine contractions until the cervix is ready to be stretched.
Rationale 4: Carboprost is a prostaglandin that may be used for pharmacologic abortion but usually is given for this reason only into the second trimester.
Global Rationale: Dinoprostone is approved to prepare the cervix for labor or to abort a fetus that has died.
Methylergonovine is not used to induce labor. Parenteral oxytocin would not be the first drug used in this client. At 25 weeks, the cervix has not ripened, so it is not wise to begin giving a medication for uterine contractions until the cervix is ready to be stretched. Carboprost is a prostaglandin that may be used for pharmacologic abortion but usually is given for this reason only into the second trimester.

Answer to Question 2

Correct Answer: 2
Rationale 1: The client was experiencing severe hot flashes, which most likely were interrupting the client's sleep. A report of 45 hours of sleep does not signify a good outcome from this medication.
Rationale 2: Having one to two hot flashes per day would be a good response to the medication. The client would not expect the hot flashes to completely disappear.
Rationale 3: Headaches are a significant side effect, which would not indicate a good outcome statement.
Rationale 4: Though improvement in mood might be a result of this medication, the client's goal would have been related to relief from hot flashes.
Global Rationale: Having one to two hot flashes per day would be a good response to the medication. The client would not expect the hot flashes to completely disappear. The client was experiencing severe hot flashes, which most likely were interrupting the client's sleep. A report of 45 hours of sleep does not signify a good outcome from this medication. Headaches are a significant side effect, which would not indicate a good outcome statement. Though improvement in mood might be a result of this medication, the client's goal would have been related to relief from hot flashes.

[fnuegbu]

TY

[Hikerman221]

You're welcome