The prenatal clinic nurse is caring for a client with hyperemesis ...

[jerry coleman]

The prenatal clinic nurse is caring for a client with hyperemesis gravidarum at 14 weeks' gestation. The vital signs are: blood pressure 95/48, pulse 114, respirations 24. Which order should the nurse implement first?
 
  1. Weigh the client.
  2. Give 1 liter of lactated Ringer's solution IV.
  3. Administer 30 mL Maalox (magnesium hydroxide) orally.
  4. Encourage clear liquids orally.

Question 2

Induction of labor is planned for a 31-year-old primip at 39 weeks due to insulin-dependent diabetes. Which nursing action is most important?
 
  1. Administer 100 mcg of misoprostol (Cytotec) vaginally every 2 hours.
  2. Place dinoprostone (Prepidil) vaginal gel and ambulate patient for 1 hour.
  3. Begin Pitocin (oxytocin) 4 hours after 50 mcg misoprostol (Cytotec).
  4. Prepare to induce labor after administering a tap water enema.

[milbourne11]

Answer to Question 1

2
Explanation: 2. The vital signs indicate hypovolemia from dehydration, which leads to hypotension and increased pulse rate. Giving this client a liter of lactated Ringer's solution intravenously will reestablish vascular volume and bring the blood pressure up, and the pulse and respiratory rate down.

Answer to Question 2

3
Rationale 1: One hundred mcg every 2 hours is too much medication administered too frequently.
Rationale 2: The patient must remain recumbent for 2 hours after administration of dinoprostone (Prepidil) vaginal gel, during which time she is continuously monitored.
Rationale 3: A minimum of 4 hours must elapse between the last dose of misoprostol (Cytotec) and the administration of Pitocin.
Rationale 4: Enemas are not routinely used in labor. This order is not expected.

[jerry coleman]

Thank you

[milbourne11]

No problemo