A patient has received two doses of dinoprostone (Prepidil) to ...

[Arii_bell]

A patient has received two doses of dinoprostone (Prepidil) to initiate labor. It has been 6 hours since the last dose.
 
  The nurse assesses the patient and notes that the cervix is ripe and dilated to 4 cm, but contractions are diminishing in intensity and frequency. What will the nurse expect to do?
  a. Administer oxytocin.
  b. Monitor urine output.
  c. Prepare for a cesarean section.
  d. Watch closely for fetal distress.

Question 2

A patient in preterm labor is receiving intravenous magnesium sulfate at a rate of 1 gm/hr. The woman reports headache and dizziness. Her blood pressure is 90/60 mm Hg. What will the nurse do?
 
  a. Ask her whether she has a history of myasthenia gravis.
  b. Expect the development of paralytic ileus.
  c. Stop the infusion and request an order for a diuretic.
  d. Tell the patient not to get up without assistance.

[joshbk44]

Answer to Question 1

ANS: A
Once the cervix is ripe and labor has occurred, labor should progress, with contractions increasing in duration and frequency. This woman is showing signs of stalled labor and, because the cervix is ripe, can be induced with oxytocin. Large doses of oxytocin can cause water intoxication, which is not a risk at this point in this patient. There is no indication for a cesarean section at this point. The risk of fetal distress is not increased at this point.

Answer to Question 2

ANS: D
Initial reactions to magnesium sulfate include transient hypotension, headache, and dizziness. Telling the patient to ask for assistance when ambulating is appropriate. The patient's signs are not associated with myasthenia gravis, which is a contraindication to treatment with magnesium sulfate. A history of myasthenia gravis should be part of the pretreatment assessment. High doses of magnesium sulfate may cause paralytic ileus, but this patient is receiving a low dose. This patient does not have signs of fluid retention.

[Arii_bell]

Excellent

TYSM