A nurse is explaining the drug oxytocin to a client. When describing this drug, the nurse notes that oxytocin is an endogenous hormone produced by which? Show posterior pituitary gland Oxytocin is an endogenous hormone produced by the posterior pituitary gland. The adrenal glands (also known as suprarenal glands) are endocrine glands that produce a variety of hormones including adrenaline and the steroids aldosterone and cortisol. The uterus is part of the female reproductive system where the fetus grows until term, it does not produce hormones, but oxytocin stimulates the smooth muscle to contract. The corpus luteum is a temporary endocrine structure in female ovaries that is involved in the production of relatively high levels of progesterone, moderate levels of estradiol and inhibin A. A nurse is caring for a client who is receiving magnesium. The nurse would be alert for which finding? depressed reflexes Magnesium affects the neuromuscular system, so the nurse would assess mentation, cranial nerve function, and deep tendon reflexes. Depressed reflexes would be a cause for concern. Vasoconstriction can occur when methylergonovine (Methergine) is administered to a client who is a heavy smoker. The calcium channel blocker (nifedipine) and the beta2-adrenergic drug (terbutaline) are used to delay the delivery process for 24 to 48 hours. Sweating, hypotension, depressed reflexes, and flaccid paralysis are other adverse reactions associated with IV administration. A 49-year-old female client is asking the nurse about how her changing hormones relate to menopause. The nurse explains that atrophic vaginitis is a common problem during menopause. The treatment for atrophic vaginitis requires replacing: estrogen. Estrogen is used for palliation of moderate to severe vasomotor symptoms, atrophic vaginitis, and kraurosis vulvae. The human chorionic gonadotropin hormone is used to help maintain the follicle once ovulation has occurred. Progesterone is used with estrogen as contraception, to treat amenorrhea, functional uterine bleeding, and as part of fertility programs. Testosterone is used to treat sexual and metabolic disorders in males. A nurse is taking care of a woman receiving an abortifacient. The nurse is aware that the most serious adverse effect is: vaginal bleeding. All of the options are adverse effects of abortifacients. However, the most serious adverse effect would be vaginal bleeding, which could indicate a perforated uterus or uterine rupture. A perforated uterus or uterine rupture can be life threatening and emergency measures must be taken by the nurse. A nurse is caring for a 25-year-old clinic client who is starting on birth control pills. What statement by the client indicates that she needs further teaching? "I will exercise more if I experience chest or leg pain." Chest or leg pain may be indicative of a thrombus, and medical care should be sought immediately. The other options are correct statements but do not address the question asked. A 31-year-old pregnant woman has been prescribed administration of a tocolytic drug. During which period is a tocolytic drug usually administered? Pre-term labor Drugs used to prevent uterine contractions are called tocolytics. They are useful in the management of pre-term labor. These drugs will decrease uterine activity and prolong the pregnancy to allow the fetus to develop more fully, thereby increasing the chance of neonatal survival. Oxytocic drugs are used antepartum (before birth of the neonate) to induce uterine contractions and initiate or augment labor. In the postpartum period and during the second stage of normal labor, the tocolytics are not of any importance. A woman who is at 31 weeks' gestation comes to the clinic in labor. The health care provider decides to use terbutaline therapy before transferring the woman to the hospital. The client is upset and confused and asks the nurse why she can't just have the baby, that it's only 5 weeks early. An appropriate response by the nurse should be: "The drug provides sufficient time for other medications to be given to improve your baby's outcome." Delivery can be delayed with the use of a tocolytic. This delay provides sufficient time to transfer the client to an acute care facility or administer essential drugs such as corticosteroids. Corticosteroids reduce the risk of neonatal death as a result of respiratory distress syndrome. Delaying the delivery does not ensure a painless delivery. Oxytocin is administered to induce uterine contractions and mild ejection for breast-feeding and to prevent and control postpartum hemorrhage if the drug is administered via IV infusion or IM injection. A 20-year-old woman will soon begin taking oral contraceptives for the first time. What advice should the nurse provide to this client? "Make sure to seek care quickly if you experience bad headaches, calf pain, or changes in vision." An important nursing intervention is teaching about signs and symptoms of potential complications of estrogen and progestin contraceptives. These may include headaches, vision changes or pain in the calves, abdomen or chest and should be reported promptly. The use of oral contraceptives does not preclude future pregnancy. There is not a 10- to 12-week time span between the initiation of oral contraceptives use and the prevention of pregnancy. A 21-year-old woman is prescribed an oral contraceptive pill to prevent pregnancy. The nurse should inform the client of which adverse effects of this medication? Nausea Taking combination oral contraceptives is commonly accompanied by nausea. The nurse should tell the client to anticipate this adverse effect. Breakthrough bleeding or spotting is likely with the medication. The nurse would be incorrect to inform the client that bleeding with cease completely. More commonly, clients taking oral contraceptives experience mild to moderate weight gain, not loss. Breast swelling and tenderness is common with this medication, not a reduction in breast tissue. While monitoring a woman who is receiving IV oxytocin for induction of labor, what event would cause the nurse to contact the health care provider immediately? The uterine contractions are occuring every 90 seconds. The health care provider should be notified immediately if there is a marked change in the frequency, rate, or rhythm of uterine contractions; uterine contractions that last more than 60 seconds; and contractions occurring more frequently than every 2-3 minutes. The client's blood pressure and pulse are within normal limits and the fetal heart rate is within normal limits. The nurse is on the phone with a woman who is taking an antispasmodic for overactive bladder syndrome. The woman states that her mouth is very dry, but she is afraid to drink because she does not want the urge to urinate to increase. What is the nurse's best response to this client? "You shouldn't restrict your fluid intake because it will only make your bladder problems worse." Dry mouth related to antispasmodics can be treated with sugarless hard candy, pieces of ice, or sugarless lozenges. The client may also perform frequent mouth care but strong mouthwash may cause oral irritation. The client shouldn't limit the amount of fluid because it will only make the urinary symptoms worse. The nurse is discussing the use of Depo-Provera with a 17-year-old female who desires birth control. The nurse recognizes that this medication is used in this client for what reason? Birth control for 3 months Depo-Provera is often used in teenagers because it is given by injection and provides effective birth control for 3 months from the first injection. The health care provider has prescribed a combination of estrogen and progestin for a client. The nurse knows that this combination carries an increased risk of which conditions? (Select all that apply.) Myocardial infarction The FDA has issued a black box warning that estrogens increase the risk of developing cancer of the uterus. The warning instructs women who take estrogens with or without progestins that there is an increased risk of dementia, myocardial infarctions, strokes, breast cancer, and blood clots. A patient who has come to the emergency department after being raped is given a dose of emergency contraception at 12 AM. The nurse would instruct the patient to take another dose of the drug at which time? 12 PM With emergency contraception, the first dose is started within 72 hours after unprotected intercourse; then, a follow-up dose of the same dosage must be taken 12 hours after the first dose. The nurse monitors a patient receiving oxytocin for water intoxication based on the understanding that this condition is the result of: release of antidiuretic hormone. Oxytocin can cause severe water intoxication, which is thought to occur because of related effects of antidiuretic hormone, which may be released in response to oxytocin activity. Oxytocin does stimulate neuroreceptor sites but this is not the reason for the development of water intoxication. Ergonovine and methylergonovine can produce ergotism. Blockage of estrogen receptor sites occurs with estrogen receptor modulators. The health care provider has ordered a variety of laboratory assessments on a client who will need estrogen replacement. The follow labs are ordered: blood urea nitrogen (BUN), creatinine, and liver function tests (LFTs). What is the nurse's best statement explaining to a client the need to draw the labs? "The labs will identify your body's ability to filter and excrete medications." Estrogens are used cautiously in a variety of disease processes, including liver impairment. The liver filter or metabolizes medications. The kidneys are the main organ that excretes medications. The nurse is providing a rationale to the client about drawing laboratory assessments. Medication adjustments are based on baseline laboratory values, but this does not explain why labs are needed currently. The health care provider or the nurse can discuss the laboratory assessments when they are completed. Additional labs may be ordered on a future date but teaching is focused on the need for labs currently. Which statements indicate that a client understands the need for a follow-up after the initial injection of medroxyprogesterone? "I know that this injection lasts for 3 months." Long-acting progestin contraceptive preparations such as the intramuscular depot medroxyprogesterone last 3 months per injection; intrauterine progesterone lasts 1 year; and levonorgestrel subcutaneous implants last 5 years. A menopausal client prescribed estrogen asks what the implications of taking the medication are. Which response by the nurse best demonstrates an understanding of the associated implications? "Estrogen increases the risk of certain cancers, myocardial infarctions, and blood clots." The FDA has issued a black box warning that estrogens increase the risk for developing cancer of the uterus. The warning instructs people who take estrogens with or without progestins of the increased risk of dementia, myocardial infarctions, strokes, breast cancer, and blood clot. What statement by the client prescribed a combination contraceptive several months ago indicates a need for health education? "It's good to know that the pill protects against some sexually transmitted infections (STIs)." Oral contraceptives provide no protection against STIs. Effectiveness approaches 100%, and blood pressure monitoring is appropriate and necessary. Health care providers also use oral contraceptive preparations to treat menstrual disorders. A client is receiving estrogen therapy. The nurse would assess the client for which as an adverse reaction? Select all that apply. abdominal bloating Abdominal bloating, breakthrough bleeding, and breast pain are adverse reactions associated with estrogens. Mental depression and insomnia are associated with progestins. The client informs the nurse that she had unprotected intercourse last night. The client is considering requesting emergency postcoital contraception. The nurse's best response is: Emergency contraception is most effective if started within 24 hours and no later than 72 hours after exposure. Plan B (levonorgestrel) is the only emergency contraceptive on the market used to avoid pregnancy after unprotected sexual intercourse. It should be used only as a backup method and is not for routine birth control. Emergency contraception is most effective if started within 24 hours and no later than 72 hours after exposure. The drug is believed to act mainly by inhibiting ovulation; the drug may also have an effect on fertilization and implantation. A client is receiving conjugated estrogens. The nurse would anticipate administering this drug by which route? Oral Conjugated estrogens are administered orally. A client who is taking an estrogen reports swelling and weight gain. The nurse notes some peripheral edema. Which nursing diagnosis would the nurse identify as the priority? Fluid volume excess The client is experiencing fluid retention, which makes this nursing diagnosis appropriate. This nursing diagnosis would be appropriate if the client was experiencing a decreased intake due to nausea and vomiting. Acute pain would be appropriate if the patient was experiencing headache or abdominal cramping. This nursing diagnosis would be appropriate if the patient was experiencing signs and symptoms of a thromboembolic disorder. Which is an adverse effect caused by all uterine stimulants because of their antidiuretic effect? water intoxication Water intoxication is an adverse effect caused by all uterine stimulants because of their antidiuretic effect. Dehydration occurs when the body does not have enough fluid to sustain homeostasis. Hypotension can result in pregnancy with uterine rupture and loss of circulating blood volume. Polydipsia is seen in diabetes as well as pregnancy-induced diabetes. Progestin medications can cause a variety of adverse effects. When assessing for adverse medication effects of drospirenone, what would the nurse assess? Potassium Drospirenone, used in combination contraceptives, has antimineralcorticoid activity and can block aldosterone, leading to increased potassium levels. Edema and weight gain are adverse effects of estrogen medications, and headache and dizziness are adverse effects of estrogen medications on the central nervous system. A nurse is caring for a patient who has been administered menotropins by the intramuscular route for the secretion of sex hormones. The patient reports pain after the drug is injected. Which intervention should the nurse perform for the patient? Rotate sites and examine previous sites for redness. When the patient experiences pain after menotropins are administered by the intramuscular route, the nurse should rotate sites and examine previous sites for redness and irritation. The nurse need not report sore throat, cough, or fever, instruct the patient about proper injection technique, or observe the skin daily for localized signs of infection. The nurse needs to report sore throat, cough, or fever in a patient taking adrenocorticotropic hormones (ACTH). When a patient is receiving growth hormones, the nurse needs to instruct the family members of the patient about the proper injection technique. The nurse needs to observe the skin daily for localized signs of infection in a patient receiving adrenocorticotropic hormones (ACTH).
A postmenopausal woman is administered estradiol for the purpose of preventing which condition? osteoporosis Conjugated estrogens are used to prevent osteoporosis in postmenopausal women. Conjugated estrogens are not administered in postmenopausal women to treat endometriosis, amenorrhea, or uterine cancer. A 27-year-old pregnant woman of 30 weeks' gestation has been administered terbutaline because of the onset of preterm labor. This drug is effective in stopping preterm labor because it: stimulates beta-2 receptors, inhibiting contractility of smooth muscle. Terbutaline is a beta-receptor agonist (stimulant) that selectively prefers the beta-2 receptors over beta-1 receptors. Stimulation of these receptors inhibits contractility of uterine smooth muscle. Terbutaline is not an oxytocin antagonist as it does not directly influence the action of neurotransmitters such as acetylcholine, or electrolytes such as calcium. Kalie, age 18, is prescribed progesterone for the treatment of primary amenorrhea. Which adverse effect would need to be reported immediately to the health care provider? Pain in one leg Pain in one leg could indicate a thrombus formation. Common side effects of progesterone are abnormal menstrual bleeding, including spotting; breast tenderness; and weight gain. The nurse is aware that older men are more prone to urinary tract infections because of what physiologic change related to aging? Enlargement of the prostate Many older men have enlarged prostate glands that compress the urethra and reduce the flow of urine, which makes men more susceptible to urinary tract infection. Reduction in renal function, loss of muscle tone in the pelvic structures, and involuntary contractions of the bladder do not lead to increased urinary tract infections in older men. The nurse is caring for a client who has cancer and who until recently took estrogen. The nurse knows that estrogen may have increased the risk of development of which types of cancer? (Select all that apply.) Breast cancer Estrogen use has been associated with the development of breast and endometrial cancer. A patient is receiving estrogen therapy. What would the nurse instruct the patient to report immediately? Shortness of breath Estrogens are associated with the development of thrombi and emboli. Reports of shortness of breath may indicate a possible pulmonary embolism necessitating emergency treatment. Abdominal bloating, weight gain, and dizziness are common adverse effects of estrogen therapy that should be reported, but it is not necessary to report them immediately. A client asks the nurse about a word they heard from the health care provider. The word was "andropause". The client asks what that is. Which is the nurse's best response? "A gradual change, related to age, that occurs in the testes." Andropause occurs in men and the changes occur gradually. Aging changes in the male reproductive system occur primarily in the testes. Like the ovary, testicular tissue diminishes; what is different between the sexes is that the male sex hormone levels of testosterone remain relatively constant. Andropause is not a medication but a condition that occurs in the body. A client prescribed terazosin asks the nurse how the medication works. Which is the nurse's best statement? "It works by relaxing the smooth muscle of the prostate and the bladder neck." Terazosin is an alpha adrenergic blocker and works by relaxing the smooth muscle of the prostate and the bladder neck. By blocking norepinephrine, the muscles relax, and this allows urine to flow to the bladder. Terazosin does not prevent the conversion of testosterone or stimulates the bladder to void. Terazosin does not affect the desire for sexual relations. A client with an extensive history of using herbal remedies asks the nurse if there is an herbal supplement for the diagnosis of BPH. Which supplement does the nurse provide information on for the treatment of BPH? saw palmetto Saw palmetto is used to relieve the symptoms of BPH, which include urinary frequency, decreased flow of urine, and nocturia. Tea tree is used for a variety of ailments and also has antioxidant properties. Ginger is used for nausea. St. John's wort is used for depression. A 20-year-old college student has presented to the campus medical clinic seeking to begin oral contraceptive therapy. The nurse has recognized the need for adequate health education related to the client's request. The nurse should emphasize the fact that successful prevention of pregnancy depends primarily on the client's: vigilant adherence to the drug regimen. It is necessary to assess each client's need and desire for contraception, as well as her willingness to comply with the prescribed regimen. Compliance is essential for effective contraception. Health status, knowledge, and risk factors are all valid focuses for health education, but these do not primarily determine success of therapy. Medroxyprogesterone acetate is indicated for the treatment of women with: uterine bleeding. Health care providers use progestins to suppress ovarian function in dysmenorrhea, endometriosis, endometrial cancer, and uterine bleeding. Progestins are not normally used to treat cervical cancer, ovarian cancer, and fibromyalgia. A new client telephones the clinic requesting a renewal prescription for contraceptives she has been taking for 4 years. It has been more than a year since her last health care visit, but she is unable to come into the clinic until next month. She insists she is "doing fine" on this medication and must have her prescription now. Considering the circumstances and related safety issues, how should the clinic nurse respond? "Before the drugs are prescribed, a complete medical history, physical examination, Pap test, urinalysis, and weight and blood pressure measurements are recommended." Because estrogens, progestins, and hormonal contraceptives are often taken for years and may cause adverse reactions, clients taking these drugs need continued supervision by a health care provider. Before the drugs are prescribed, a complete medical history; a physical examination including breast and pelvic examinations and a Pap test; urinalysis; and weight and blood pressure measurements are recommended. These examinations should be repeated at least annually if the client is taking the drugs. A client diagnosed with erectile dysfunction has been advised to take sildenafil. For up to how many hours does the action of the drug persist? 4 hours The action of sildenafil persists for 4 hours. The duration of the drug is from 30 minutes to 4 hours before sexual activity. Medical attention should be sought for erections sustained for more than 4 hours. The action of the drug does not persist for 8, 12, or 24 hours. A client is prescribed an alpha-adrenergic blocker for treatment of BPH. When explaining the action of the drug to the client, which information would the nurse integrate into the explanation? relaxation of the smooth muscles Alpha-adrenergic blockers block norepinephrine, allowing the smooth muscle of the prostate and bladder neck to relax and allow urine to flow from the bladder. Androgen hormone inhibitors prevent the conversion of testosterone into the androgen 5-alpha-dihydrotestosterone. Antispasmodics counteract the smooth muscle spasm of the urinary tract by relaxing the detrusor muscle and other muscles through action of the parasympathetic nerve receptors. Phosphodiesterase type 5 inhibitors facilitate the enzyme involved in an erection. Which would the nurse include in a teaching plan about the signs and symptoms of thrombophlebitis and thromboembolism that should be reported by a client taking estrogen? Headaches Pain in the groin, headaches, dizziness, and chest pain are symptoms of thrombophlebitis and thromboembolism, which are two common adverse effects of taking estrogen. Cholestatic jaundice is an adverse effect of estrogen. Amenorrhea is an indication for progesterone therapy. Breast tenderness is an adverse effect of progesterone. On the advice of her sister, a 52-year-old woman has visited her nurse practitioner to discuss the potential benefits of hormone replacement therapy in controlling the symptoms of menopause. Which response by the nurse is most appropriate? "It's important to balance the possible benefits of HRT with the fact that it might increase your risk of heart disease and stroke" Research from the WHI trial indicates that estrogen given to postmenopausal women in combination with progestin significantly increases the risk of stroke and coronary heart disease (CHD). HRT is associated with increased, not decreased, risk of breast cancer and it may complicate early diagnosis of the disease. HRT does not exacerbate low bone density or constitute a risk factor for osteoporosis. The health care provider has ordered oxytocin to be administered via IV pump and titrated until a client's contractions are every 3 minutes. The nurse caring for the client is aware that oxytocin can cause dangerous effects to the CNS, musculoskeletal, and cardiovascular systems of the client. What is the cause of these adverse effects? Water intoxication Oxytocin increases the water permeability of the nephron, which causes more water retention than sodium reabsorption and, in turn, leads to water intoxication. Symptoms of water intoxication primarily affect the CNS and musculoskeletal systems. Oxytocin infusions, when given to a client with autism or Asperger's disorder, result in a significant reduction in repetitive behaviors. Tachysystole and abnormal atrioventricular rhythms are not the cause of adverse effects. When reviewing the history of a patient, which would the nurse identify as a contraindication for the use of progestins? Pelvic inflammatory disease Progestins are contraindicated in patients with pelvic inflammatory disease because progestins affect the vasculature of the uterus. Cautious use is necessary for women with migraine headaches, asthma, and epilepsy due to possible exacerbation of these conditions with the use of progestins. The nurse examines the history of a client prescribed oral contraceptive with estrogen and progestin and should report which as contraindication(s)? Select all that apply. Deep vein thrombosis The nurse should examine the history noting that hypertension is not a contraindication for taking an oral contraceptive. Thromboembolism, including deep vein thrombosis or a pulmonary embolism are contraindications because oral contraceptives increase risks for the formation of blood clots. Primary breast cancer whether it is estrogen dependent or not is a contraindication for taking an oral contraceptive. Any estrogen dependent neoplasm, such as uterine or ovarian is also a contraindication. Any liver disease, or a reduction of the liver function is a contraindication for progestin because the hormone will not be properly metabolized. Migraine is a contraindication for progestin, one of the ingredients of the listed oral contraceptive. A client alerts the nurse she has been in menopause for a couple of months. The nurse teaches the client how menopause occurs. Which statement reflects the teaching has been effective? "Estrogen and progesterone diminish." During menopause, estrogen and progesterone diminish, causing the menstrual cycle to become more irregular and then stop altogether. Symptoms of the decrease in estrogen and progesterone are hot flashes, night sweats, vaginal dryness, and sleep problems. There is not an increase of gonadotropins during menopause. What additional warnings or risks should the nurse include in the teaching plan of a client receiving estrogen? endometrial cancer Warnings associated with the administration of estrogen include an increased risk of endometrial cancer, gallbladder disease, hypertension, hepatic adenoma (a benign tumor of the liver), cardiovascular disease, and thromboembolic disease, and hypercalcemia in those with breast cancer and bone metastases. A menopausal client, prescribed estrogen and progesterone, asks why she should take two different medications. Which explanation best addresses the client's question? When estrogens are used alone, they cause endometrial hyperplasia and may cause endometrial cancer. During menopause, estrogens are prescribed to relieve symptoms of estrogen deficiency and to prevent or treat osteoporosis. When estrogen is prescribed for women with an intact uterus, a progestin is also given to prevent unwanted thickening of the lining of the uterus and to decrease the risk of cancer of the uterus, a possible result of using estrogen alone. Both drug therapies are commonly referred to as hormone replacement therapy (HRT) or menopausal hormone therapy (MHT). None of the other options accurately describe the reason for the prescription of both medications. A 63-year-old woman taking estrogen and progestin for several years has recently changed to estrogen alone. What medical event would prompt such a change in treatment? hysterectomy Women who have an intact uterus should take both estrogen and progestin; the progestin component prevents endometrial cancer, an adverse effect of estrogen-only therapy. Posthysterectomy, women should take estrogen-only medications. None of the other options would require a treatment change. After teaching a woman using an intravaginal estrogen preparation, the nurse determines that the teaching was successful when the client states that she will remain lying for at least how long after instilling the drug? 30 minutes After an intravaginal application, the client should remain in the recumbent position for at least 30 minutes for optimal absorption. Times of 10 and 20 minutes are not the optimal time. The time of 45 minutes does not enhance medication effects. What are the adverse reaction of oxytocin?Oxytocin side effects
a fast, slow, or uneven heart rate; excessive bleeding long after childbirth; severe headache, blurred vision, pounding in your neck or ears; or. confusion, severe weakness, feeling unsteady.
Which adverse effect would the nurse assess for after administering oxytocin to a client to stimulate labor?The main adverse effects of oxytocin are related to uterine hyperstimulation, where there's too much contraction. This could cause painful contractions, and lead to uterine rupture and hemorrhage. It could even restrict placental blood flow, resulting in abnormal fetal heart rate patterns.
What are uterine stimulants?Oxytocin and prostaglandin and their synthetic derivatives are the most commonly used uterine stimulants. They are used to speed up labour, stem bleeding, termination and labour induction but have the risk of uterine hyperstimulation and rupture.
What hormone is a strong stimulant of uterine contractions?The two main actions of oxytocin in the body are contraction of the womb (uterus) during childbirth and lactation. Oxytocin stimulates the uterine muscles to contract and also increases production of prostaglandins, which increase the contractions further.
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Which is an adverse effect caused by all uterine stimulants because of their antidiuretic effect?
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