Question 1

A woman who is 2 months pregnant tells the nurse that she has never received the MMR vaccine and has not had these diseases.She has a 3-year-old and a 5-year-old child who have not been immunized.The nurse will counsel the patient to perform which action?

Accepted Answer

Pregnant women should not receive MMR vaccine because it is a live virus and there is risk to the fetus.Her children should be vaccinated so they do not contract rubella and pass it to her.

Question 2

The nurse is caring for a postpartal woman and reviews the following lab results in her medical record: HBsAg-negative,rubella titer less than 1:8/1:10,Rh-negative with Rh-positive infant.Which injections will the nurse expect to be ordered?

Accepted Answer

The woman needs RhoGAM today and will need an MMR since her rubella titer is low.Because it is a live vaccine,the MMR should be given in 3 months.She does not need hepatitis B immune globulin.

Question 3

The nurse has just administered Rh?(D)immune globulin (RhoGAM)to a postpartal woman.What information will the nurse include when teaching this patient?

Accepted Answer

Patients receiving Rh?(D)immune globulin should be cautioned to avoid live vaccines for 3 months.Patients can experience hypersensitivity reactions to the immune globulin,and Rh?(D)immune globulin crosses into breast milk.Women will need to have the immune globulin with future deliveries if the infant is Rh-positive.

Question 4

The nurse is instructing a nursing student who will administer erythromycin ophthalmic ointment and phytonadione (vitamin K)injection to a newborn infant.The nurse will instruct the student to perform which action?

Accepted Answer

Erythromycin ointment should be applied in a 1-cm ribbon along the lower lid.The ointment should be administered first,since the injection may cause the infant to cry.The ointment should not be placed in the warmer.

Question 5

The nurse is caring for a postpartal patient who has just delivered her first baby by caesarean section.The mother's blood type is Rh-negative,and the infant's blood type is Rh-positive.The provider has ordered human D immune globulin (RhoGAM).The nurse understands that this patient will need

Accepted Answer

For women with abruption,previa,caesarean births,or manual placental removal,more than 15 mL of fetal-maternal hemorrhage of Rh-positive red blood cells may have occurred,necessitating an increased dose of D immune globulin.

Question 6

The nurse tells a postpartal woman that her baby will need hepatitis B vaccine.The mother says she does not want her baby to have a shot and refuses to sign the consent.The nurse will

Accepted Answer

Although hepatitis B vaccine is recommended,patients have a right to refuse.The refusal should be documented in the mother's and baby's chart.The nurse should never administer the vaccine without consent.Telling the mother that she will harm her baby if she does not consent is coercive.The vaccine is recommended and is required for admission to schools,but parents still have a right to refuse.

Question 7

When teaching a postpartal patient about the use of mineral oil as a laxative,the nurse will explain that mineral oil

Accepted Answer

Mineral oil should be given with fruit juice or soda to disguise the taste.It can be aspirated,causing aspiration pneumonia-a serious side effect.It should not be taken with food and should not be taken with other laxatives.

Question 8

The nurse provides teaching for a postpartal woman who will take bisacodyl tablets to help with constipation.What information will the nurse include when teaching this patient about this medication?

Accepted Answer

Bisacodyl tablets should be stored in a cool,dry place.They should not be crushed.It is not necessary to give with a carbonated beverage.Bisacodyl tablets should not be taken within 1 to 2 hours of milk or antacid.

Question 9

The nurse is caring for a postpartum woman who has chosen not to breastfeed her infant.She asks why she cannot use drugs to suppress lactation.Which response by the nurse is correct?

Accepted Answer

Estrogenic drug therapy is less common than in the past because of the increased risk of thrombophlebitis.They are more effective than complementary drugs.They do not increase constipation or promote uterine atony.

Question 10

A woman who has just delivered her infant observes the nurse administering ophthalmic ointment into her infant's eyes,and she asks why this is being done.The nurse will explain that this ointment is given for which purpose?

Accepted Answer

To prevent the risk of infection,infants are treated with erythromycin ophthalmic ointment.Chemical conjunctivitis may occur in 20% of infants as an adverse effect of the drug.It is not used as a moisturizer.It is given as prophylaxis not treatment.

Question 11

The nurse is caring for a newborn infant whose mother is HBsAg-negative.The nurse expects to give the infant

Accepted Answer

Infants whose mothers are HBsAg-negative will need to receive recombinant hepatitis B vaccine.Immune globulin is given to infants whose mother's status is unknown or who are positive.All infants receive the hepatitis B vaccine.

Quiz 55: Postpartum and Newborn Drugs