Safety and Infection Control Q 11
A primigravida with diabetes is admitted to the labor and delivery unit at 34 weeks gestation. Which doctor’s order should the nurse question?
A. Magnesium sulfate 4gm (25%) IV
B. Brethine 10 mcg IV
C. Stadol 1 mg IV push every 4 hours as needed prn for pain
D. Ancef 2gm IVPB every 6 hours
Correct Answer: B. Brethine 10 mcg IV
Brethine is used cautiously because it raises the blood glucose levels. Terbutaline can cause a temporary increase in the baby’s heart rate and blood sugar levels. These side effects usually aren’t serious and are easy to treat after delivery if they occur. There are concerns about long term use of this drug because the incidence of danger to the baby increases.
Option A: Magnesium sulfate is indicated to prevent seizures associated with pre-eclampsia, and for control of seizures with eclampsia. Magnesium levels must be monitored frequently by checking serum levels every 6 to 8 hours or clinically by following patellar reflexes or urinary output. If serum concentration levels are low, a proper dose of magnesium sulfate can be given parenterally to replete low serum concentrations with recommended follow up laboratory testing.
Option C: Stadol is indicated for labor pain in full-term (37 weeks gestation or more) women without fetal distress in early labor. This medication is used to treat moderate to severe pain, including pain from surgery, muscle pain, and migraine headaches. Butorphanol is an opioid pain reliever similar to morphine. It acts on certain centers in the brain to give pain relief.
Option D: Ancef is generally acceptable for pregnant women. Controlled studies in pregnant women show no evidence of fetal risk. Cefazolin is an antibiotic used to treat a wide variety of bacterial infections. It may also be used before and during certain surgeries to help prevent infection. This medication is known as a cephalosporin antibiotic. It works by stopping the growth of bacteria.