A nurse is caring for a client who is currently 34-weeks gestation. Which of the following medications would be avoided due to its category X classification?
morphine
famotidine (Pepcid)
misoprostol (Cytotec)
ibuprofen (Advil)
The Correct Answer is C
A. Morphine is a category C medication, which means it may be used if the benefits outweigh the risks; it is not contraindicated in pregnancy.
B. Famotidine (Pepcid) is also a category B medication and is generally considered safe to use during pregnancy.
C. Misoprostol (Cytotec) is classified as category X due to its association with causing uterine contractions and the potential for fetal harm; thus, it should be avoided during pregnancy.
D. Ibuprofen (Advil) is a category C medication, and while it is not typically recommended in the third trimester, it is not classified as category X.
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Correct Answer is A
Explanation
A. Hypokalemia increases the risk of digoxin toxicity because low potassium levels enhance digoxin's effects on the myocardium. Monitoring and correcting potassium levels is essential in clients on digoxin.
B. Hypophosphatemia is not directly linked to digoxin toxicity and is not a primary concern.
C. Hypocalcemia does not increase the risk of digoxin toxicity; in fact, hypercalcemia would be more concerning in terms of potential toxicity.
D. Hypernatremia does not have a significant effect on digoxin toxicity, so it is not a primary concern when assessing this medication’s safety.
Correct Answer is C
Explanation
A. PT/INR is not the appropriate measure for heparin therapy, as heparin is monitored using activated partial thromboplastin time (aPTT). This response could mislead the client regarding treatment expectations.
B. While it may take time to reach therapeutic levels, this statement doesn't clarify that heparin is not a clot-dissolving agent.
C. Heparin prevents the extension of existing clots and the formation of new clots but does not actively dissolve clots already present.
D. This statement incorrectly suggests that immediate effects are seen, which is not the case as heparin's action involves prevention rather than dissolution.