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 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.
Correct Answer is D
Explanation
A. Hypertension is not a direct adverse effect of febuxostat; monitoring blood pressure is important but not the primary concern with this medication.
B. Malignant hyperthermia is a rare condition typically associated with certain anesthetic agents and is not related to febuxostat.
C. Steven's Johnson Syndrome is a serious skin reaction that can occur with some medications, but it is not specifically associated with febuxostat.
D. Renal impairment is a known risk with febuxostat, and the nurse should monitor renal function closely, as gout can also be exacerbated by kidney issues and febuxostat is primarily excreted by the kidneys.