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. While hormonal contraceptives can affect blood pressure, the risk of significant hypertension is less immediate than thromboembolism.
B. Dysfunctional uterine bleeding can occur but is generally not as serious as thromboembolism and may resolve with continued use.
C. Combination birth control pills increase the risk of thromboembolic events, such as deep vein thrombosis (DVT) and pulmonary embolism, making it essential to monitor for signs of these complications.
D. Osteoporosis is a long-term concern but is not an acute effect of combination birth control pills; monitoring for thromboembolism is more critical.