Question 1

Types of IV Fluids

Accepted Answer

Colliods
Crystalloids

Question 2

Colliods are

Accepted Answer

infusion fluids that contain large molecules to keep the infusate in the intravascular space for a long time exerting oncontic pressure (not commonly used

Question 3

Crystalloids are

Accepted Answer

solutions in water of small inorganic ions and small organic molecules.n (NaCl most commonly used)

Question 4

Examples of Crystalloids

Accepted Answer

Hypertonic
Isotonic
Hypotonic

Question 5

Reasons someone might need Parental Therapy (IV)

Accepted Answer

dehydration, Burns severe, NPO status,

Question 6

Types of PERT

Accepted Answer

Protease, Lipase, amylase

Question 7

What determines the type of PERT a perosn receives?

Accepted Answer

Based on client need, condition, age, gender and diet

Question 8

Balanced Anesthesia is

Accepted Answer

Also called multimodal due to combo of drugs to achieve physiological and pharmacological  equilibrium

Question 9

Balanced anesthesia causes

Accepted Answer

Amnesia , analgesia, hypnosis, muscle relaxation or immobility

5 drug classes are used

Question 10

Three phases of general anesthesia

Accepted Answer

Induction.  Maintenance and emergence

Question 11

polyenes(Amphotericin)

Accepted Answer

binds to fungal cell membrane-used for severe fungal infections

Question 12

Adverse effects of Polyenes

Accepted Answer

GI bleeding , Kidney failure Leuko/thhromcytopenia, hypokalemia/magnesemia/natremia

Question 13

Nursing implications

Accepted Answer

Need culture prior to administration, no need to wait for culture results
Monitor for phlebitis
premedicate asprin,antihistimes and antiemtics

Question 14

Azoles

Accepted Answer

fluconazole(Diflucan

Question 15

Purpose of Azoles

Accepted Answer

produce a fungicidal/fungistatic effect

Question 16

Adverse reactions of azoles

Accepted Answer

Increase liver enzymes Hepatotoxcity,Alopecia(long-term use Skin rash

Question 17

Patient education on Azoles

Accepted Answer

Avoid potted plants, fresh flowers adhesive, kidney and liver labs ,small meals to prevent nausea/vomit, report skin rashes and urinary changes

Question 18

Erythropoietin stimulating agents

Accepted Answer

epoetin and procrit

Question 19

Patient teaching for erythropoietin drugs

Accepted Answer

Need iron to be effective ( supplement)
ReportCP, Sob. Signs of Cva
Regular dosing needed and labs

Question 20

Inhibits viral replication
Approved for 12 or older; weigh > 40kg
Do not crush or chew
Reduce dosage for renal patients
Do not double the dose

Accepted Answer

Definition: Inhibits bacterial growth and reproduction without directly killing the bacteria.
Mechanism: Interferes with protein synthesis, DNA replication, or metabolism.
Examples: Macrolides, tetracyclines, sulfonamides.

Question 21

Bactericidal

Accepted Answer

Definition: Directly kills bacteria.
Mechanism: Disrupts cell wall synthesis, damages cell membranes, or interferes with essential enzymes.
Examples: Penicillins, cephalosporins, fluoroquinolones.

Question 22

Macrolides   Prototype: erythromycin (end in –thromycin

Accepted Answer

Respiratory infections
STD’s
Helicobacter pylori

Question 23

Why can pregnant patients need different drug doses than non-pregnant patients?

Accepted Answer

↑ blood volume/cardiac output (dilution), ↑ body fat (wider distribution/longer storage), altered protein binding (more free drug), ↑ renal blood flow early (↑ excretion), possible ↓ renal flow late (↓ excretion), ↑ hormones (↑ metabolism/clearance).

Question 24

What’s the fetal risk of most drugs crossing the placenta early vs late?

Accepted Answer

Organogenesis (early) → teratogenic risk; 2nd/3rd trimester → neonatal effects after birth; brain is vulnerable any time. Use only if clearly needed, weigh risk/benefit.

Question 25

Why do fetal drug effects last longer?

Accepted Answer

Slow fetal liver metabolism, slow renal excretion, easy BBB passage; ~½ of fetal drug returns to maternal circulation for metabolism.

Question 26

First-line for GERD in pregnancy?

Accepted Answer

Non-pharmacologic (elevation/smaller meals); can add antacids or sucralfate if needed.

Question 27

Preferred treatment for GDM because it does not cross the placenta?

Accepted Answer

Insulin.

Question 28

GBS screening timing and first-line intrapartum antibiotic?

Accepted Answer

36–37.5 weeks; penicillin is drug of choice.

Question 29

Antihypertensives you’ll see in pregnancy? What prevents seizures?

Accepted Answer

Nifedipine, hydralazine, labetalol for BP; magnesium sulfate for seizure prophylaxis with calcium gluconate on hand as antidote.

Question 30

Indomethacin—when is it used and what’s the gestational age limit?

Accepted Answer

NSAID tocolytic; avoid after 32 weeks and limit to ≤48 hours due to ductus arteriosus constriction and oligohydramnios risk. Maternal AE: GI upset, ↑ bleeding.

Question 31

Nifedipine—major caution and who should not get it?

Accepted Answer

: Hypotension (may ↓ uteroplacental flow), worse if combined with IV magnesium; avoid in hemodynamic instability or significant cardiovascular disease.

Question 32

Terbutaline—what maternal/fetal effects require close monitoring?

Accepted Answer

Maternal: tachycardia, palpitations, tremor, hypokalemia, hyperglycemia, pulmonary edema. Fetal: tachycardia, neonatal hypoglycemia. Avoid with hyperthyroidism/diabetes, placenta previa/abruption; limit 48–72 h

Question 33

Magnesium sulfate as a tocolytic—key safety steps?

Accepted Answer

Follow unit protocol for serum Mg, monitor reflexes/respirations, watch for hyporeflexia/resp depression/fetal bradycardia; keep calcium gluconate available. Contraindicated in myasthenia gravis, cardiac compromise; reduce dose in kidney disease

Question 34

Induction/Cervical ripening  Dinoprostone (PGE2)—how used and top contraindications?

Accepted Answer

Gel/vaginal insert for cervical ripening (also suppository abortifacient). Contra: prior cesarean/uterine surgery, CPD, fetal distress, VB. AE: back pain, abnormal uterine contractions, GI upset/fever. Oxytocin may start 30 min after insert removal or 6–1

Question 35

Misoprostol (PGE1)—key safety timing and two big cautions?

Accepted Answer

Unlabeled for ripening/induction; wait 4 hours from last dose before starting oxytocin. Avoid in prior cesarean/uterine surgery due to hyperstimulation/rupture risk.

Question 36

Oxytocin—primary use and three situations it’s contraindicated?

Accepted Answer

Induction/augmentation to create rhythmic ctx. Contra: fetal distress, unfavorable malpresentation/position, hypertonic uterus, CPD, or emergencies better for C/S. Maternal AE: dysrhythmias, HTN, N/V, excessive stimulation; Fetal AE: bradycardia/arrhythmi

Question 37

Non-reassuring FHR with tachysystole on oxytocin—what’s your sequence?

Accepted Answer

Stop oxytocin, reposition, IV bolus, evaluate BP/sterile exam, O₂ per order, notify provider; consider tocolysis if needed. (Principle applied to oxytocin AEs.)

Question 38

Uterotonics (for PPH) Carboprost (PGF2α)—when used, key contraindications, and frequent AE?

Accepted Answer

: For PPH control by stimulating strong uterine contractions. Contra: prostaglandin allergy, acute PID, pulmonary/hepatic/renal/cardiac disease. AE: GI upset (N/V/diarrhea), wheezing (bronchospasm)

Question 39

Uterotonics (for PPH) Methylergonovine—what condition makes it unsafe?

Accepted Answer

Hypertension (ergots can raise BP); screen BP before giving. (Listed with uterotonics in your slide.)

Question 40

On Mg infusion, RR 10/min and absent DTRs—what do you do now?

Accepted Answer

Stop Mg, support airway/O₂, give calcium gluconate per protocol, notify provider. (Safety measures emphasized in slide.)

Question 41

31-week PTL; provider orders indomethacin. What two fetal risks guide the time limit and GA cutoff?

Accepted Answer

DA constriction and oligohydramnios → ≤48 h use and avoid after 32 wks.

Question 42

Starting nifedipine tocolysis; patient has cardiomyopathy. Safe or not?

Accepted Answer

Not safe—avoid in CVD/hemodynamic instability; risk of profound hypotension ↓ uterine perfusion.

Question 43

Terbutaline given; mother now tachycardic and tremulous. What labs/assessments

Accepted Answer

: Check K⁺ (hypokalemia), glucose (hyperglycemia), lung sounds (pulmonary edema), FHR (fetal tachy). Limit duration 48–72 h.

Question 44

Cervix unfavorable; plan dinoprostone then oxytocin. How do you time oxytocin?

Accepted Answer

30 minutes after vaginal insert removal or 6–12 hours after final gel dose.

Question 45

Prior low-transverse C/S—which cervical ripener is contraindicated?

Accepted Answer

Misoprostol (also avoid other prostaglandins depending on policy). Use mechanical/other strategies.

Question 46

Post-delivery heavy bleeding; asthmatic patient. Which uterotonic should you avoid?

Accepted Answer

Carboprost (risk of bronchospasm/wheezing). Choose an alternative. 

N2362 Reproduction I (1)

Question 47

GBS positive in labor—what key med and why?

Accepted Answer

Penicillin to reduce early-onset neonatal GBS infection; screen at 36–37.5 wks

Question	Answer
Types of IV Fluids	Colliods Crystalloids
Colliods are	infusion fluids that contain large molecules to keep the infusate in the intravascular space for a long time exerting oncontic pressure (not commonly used
Crystalloids are	solutions in water of small inorganic ions and small organic molecules.n (NaCl most commonly used)
Examples of Crystalloids	Hypertonic Isotonic Hypotonic
Reasons someone might need Parental Therapy (IV)	dehydration, Burns severe, NPO status,
What is Pancrelipase?
Types of PERT	Protease, Lipase, amylase
What determines the type of PERT a perosn receives?	Based on client need, condition, age, gender and diet
Balanced Anesthesia is	Also called multimodal due to combo of drugs to achieve physiological and pharmacological equilibrium
Balanced anesthesia causes	Amnesia , analgesia, hypnosis, muscle relaxation or immobility 5 drug classes are used
Three phases of general anesthesia	Induction. Maintenance and emergence
Suboxone
Naltrexone
Disulfiram
polyenes(Amphotericin)	binds to fungal cell membrane-used for severe fungal infections
Adverse effects of Polyenes	GI bleeding , Kidney failure Leuko/thhromcytopenia, hypokalemia/magnesemia/natremia
Nursing implications	Need culture prior to administration, no need to wait for culture results Monitor for phlebitis premedicate asprin,antihistimes and antiemtics
Azoles	fluconazole(Diflucan
Purpose of Azoles	produce a fungicidal/fungistatic effect
Adverse reactions of azoles	Increase liver enzymes Hepatotoxcity,Alopecia(long-term use Skin rash
Patient education on Azoles	Avoid potted plants, fresh flowers adhesive, kidney and liver labs ,small meals to prevent nausea/vomit, report skin rashes and urinary changes
Erythropoietin stimulating agents	epoetin and procrit
Patient teaching for erythropoietin drugs	Need iron to be effective ( supplement) ReportCP, Sob. Signs of Cva Regular dosing needed and labs
Inhibits viral replication Approved for 12 or older; weigh > 40kg Do not crush or chew Reduce dosage for renal patients Do not double the dose	Definition: Inhibits bacterial growth and reproduction without directly killing the bacteria. Mechanism: Interferes with protein synthesis, DNA replication, or metabolism. Examples: Macrolides, tetracyclines, sulfonamides.
Bactericidal	Definition: Directly kills bacteria. Mechanism: Disrupts cell wall synthesis, damages cell membranes, or interferes with essential enzymes. Examples: Penicillins, cephalosporins, fluoroquinolones.
Macrolides Prototype: erythromycin (end in –thromycin	Respiratory infections STD’s Helicobacter pylori
Why can pregnant patients need different drug doses than non-pregnant patients?	↑ blood volume/cardiac output (dilution), ↑ body fat (wider distribution/longer storage), altered protein binding (more free drug), ↑ renal blood flow early (↑ excretion), possible ↓ renal flow late (↓ excretion), ↑ hormones (↑ metabolism/clearance).
What’s the fetal risk of most drugs crossing the placenta early vs late?	Organogenesis (early) → teratogenic risk; 2nd/3rd trimester → neonatal effects after birth; brain is vulnerable any time. Use only if clearly needed, weigh risk/benefit.
Why do fetal drug effects last longer?	Slow fetal liver metabolism, slow renal excretion, easy BBB passage; ~½ of fetal drug returns to maternal circulation for metabolism.
First-line for GERD in pregnancy?	Non-pharmacologic (elevation/smaller meals); can add antacids or sucralfate if needed.
Preferred treatment for GDM because it does not cross the placenta?	Insulin.
GBS screening timing and first-line intrapartum antibiotic?	36–37.5 weeks; penicillin is drug of choice.
Antihypertensives you’ll see in pregnancy? What prevents seizures?	Nifedipine, hydralazine, labetalol for BP; magnesium sulfate for seizure prophylaxis with calcium gluconate on hand as antidote.
Indomethacin—when is it used and what’s the gestational age limit?	NSAID tocolytic; avoid after 32 weeks and limit to ≤48 hours due to ductus arteriosus constriction and oligohydramnios risk. Maternal AE: GI upset, ↑ bleeding.
Nifedipine—major caution and who should not get it?	: Hypotension (may ↓ uteroplacental flow), worse if combined with IV magnesium; avoid in hemodynamic instability or significant cardiovascular disease.
Terbutaline—what maternal/fetal effects require close monitoring?	Maternal: tachycardia, palpitations, tremor, hypokalemia, hyperglycemia, pulmonary edema. Fetal: tachycardia, neonatal hypoglycemia. Avoid with hyperthyroidism/diabetes, placenta previa/abruption; limit 48–72 h
Magnesium sulfate as a tocolytic—key safety steps?	Follow unit protocol for serum Mg, monitor reflexes/respirations, watch for hyporeflexia/resp depression/fetal bradycardia; keep calcium gluconate available. Contraindicated in myasthenia gravis, cardiac compromise; reduce dose in kidney disease
Induction/Cervical ripening Dinoprostone (PGE2)—how used and top contraindications?	Gel/vaginal insert for cervical ripening (also suppository abortifacient). Contra: prior cesarean/uterine surgery, CPD, fetal distress, VB. AE: back pain, abnormal uterine contractions, GI upset/fever. Oxytocin may start 30 min after insert removal or 6–1
Misoprostol (PGE1)—key safety timing and two big cautions?	Unlabeled for ripening/induction; wait 4 hours from last dose before starting oxytocin. Avoid in prior cesarean/uterine surgery due to hyperstimulation/rupture risk.
Oxytocin—primary use and three situations it’s contraindicated?	Induction/augmentation to create rhythmic ctx. Contra: fetal distress, unfavorable malpresentation/position, hypertonic uterus, CPD, or emergencies better for C/S. Maternal AE: dysrhythmias, HTN, N/V, excessive stimulation; Fetal AE: bradycardia/arrhythmi
Non-reassuring FHR with tachysystole on oxytocin—what’s your sequence?	Stop oxytocin, reposition, IV bolus, evaluate BP/sterile exam, O₂ per order, notify provider; consider tocolysis if needed. (Principle applied to oxytocin AEs.)
Uterotonics (for PPH) Carboprost (PGF2α)—when used, key contraindications, and frequent AE?	: For PPH control by stimulating strong uterine contractions. Contra: prostaglandin allergy, acute PID, pulmonary/hepatic/renal/cardiac disease. AE: GI upset (N/V/diarrhea), wheezing (bronchospasm)
Uterotonics (for PPH) Methylergonovine—what condition makes it unsafe?	Hypertension (ergots can raise BP); screen BP before giving. (Listed with uterotonics in your slide.)
On Mg infusion, RR 10/min and absent DTRs—what do you do now?	Stop Mg, support airway/O₂, give calcium gluconate per protocol, notify provider. (Safety measures emphasized in slide.)
31-week PTL; provider orders indomethacin. What two fetal risks guide the time limit and GA cutoff?	DA constriction and oligohydramnios → ≤48 h use and avoid after 32 wks.
Starting nifedipine tocolysis; patient has cardiomyopathy. Safe or not?	Not safe—avoid in CVD/hemodynamic instability; risk of profound hypotension ↓ uterine perfusion.
Terbutaline given; mother now tachycardic and tremulous. What labs/assessments	: Check K⁺ (hypokalemia), glucose (hyperglycemia), lung sounds (pulmonary edema), FHR (fetal tachy). Limit duration 48–72 h.
Cervix unfavorable; plan dinoprostone then oxytocin. How do you time oxytocin?	30 minutes after vaginal insert removal or 6–12 hours after final gel dose.
Prior low-transverse C/S—which cervical ripener is contraindicated?	Misoprostol (also avoid other prostaglandins depending on policy). Use mechanical/other strategies.
Post-delivery heavy bleeding; asthmatic patient. Which uterotonic should you avoid?	Carboprost (risk of bronchospasm/wheezing). Choose an alternative. N2362 Reproduction I (1)
GBS positive in labor—what key med and why?	Penicillin to reduce early-onset neonatal GBS infection; screen at 36–37.5 wks

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