Question

1. a patient taking oral contraceptives complains of shortness of breath, chest pain, and a mild elevation in blood pressure. What advice should be given by the nurse?

1. 1. “The symptoms you describe are normal side effects of oral contraceptives.”
   2. “ Go to the Emergency Room immediately.”
   3. Stop taking the contraceptives and come in to have your prescription changed by the nurse.”
   4. “Continue taking the contraceptives and the symptoms will go away in the next month or two.”
2. which of the following should the nurse do before starting Pitocin induction?
3. 1. Administer a 500cc bolus of IV fluid to prevent hypotension
   2. Perform an ultrasound to determine fetal size.
   3. Monitor contractions to determine the need for Pitocin.
   4. Monitor fetal heart rate pattern to determine fetal well-being.

Answer 1

ANSWERS :

1.The patient taking oral contraceptive pills complaining of chest pain ,shortness of breath and a mild elevation of blood pressure should "Go to Emergency Room immediately"(option B)

Reason : Shortness of breath and chest pain are the dangerous symptoms of severe side effects of contraceptive pills.

Adverse side effects are :

• Pulmonary embolism.
• Deep vein thrombosis.
• Stroke or heart attack.

Other options :

a) Normal sideeffects of contraceptive pills :

• Nausea
• Headache
• Breast tenderness
• Mood changes
• Decreased libido
• Weight gain

c)Stopping and changing the contraceptive pills will not revert back the symptoms of pulmonary embolism or stroke.

d)Continuing the contraceptive pills without taking medical attention can worsen her condition.

2.Before starting pitocin induction nurse should "monitor fetal heart rate pattern to determine fetal well being".(option D)

Reason : Electronic fetal monitoring should be done prior to induction so that if there is any abnormal fetal heart patterns in the cardiotochogram the pitocin induction can be withheld or stopped.If fetal heart rate abnormality persists pitocin induction is contraindicated.

Other options :

a)IV fluid administration prior to induction is not mandatory for every patient.It is needed depending on the blood pressure of the patient and pitocin titration.

b)Fetal size or weight will be assessed by gynaecologist by ultrasound during the prior antenatal checkup itself.

c)Uterine contractions should be monitored prior to pitocin acceleration rather than pitocin induction.