Editing Maternal and Newborn Nursing – RN Practice Questions (section)

==Question 12==
A nurse is preparing to administer carboprost tromethamine to a postpartum client with refractory uterine atony. Which item in the client's history most requires the nurse to question the order?
# Type 2 diabetes mellitus
# Asthma requiring daily inhaled corticosteroids
# Iron deficiency anemia
# Prior cesarean birth

'''Answer:''' 2 (B). Asthma requiring daily inhaled corticosteroids.

''Rationale:'' Carboprost is a prostaglandin F2-alpha analogue that causes bronchoconstriction and is contraindicated in asthma because it can precipitate severe bronchospasm. Expected adverse effects in any client include diarrhea, nausea, vomiting, fever, and chills, and antidiarrheal premedication is often given. Diabetes (option 1) and anemia (option 3) are not contraindications, and anemia in fact increases the urgency of controlling bleeding. Prior cesarean birth (option 4) raises the risk of atony and abnormal placentation but is not a contraindication to the drug.