Question: A multipara is admitted to the birthing room in active labor. Her vital signs are temperature, 98° F; pulse, 70 beats per minute; respirations, 18 per minute; and blood pressure, 126/76. A vaginal examination reveals a cervix that is 90% effaced and 7cm dilated with the vertex presenting at 2+ station. The client is complaining of pain and asks for medication. Which medication should be avoided because it may cause respiratory depression in the newborn?
1. Naloxone (Narcan)
2. Lorazepam (Ativan)
3. Meperidine (Demerol)
4. Promethazine (Phenergan)
Rationale: Meperidine (Demerol) is an opioid that can cause respiratory depression in the neonate if administered less than 4 hours before birth. Naloxone (Narcan) is an opioid antagonist that reverses the effects of respiratory depression in the newborn. Lorazepam (Ativan) is a sedative; it does not cause respiratory depression in the newborn, but it does not relieve pain by itself. Promethazine (Phenergan) is a tranquilizer; it does not cause respiratory depression in the newborn. Promethazine does not relieve pain by itself.
This week’s NCLEX exam practice question came from:
Nugent: Mosby's Review Questions for the NCLEX-RN Exam, 7th Edition, Chapter 4, pg 340, question 468
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