When administering indomethacin to a premature infant who has patent ductus arteriosus, the nurse should anticipate which outcome?
A.
Increased number of red blood cells.
B.
Increased respiratory effort.
C.
Decreased cardiac murmur.
D.
Decreased urinary output
The correct answer and Explanation is :
The correct answer is C. Decreased cardiac murmur.
Explanation:
Indomethacin is a nonsteroidal anti-inflammatory drug (NSAID) often used in neonates to treat patent ductus arteriosus (PDA), a condition where the ductus arteriosus—a blood vessel that connects the pulmonary artery to the aorta in fetal circulation—fails to close after birth. In full-term infants, this duct normally closes shortly after birth, but in premature infants, it can remain open, leading to potential complications such as heart failure and respiratory distress.
Indomethacin works to close the PDA by inhibiting prostaglandin E2 synthesis. Prostaglandin E2 is a substance that helps keep the ductus arteriosus open, so by reducing its levels, indomethacin encourages the ductus to close.
Outcome: Decreased Cardiac Murmur
When the PDA is patent, it often produces a characteristic “machinery-like” heart murmur due to the abnormal blood flow between the aorta and pulmonary artery. Administering indomethacin should lead to a reduction in the PDA size or closure, which typically results in a decrease or disappearance of this murmur.
Other Options:
- Increased Number of Red Blood Cells: Indomethacin does not directly influence red blood cell production or count. Thus, an increase in red blood cells is not a typical outcome of indomethacin treatment for PDA.
- Increased Respiratory Effort: Indomethacin is used to manage PDA and may improve respiratory effort if it successfully closes the ductus. However, increased respiratory effort is not an expected direct outcome of indomethacin; rather, decreased respiratory distress is more likely if the treatment is successful.
- Decreased Urinary Output: Indomethacin may affect renal function, but decreased urinary output is not a primary or expected outcome directly related to its use in treating PDA. Monitoring of renal function is important, but it is not the primary indicator of therapeutic success.
In summary, the main anticipated outcome of administering indomethacin to a premature infant with PDA is a decreased cardiac murmur, reflecting the closure or reduction in size of the patent ductus arteriosus.