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A nurse is caring for a preterm infant. Upon assessment, the infant has a wide pulse pressure and presence of a machine-like murmur at the left sternal border. She suspects patent ductus arteriosus. Which of the following promote closure of the ductus arteriosus?

Explanation

• Indomethacin is a non-steroidal anti-inflammatory agent that inhibits prostaglandin synthesis.

• One reason why the ductus arteriosus remains open in fetal life is stimulation by prostaglandins, particularly PGE2, from the placenta and the low oxygen level of the fetal blood.

• After birth, when the PGE level falls and the oxygen level increases, the ductus arteriosus is stimulated to close. Medical management for the preterm infant may consist of administration of oral or IV Indomethacin therapy, a prostaglandin inhibitor. This lowers the PGE level and leads to ductus closure.

• Incorrect: Erythromycin and penicillin are antibiotics for rheumatic fever. Digoxin is a cardiac glycoside to strengthen heart action.

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