Chapter 10: Complications of Pregnancy
53 Questions
1 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

A patient with preeclampsia is being treated with bed rest and intravenous magnesium sulfate. The drug classification of this medication is a

  • tocolytic.
  • anticonvulsant. (correct)
  • antihypertensive.
  • diuretic.
  • Which clinical intervention is the only known cure for preeclampsia?

  • Delivery of the fetus (correct)
  • Administration of aspirin (ASA) every day of the pregnancy
  • Magnesium sulfate
  • Antihypertensive medications
  • The clinic nurse is performing a prenatal assessment on a pregnant patient at risk for preeclampsia. Which clinical sign would not present as a symptom of preeclampsia?

  • Proteinuria
  • Glucosuria (correct)
  • Edema
  • Hypertension
  • Which intrapartal assessment should be avoided when caring for a patient with HELLP syndrome?

    <p>Abdominal palpation</p> Signup and view all the answers

    A nurse is explaining to the nursing students working on the antepartum unit how to assess for edema. Which edema assessment score indicates edema of the lower extremities, face, hands, and sacral area?

    <p>+3</p> Signup and view all the answers

    Which maternal condition always necessitates delivery by cesarean birth?

    <p>Total placenta previa</p> Signup and view all the answers

    Spontaneous termination of a pregnancy is considered to be an abortion if

    <p>the pregnancy is less than 20 weeks.</p> Signup and view all the answers

    An abortion when the fetus dies but is retained in the uterus is called

    <p>missed.</p> Signup and view all the answers

    A placenta previa when the placental edge just reaches the internal os is called

    <p>marginal.</p> Signup and view all the answers

    Which finding would indicate concealed hemorrhage in abruptio placentae?

    <p>Hard boardlike abdomen</p> Signup and view all the answers

    The priority nursing intervention when admitting a pregnant patient who has experienced a bleeding episode in late pregnancy is to

    <p>assess fetal heart rate and maternal vital signs.</p> Signup and view all the answers

    A patient with preeclampsia is admitted complaining of pounding headache, visual changes, and epigastric pain. Nursing care is based on the knowledge that these signs indicate

    <p>worsening disease and impending convulsion.</p> Signup and view all the answers

    Rh incompatibility can occur if the patient is Rh-negative and the

    <p>fetus is Rh-positive.</p> Signup and view all the answers

    In which situation would a dilation and curettage (D&C) be indicated?

    <p>Incomplete abortion at 10 weeks</p> Signup and view all the answers

    Which data found on a patient’s health history would place her at risk for an ectopic pregnancy?

    <p>Recurrent pelvic infections</p> Signup and view all the answers

    Which finding on a prenatal visit at 10 weeks might suggest a hydatidiform mole?

    <p>Fundal height measurement of 18 cm</p> Signup and view all the answers

    Which routine nursing assessment is contraindicated for a patient admitted with suspected placenta previa?

    <p>Determining cervical dilation and effacement</p> Signup and view all the answers

    A laboratory finding indicative of DIC is one that shows

    <p>decreased fibrinogen.</p> Signup and view all the answers

    Which assessment in a patient diagnosed with preeclampsia who is taking magnesium sulfate would indicate a therapeutic level of medication?

    <p>Normal deep tendon reflexes</p> Signup and view all the answers

    A patient taking magnesium sulfate has a respiratory rate of 10 breaths per minute. In addition to discontinuing the medication, which action should the nurse take?

    <p>Administer calcium gluconate.</p> Signup and view all the answers

    A 32-year-old primigravida is admitted with a diagnosis of ectopic pregnancy. Nursing care is based on which of the following?

    <p>Hemorrhage is the primary concern.</p> Signup and view all the answers

    A patient who was pregnant had a spontaneous abortion at approximately 4 weeks’ gestation. At the time of the miscarriage, it was thought that all products of conception were expelled. Two weeks later, the patient presents at the clinic office complaining of “crampy” abdominal pain and a scant amount of serosanguineous vaginal drainage with a slight odor. The pregnancy test is negative. Vital signs reveal a temperature of 100F, with blood pressure of 100/60 mm Hg, irregular pulse 88 beats/minute (bpm), and respirations, 20 breaths per minute. Based on this assessment data, what does the nurse anticipate as a clinical diagnosis?

    <p>Uterine infection</p> Signup and view all the answers

    A patient with no prenatal care delivers a healthy male infant via the vaginal route, with minimal blood loss. During the labor period, vital signs were normal. At birth, significant maternal hypertension is noted. When the patient is questioned, she relates that there is history of heart disease in her family; but, that she has never been treated for hypertension. Blood pressure is treated in the hospital setting and the patient is discharged. The patient returns at her scheduled 6-week checkup and is found to be hypertensive. Which type of hypertension is the patient is exhibiting?

    <p>Undiagnosed chronic hypertension</p> Signup and view all the answers

    A high-risk labor patient progresses from preeclampsia to eclampsia. Aggressive management is instituted, and the fetus is delivered via cesarean birth. Which finding in the immediate postoperative period indicates that the patient is at risk of developing HELLP syndrome?

    <p>Platelet count of 50,000/mcL</p> Signup and view all the answers

    As the triage nurse in the emergency room, you are reviewing results for the high-risk obstetric patient who is in labor because of traumatic injury experienced as a result of a motor vehicle accident (MVA). You note that the Kleihauer–Betke test is positive. Based on this information, you anticipate that

    <p>immediate birth is required.</p> Signup and view all the answers

    A patient who had premature rupture of the membranes (PROM) earlier in the pregnancy at 28 weeks returns to the labor unit 1 week later complaining that she is now in labor. The labor and birth nurse performs the following assessments. The vaginal exam is deferred until the physician is in attendance. The patient is placed on electronic fetal monitoring (EFM) and a baseline FHR of 130 bpm is noted. No contraction pattern is observed. The patient is then transferred to the antepartum unit for continued observation. Several hours later, the patient complains that she does not feel the baby move. Examination of the abdomen reveals a fundal height of 34 cm. Muscle tone is no different from earlier in the hospital admission. The patient is placed on the EFM and no fetal heart tones are observed. What does the nurse suspect is occurring?

    <p>Hidden placental abruption</p> Signup and view all the answers

    What is the priority nursing intervention for the patient who has had an incomplete abortion?

    <p>Insertion of IV line for fluid replacement</p> Signup and view all the answers

    Which finding in the assessment of a patient following an abruption placenta could indicate a major complication?

    <p>Bleeding at IV insertion site</p> Signup and view all the answers

    Which assessment by the nurse would differentiate a placenta previa from an abruptio placentae?

    <p>Pain level 0 on a scale of 0 to 10</p> Signup and view all the answers

    A blood-soaked peripad weighs 900g. The nurse would document a blood loss of mL.

    <p>900</p> Signup and view all the answers

    Which intervention is the priority for the patient diagnosed with an intact tubal pregnancy?

    <p>Administration of methotrexate</p> Signup and view all the answers

    Which finding in the exam of a patient with a diagnosis of threatened abortion would change the diagnosis to inevitable abortion?

    <p>Clear fluid from vagina</p> Signup and view all the answers

    What should the nurse recognize as evidence that the patient is recovering from preeclampsia?

    <p>Urine output &gt;100 mL/hour</p> Signup and view all the answers

    Fraternal twins are delivered by your Rh-negative patient. Twin A is Rh-positive and twin B is Rh-negative. Prior to administering Rho(D) immune globulin (RhoGAM), the nurse should determine the results of the

    <p>indirect Coombs test of the mother.</p> Signup and view all the answers

    For the patient who delivered at 6:30 AM on January 10, Rho(D) immune globulin (RhoGAM) must be administered prior to

    <p>6:30 AM on January 13.</p> Signup and view all the answers

    The labor and birth nurse is reviewing the risk factors for placenta previa with a group of nursing students. The nurse determines that the students understood the discussion when they identify which patient being at the highest risk for developing a placenta previa?

    <p>Male fetus, African American, previous cesarean birth</p> Signup and view all the answers

    A labor and birth nurse receives a call from the laboratory regarding a preeclamptic patient receiving an IV infusion of magnesium sulfate. The laboratory technician reports that the patient’s magnesium level is 7.6 mg/dL. What is the nurse’s priority action?

    <p>Assess the patient’s respiratory rate.</p> Signup and view all the answers

    Which factor is most important in diminishing maternal, fetal, and neonatal complications in a pregnant patient with diabetes?

    <p>Degree of glycemic control before and during the pregnancy</p> Signup and view all the answers

    Which major neonatal complication is carefully monitored after the birth of the infant of a diabetic mother?

    <p>Hypoglycemia</p> Signup and view all the answers

    Which factor is known to increase the risk of gestational diabetes mellitus?

    <p>Previous birth of large infant</p> Signup and view all the answers

    Which disease process improves during pregnancy?

    <p>Rheumatoid arthritis</p> Signup and view all the answers

    Nursing intervention for pregnant patients with diabetes is based on the knowledge that the need for insulin is

    <p>varied depending on the stage of gestation.</p> Signup and view all the answers

    Which form of heart disease in women of childbearing years usually has a benign effect on pregnancy?

    <p>Mitral valve prolapse</p> Signup and view all the answers

    Which instructions should the nurse include when teaching a pregnant patient with Class II heart disease?

    <p>Instruct her to avoid strenuous activity.</p> Signup and view all the answers

    Anti-infective prophylaxis is indicated for a pregnant patient with a history of mitral valve stenosis related to rheumatic heart disease because the patient is at risk of developing

    <p>bacterial endocarditis.</p> Signup and view all the answers

    Signup and view all the answers

    A patient has a history of drug use and is screened for hepatitis B during the first trimester. Which action is most appropriate?

    <p>Plan for retesting during the third trimester.</p> Signup and view all the answers

    A patient has tested HIV-positive and has now discovered that she is pregnant. Which statement indicates that she understands the risks of this diagnosis?

    <p>“Even though my test is positive, my baby might not be affected.”</p> Signup and view all the answers

    Examination of a newborn in the birth room reveals bilateral cataracts. Which disease process in the maternal history would likely cause this abnormality?

    <p>Rubella</p> Signup and view all the answers

    Which postpartum patient requires further assessment?

    <p>G1 P1 with Class II heart disease who complains of frequent coughing</p> Signup and view all the answers

    The nurse is reviewing the instructions given to a patient at 24 weeks’ gestation for a glucose challenge test (GCT). The nurse determines that the patient understands the teaching when she makes which statement?

    <p>“I will have blood drawn at 1 hour after I drink the glucose solution.”</p> Signup and view all the answers

    The labor nurse is admitting a patient in active labor with a history of genital herpes. On assessment, the patient reports a recent outbreak, and the nurse verifies lesions on the perineum. What is the nurse’s next action?

    <p>Ask the patient when she last had anything to eat or drink.</p> Signup and view all the answers

    The nurse is monitoring a patient with severe preeclampsia who is on IV magnesium sulfate. Which signs of magnesium toxicity should the nurse monitor for? (Select all that apply.)

    <p>Altered sensorium</p> Signup and view all the answers

    More Like This

    Use Quizgecko on...
    Browser
    Browser