Chapter 10: Complications of Pregnancy

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

Which clinical intervention is the only known cure for preeclampsia?

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?

Which intrapartal assessment should be avoided when caring for a patient with HELLP syndrome?

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?

Which maternal condition always necessitates delivery by cesarean birth?

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

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

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

Which finding would indicate concealed hemorrhage in abruptio placentae?

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

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

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

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

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

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

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

A laboratory finding indicative of DIC is one that shows

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

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?

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

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?

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?

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?

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

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?

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

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

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

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

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

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

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

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

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

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?

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?

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

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

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

Which disease process improves during pregnancy?

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

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

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

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

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

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?

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

Which postpartum patient requires further assessment?

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?

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?

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.)

Magnesium Sulfate

Preeclampsia

Delivery of the fetus

Glucosuria

HELLP Syndrome

Edema Assessment Score +3

Total Placenta Previa

Abortion

Missed Abortion

Marginal Placenta Previa

Abruptio Placentae

Hard Boardlike Abdomen

Assessing fetal heart rate and maternal vital signs

Pounding headache, visual changes, and epigastric pain

Rh Incompatibility

Dilation and Curettage (D&C)

Recurrent Pelvic Infections

Ectopic Pregnancy

Hydatidiform Mole

Determining cervical dilation and effacement

Decreased Fibrinogen

Normal Deep Tendon Reflexes

Respiratory rate of 10 breaths per minute

Ectopic Pregnancy

Hemorrhage

Uterine Infection

Undiagnosed Chronic Hypertension

HELLP Syndrome

Kleihauer-Betke Test

Premature Rupture of Membranes (PROM)

Hidden Placental Abruption

Inserting an IV line for fluid replacement

Bleeding at IV insertion site

Pain Level

900 mL

Administration of Methotrexate

Clear fluid from vagina

Urine output greater than 100 mL/hour

Indirect Coombs Test

Within 72 hours of delivery

Male fetus, African American, previous cesarean birth

Assess the patient's respiratory rate

Degree of glycemic control before and during pregnancy

Hypoglycemia

Previous birth of a large infant

Rheumatoid Arthritis

Varied depending on the stage of gestation

Mitral Valve Prolapse

Avoid strenuous activity

Risk of developing bacterial endocarditis

Plan for retesting during the third trimester

Even though my test is positive, my baby might not be affected.

Maternal Rubella infection

G1 P1 with Class II heart disease complaining of frequent coughing