Nursing Care of High-Risk Pregnant Clients
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Questions and Answers

What is the recommended gestational age for a 50-g glucose challenge test to screen for gestational diabetes?

  • 16-20 weeks
  • 38-40 weeks
  • 24-28 weeks (correct)
  • 32-36 weeks

    • Which of the following is NOT a predisposing condition for gestational diabetes?

  • History of large babies (10 lb or more)
  • Family history of diabetes
  • History of polycystic ovary syndrome
  • History of multiple pregnancies (correct)

    • In a 3-hour glucose tolerance test, a diagnosis of gestational diabetes is made if _____.

  • Two of the four blood samples show abnormal glucose levels (correct)
  • One of the four blood samples shows an abnormal glucose level
  • All four blood samples show abnormal glucose levels
  • The fasting glucose level is above 100 mg/dl

    • What is the normal fasting glucose level in a pregnant woman?

    <p>95 mg/dl (B)</p> Signup and view all the answers

    Which of the following is NOT a maternal effect of uncontrolled gestational diabetes?

    <p>Premature rupture of membranes (D)</p> Signup and view all the answers

    Which of these conditions is a potential fetal effect of gestational diabetes?

    <p>Hypoglycemia (C)</p> Signup and view all the answers

    What is the recommended treatment for gestational diabetes?

    <p>Insulin injections or oral medications, depending on the individual (C)</p> Signup and view all the answers

    What is the primary reason for screening for gestational diabetes?

    <p>To manage the mother's blood sugar levels and prevent complications (A)</p> Signup and view all the answers

    Which of the following is a key monitoring parameter for maternal wellbeing?

    <p>Blood pressure every 4 hours (A)</p> Signup and view all the answers

    What is the primary purpose of administering magnesium sulfate in pregnant patients?

    <p>To prevent seizures (A)</p> Signup and view all the answers

    In the tonic phase of an eclamptic seizure, what physiological response is observed?

    <p>All muscles contract and the patient may bite her tongue (C)</p> Signup and view all the answers

    What should be done immediately after an eclamptic seizure occurs?

    <p>Turn the client on her side and ensure an open airway (B)</p> Signup and view all the answers

    Which dietary recommendation is suggested for pregnant women at risk of hypertension?

    <p>High in protein and moderate in sodium (D)</p> Signup and view all the answers

    What is an important nursing intervention during the postictal stage of a seizure?

    <p>Insert an oral airway and suction as needed (C)</p> Signup and view all the answers

    What is a potential sign of magnesium sulfate toxicity that should be monitored?

    <p>Respiratory depression (A)</p> Signup and view all the answers

    Which medication is typically administered to control hypertension in pregnant patients?

    <p>Hydralazine (D)</p> Signup and view all the answers

    What is the expected outcome for children if the father is homozygous Rh-positive (DD)?

    <p>100% will be Rh-positive (C)</p> Signup and view all the answers

    What condition may arise in an Rh-positive fetus carried by an Rh-negative mother who is sensitized?

    <p>Hemolytic disease of the newborn (C)</p> Signup and view all the answers

    What immunological response happens in an Rh-negative mother when exposed to Rh-positive fetal blood?

    <p>Formation of antibodies (B)</p> Signup and view all the answers

    When do most maternal antibodies against Rh-positive blood typically form?

    <p>Within 72 hours after birth (A)</p> Signup and view all the answers

    What is the significance of a Coomb’s test being positive?

    <p>Shows presence of maternal antibodies (B)</p> Signup and view all the answers

    What causes fetal blood to occasionally enter maternal circulation during pregnancy?

    <p>Villus rupture (B)</p> Signup and view all the answers

    What factors can contribute to the sensitization of an Rh-negative mother?

    <p>Amniocentesis and blood transfusion (B), Invasive procedures and childbirth (C)</p> Signup and view all the answers

    What is the risk for children of an Rh-negative mother after she has birthed her first Rh-positive child?

    <p>Increased risk of hemolytic disease in subsequent children (D)</p> Signup and view all the answers

    What is a primary concern for pregnant women with cardiac disease?

    <p>Increased circulatory volume (B)</p> Signup and view all the answers

    At what weeks are women with cardiac disease most at risk during pregnancy?

    <p>Weeks 28 to 32 (B)</p> Signup and view all the answers

    What is one key focus of nursing care for pregnant women with pre-existing illnesses?

    <p>Close observation of maternal health and fetal well-being (A)</p> Signup and view all the answers

    What can happen if a woman with severe heart disease experiences pregnancy?

    <p>Her cardiac output may fall, affecting vital organ perfusion. (B)</p> Signup and view all the answers

    What is a recommended approach for nursing care during complications in pregnancy?

    <p>Help the woman regain her health quickly (C)</p> Signup and view all the answers

    Which complication can arise from pre-existing illnesses during pregnancy?

    <p>Early pregnancy loss or preterm delivery (A)</p> Signup and view all the answers

    How should nursing care approach the psychological readiness of a woman during pregnancy complications?

    <p>Provide psychological support alongside physical care (A)</p> Signup and view all the answers

    What is a common sign that nursing care may educate a pregnant woman to monitor for?

    <p>Severe shortness of breath (B)</p> Signup and view all the answers

    What is a potential complication for a newborn of a diabetic mother?

    <p>Hypoglycemia (D)</p> Signup and view all the answers

    At what point in pregnancy should women be screened for gestational diabetes?

    <p>Between 24 and 28 weeks (D)</p> Signup and view all the answers

    Which of the following interventions could be performed if hypoglycemia is present in a newborn?

    <p>Intravenous glucose infusion (B)</p> Signup and view all the answers

    What change occurs in maternal insulin needs during the second and third trimesters of pregnancy?

    <p>They increase (C)</p> Signup and view all the answers

    What should be observed for at birth due to potential complications from thrombocytopenia?

    <p>Maternal hemorrhage (A)</p> Signup and view all the answers

    What is true regarding the size of a newborn from a diabetic mother?

    <p>Size is related to gestational age rather than diabetes (B)</p> Signup and view all the answers

    What is an important consideration when performing epidural anesthesia in pregnant women with low platelet counts?

    <p>There is a high risk of bleeding at the epidural site (D)</p> Signup and view all the answers

    What characterizes gestational diabetes mellitus?

    <p>Manifests when the pancreas cannot meet insulin demands (C)</p> Signup and view all the answers

    What is the highest risk period for perinatal transmission of HIV?

    <p>During delivery through the birth canal (C)</p> Signup and view all the answers

    Which procedure should be avoided to decrease the risk of maternal blood exposure during labor?

    <p>Episiotomy (D)</p> Signup and view all the answers

    How should the newborn be treated immediately after delivery to minimize exposure to maternal blood?

    <p>Promptly remove the neonate from the mother’s blood (A)</p> Signup and view all the answers

    What should be done regarding breastfeeding for a mother who is HIV-positive?

    <p>Restrict breastfeeding (B)</p> Signup and view all the answers

    What is the duration for which zidovudine should be administered to the newborn after birth?

    <p>For the first 6 weeks (C)</p> Signup and view all the answers

    Which of the following testing procedures is recommended for infants at risk for HIV infection?

    <p>HIV culture at 1 and 4 months (D)</p> Signup and view all the answers

    What is one of the recommended methods to reduce the risk of HIV transmission to the neonate?

    <p>Reduce exposure of the neonate to maternal blood (C)</p> Signup and view all the answers

    What sign should postpartum mothers monitor for after delivery if they are HIV-positive?

    <p>Signs of infection (B)</p> Signup and view all the answers

    Study Notes

    Module 3: Nursing Care of the High-Risk Pregnant Client (Medical Complications in Pregnancy)

    • Description: More women enter pregnancy with pre-existing conditions (e.g., cardiac or respiratory illnesses) that can complicate pregnancy. Nursing focuses on close observation of maternal and fetal health, educating the woman and family about warning signs, and minimizing complications. The module covers illnesses and events that may complicate pregnancy, pre-existing or otherwise.

    Learning Outcomes

    • LO1: Integrate scientific and humanistic concepts for high-quality maternal and child nursing care.
    • LO2: Apply maternal and child nursing principles to prevent pregnancy complications that put the mother and fetus at high risk.
    • LO3: Assess mothers experiencing pregnancy complications using appropriate methods and tools to address existing needs.
    • LO4: Develop nursing diagnoses to address maternal and family needs related to pregnancy complications.
    • LO5: Implement safe and effective interventions to address maternal and fetal needs and improve outcomes.
    • LO7: Evaluate expected outcomes with mothers and families for care effectiveness and improvement.
    • LO8: Prevent pregnancy complications, minimizing potential risks.

    Module Outline

    • Cardiovascular Disorder: Assessing for signs of cardiac decompensation (e.g., cough, respiratory congestion, dyspnea, fatigue, palpitations, tachycardia, peripheral edema, chest pain) and respiratory infection/pulmonary edema. Interventions include monitoring vital signs, fetal heart rate (FHR), and fetal condition, limiting activities, and promoting rest. Adequate nutrition for anemia prevention, low sodium diet, and avoiding excessive weight gain are essential. Medications (digitalis, iron) may be part of the treatment plan. During labor, monitoring, cardiac monitors, fetal monitors, maintaining bed rest, oxygen as needed, controlled pushing, and pain management (caudal anesthesia). Postpartum care focuses on monitoring.
    • Hypertensive Disorders:
      • Gestational Hypertension: Vasospasm in blood vessels, leading to elevated blood pressure during pregnancy. Pre-eclampsia is a related condition with proteinuria; effects include problems with organs like kidneys, pancreas, liver, and brain.
      • Risk Factors: Women of color, multiple pregnancies, young (<20) or older (>40) primiparas, low socio-economic background, multiple pregnancies, polyhydramnios, underlying conditions (heart disease, diabetes, renal disease).
      • Preeclampsia: Elevated blood pressure and proteinuria. The severity ranges from preeclampsia without severe features (managed at home with monitoring) to preeclampsia with severe features (hospitalization) and eclampsia (seizures requiring intensive care).
      • Intervention: Close blood pressure monitoring, monitoring of the fetus, promoting bed rest, and promoting good nutritional intake. Hydralazine or nifedipine may be administered to reduce hypertension. Delivery may be by vaginal route if stable, otherwise C-section.
    • HELLP Syndrome: A serious condition involving hemolysis (red blood cell destruction), elevated liver enzymes, and low platelets. Assessment and interventions focus on maintaining maternal and fetal well-being while managing the condition.
    • Urinary Tract Infection (UTI): Assessment includes signs like frequency/urgency of urination; pelvic pain; and fever. Intervention includes increasing fluid intake, hygiene measures, and antibiotic treatment.
    • Rh Incompatibility: Mother is Rh-negative, fetus is Rh-positive. Maternal antibodies can attack fetal red blood cells, leading to hemolytic disease. Prevention involves Rh immunoglobulin (RhoGAM) administration in the mother.
    • HIV/AIDS: Transmission prevention and management strategies are crucial for mothers and the unborn child.
    • Substance Abuse: Assessment involves the use of substances and its effect on the mother and fetus. Interventions are dependent on the specific substance and involve education, counseling, and support.

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    Related Documents

    Module 3 Medical Complications in Pregnancy 2024-2025 PDF

    Description

    This module covers the nursing care required for high-risk pregnant clients, addressing medical complications that can arise due to pre-existing conditions. Emphasis is placed on observing maternal and fetal health, educating families about warning signs, and minimizing risks during pregnancy. Learn to integrate nursing principles with scientific knowledge to support mothers at risk.

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