18 Questions
What is the initial step in the nursing management of a patient with PROM?
Monitor the patient regularly and report any signs of changes immediately
Which medication is used as an antidote for magnesium sulfate toxicity?
Calcium gluconate
What is the recommended therapy for a patient with preeclampsia?
Complete bed rest and antihypertensive drugs
What is a common sign of chorioamnionitis that should be monitored in patients?
Fever
When should an indwelling urinary catheter be inserted in a patient with pregnancy-induced hypertension (PIH)?
If the patient develops seizures
What is the purpose of using hydralazine in the medical management of patients with preeclampsia?
To act as an antihypertensive (vasodilator)
What is one of the cardinal signs of preeclampsia?
Proteinuria
What diagnostic finding confirms premature rupture of membranes (ROM)?
Evident ferning
What condition is associated with severe preeclampsia and involves hemolysis, elevated liver enzyme levels, and a low platelet count?
HELLP syndrome
In pregnancy-induced hypertension (PIH), what is thought to produce decreased blood flow through the placenta and maternal organs?
Generalized arteriolar vasoconstriction
What assessment finding may indicate infection in the context of premature rupture of membranes (PROM)?
Fetal tachycardia
How is HELLP syndrome managed?
Magnesium sulfate administration for cathartic effect
Which of the following is the most appropriate initial nursing intervention for a patient with preterm premature rupture of membranes (PROM)?
Initiate continuous fetal monitoring and assess for contractions.
A patient with gestational hypertension develops new-onset proteinuria and visual disturbances. Which of the following is the most likely diagnosis?
Preeclampsia
A patient with preterm PROM at 32 weeks gestation is being managed expectantly. Which of the following is the most appropriate nursing intervention?
Monitor for signs of chorioamnionitis and fetal well-being.
A patient with severe preeclampsia is being prepared for an emergent cesarean delivery. Which of the following is the most appropriate nursing intervention?
Administer magnesium sulfate for seizure prophylaxis.
A patient with preterm PROM at 28 weeks gestation is being managed expectantly. Which of the following is the most appropriate nursing intervention to prevent chorioamnionitis?
Administer prophylactic broad-spectrum antibiotics.
A patient with gestational hypertension develops severe headaches and epigastric pain. Which of the following is the most appropriate initial nursing intervention?
Initiate continuous fetal monitoring and assess vital signs.
Study Notes
Preeclampsia
- Affects 7% of pregnancies, more common in nulliparous women, multiple fetuses, and those with a history of vascular disease
- Characterized by hypertension, proteinuria, and edema after 20 weeks' gestation
- Can be mild or severe, with severe preeclampsia defined by 160/110 mmHg blood pressure and +3/+4 on reagent test strip
Eclampsia
- Convulsive form of preeclampsia, occurring between 24 weeks' gestation and the end of the first postpartum week
- May progress to complications such as cerebral hemorrhage, liver rupture, and coma
- Defined by the onset of a grand mal seizure
Management
- Goals: stop the disorder's progression, ensure fetal survival, and manage symptoms
- Conservative approach: complete bed rest and antihypertensive drugs
- Medical management: magnesium sulfate, hydralazine, diazepam, calcium gluconate, and corticosteroids
- Nursing management: monitor patient regularly, report any signs of changes, and observe for signs and symptoms of fetal distress
Complications
- Intrauterine growth retardation, placental infarcts, and abruptio placentae
- Hemolysis, elevated liver enzyme levels, and low platelet count (HELLP syndrome)
- Stillbirth, seizures, coma, premature labor, renal failure, and hepatic damage in the mother
HELLP Syndrome
- Managed through platelet transfusion, magnesium sulfate, corticosteroids, and bed rest
- Requires careful monitoring and management to prevent complications
Pregnancy-Induced Hypertension (PIH)
- Pathophysiology: generalized arteriolar vasoconstriction, decreased blood flow through the placenta and maternal organs
- Changes associated with PIH: vascular changes, premature rupture of membranes, and renal and interstitial tissue changes
Assessment and Diagnostic Findings
- Assessment findings: proteinuria, edema, seizure, and hypertension
- Diagnostic findings: ferning, nitrazine test, and ultrasound
Test your knowledge about preeclampsia and eclampsia, two serious pregnancy-related conditions. Learn about the cardinal signs, risk factors, and complications associated with these disorders.
Make Your Own Quizzes and Flashcards
Convert your notes into interactive study material.
Get started for free
