Chp 21
A woman diagnosed with gestational trophoblastic disease is to undergo human chorionic gonadotropin (hCG) testing after suction curettage to evacuate the abnormal trophoblast cells. The nurse determines that the client has understood the instructions for testing based on which client statement?
>"After the first 2 weeks, I need levels drawn each week until negative."
A primipara at 36 weeks' gestation is being monitored in the prenatal clinic for risk of preeclampsia. Which sign or symptom shut the nurse prioritize?
>A dipstick value of 2+ for protein
An 18-year-old pregnant client is hospitalized as she recovers from hyperemesis gravidarum. The client reveals she wanted to have an abortion (elective termination of pregnancy) but her cultural background forbids it. She is very unhappy about being pregnant and even expresses a wish for a spontaneous abortion (miscarriage). Which action by the nurse is most appropriate?
>Contact the healthcare provider to report the clients feelings
A woman at 10 weeks' gestation comes to the clinic for an evaluation. Which assessment finding should the nurse prioritize?
>Fundal height measurement of 18 cm R: A fundal height of 18 cm is larger than expected and should be further investigated for gestational trophoblastic disease (hydatidiform mole).
A woman at 8 weeks' gestation is admitted for ectopic pregnancy. She's asking why this has occurred. The nurse knows that which factor is a known risk factor for ectopic pregnancy?
>History of endometriosis
A pregnant client at 32 weeks' gestation with preterm labor is being discharged home after successful cessation of labor. The nurse is teaching a client about ways to help prevent a recurrence. The nurse determines that the teaching was successful based on which client statement? Select all that apply
>I need a drink about 8 to 10 glasses of water each day >I should call my healthcare provider immediately if my water breaks >I'll be able to catch up on my reading so I'm not so bored
A woman at 34 weeks' gestation presents to labor and delivery with vaginal bleeding. Which finding from the obstetric examination would lead to a diagnosis of placental abruption (abruptio placentae)?
>Onset of vaginal bleeding was sudden and painful
A pregnant client with preeclampsia is to receive magnesium sulfate IV. Which assessment should the nurse prioritize before administering a new dose?
>Patellar reflex
A client at 33 weeks' gestation comes to the emergency department with vaginal bleeding. Assessment reveals the following: • Onset of slight vaginal bleeding at 29 weeks with spontaneous cessation • Recent onset of bright red vaginal bleeding, more than with previous episode • No uterine contractions at present • Fetal heart rate within normal range • Uterus soft and nontender Based on the assessment findings, which condition would the nurse likely suspect?
>Placenta previa
During a routine prenatal visit, a client is found to have 1+ proteinuria and a blood pressure rise to 140/90 mm Hg with mild facial edema. The nurse recognizes that the client has which condition?
>Preeclampsia without severe features
The nurse is caring for a woman at 32 weeks' gestation with severe preeclampsia. Which assessment finding should the nurse prioritize after the administration of hydralazine to this client?
>Tachycardia R: hydralazine reduces BP but is associated with adverse effects such as palpitation, tachycardia, headache, anorexia, and N+V+D.
A young client gives birth to twin boys who shared the same placenta. What serious complication are they at risk for?
>Twin-to-twin transfusion syndrome (TTTS)
