maternity EQ
which cardiac disease has the lowest risk for maternal mortality
patent ductus arteriosus
which sign would indicate possible heart failure in a client with heart disease in the immediate postpartum period?
tachypnea
for which reason is a client with heavy bleeding from a complete placenta previa in a lateral trendelenburg position
to prevent shock
which nursing intervention holds the highest priority for a client tight class I heart disease during the postpartum period?
watching for signs of cardiac decompensation
a client states her husband is a fraternal twin and asks about her probability of having twins. which is an appropriate response by the nurse
you have no greater probability of having twins than anyone else in the general population
for which complication is a client with gestational hypertension at risk?
abruption placentae
which intervention would the plan of care for a client with a tentative diagnosis of partial abrupt placentae include
external fetal monitoring and observation
a pregnant client is admitted to the high risk unit with abruptio placentae. which priority assessment would be included with vital signs, skin color, urine output and fetal heart rate
fundal height
which procedure would the nurse anticipate when caring for a client with a tentative diagnosis of placenta previa?
ultrasound exam
a client comes to the emergency room reporting severe abdominal cramping and heavy bleeding at 10 weeks gestation. cervical examination reveals heavy bleeding; the cervical os is open and tissue is present. which type of abortion is the client experiencing?
inevitable
which would the nurse do to prepare a client in her third trimester who is scheduled for an amniocentesis?
instruct her to void immediately before the test
which is the nurses most critical assessment for a client with preeclampsia during the immediate postpartum period
vital signs
the nurse applies fetal and uterine monitors to the abdomen of a client tin active labor. when the client has contractions, the nurse notes a 15 beats/min deceleration of the fetal heart rate below the baseline lasting 15 seconds. which is the next nursing action?
changing the maternal position
which assessment finding in a pregnant client would prompt the nurse to notify the primary health care provider
fundal height at the umbilicus at 16 weeks gestation
which intervention would the nurse initiate when a fetal heart pattern signifying uteroplacental insufficiency occurs?
helping the client turn to the side lying position
which postpartum complication would the nurse monitor for in a client with hydramnios
hemmorrhage
when caring for a client in the third trimester of pregnancy with a history of myocardial infarction, which statement made by the client would concern the nurse the most?
i have been using cough drops to try and get rid of my cough
a recently postpartum client who has heavy vaginal bleeding that does not lessen after fundal massage says, "I'm so thirsty. may i have some gingerly?" which is an appropriate reply by the nurse?
i know this is difficult; however, its best for you to wait until the bleeding has subsided. i can give you a moisturizer for your lips to relieve the dryness
which statement by a woman with preeclampsia indicates the need for further teaching about needed dietary changes
i should avoid excess salt
which is the priority nursing action when caring for a client who has just had an amniotomy and the fetal heart rate immediately decreases from 140 to 180
inspecting the vagina
the nurse is admitting a client to the unit after fetal death was confirmed by ultrasound. while initiating iv therapy the nurse notes blood continually oozing from the puncture site. which is the nurses next action?
informing the pcp of this finding
for which condition is a pregnant client who takes levothyroxine at increased risk
preeclampsia
which is the nursing priority nursing intervention immediately following amniocentesis
monitoring for uterine contractions
a client at 28 weeks gestation visits the clinic for a routine examination. which finding is of greatest concern to the nurse
puffy fingers
assessment of a client at 39 weeks gestation reveals ruptured membranes, mild, irregular contractions 10 to 15 minutes apart, and a fetal heart rate of 186 between contractions. which conclusion would the nurse draw from these findings
a further assessment is necessary
a pregnant client is admitted to the high risk unit with abdominal pain and heavy vaginal bleeding. which is the nurses priority intervention
starting oxygen therapy
which finding indicates a complication of the labor process in a client with a history of T5 spinal cord injury
increased blood pressure
which is a potential cause of fetal tachycardia when a client is in active labor
increased maternal metabolism
the risk for which pregnancy complication is increased in the client with type 1 diabetes mellitus?
hypertensive disorders of pregnancy
a client is admitted to the high risk unit in preterm labor and is 8cm dilated. which is a possible cause of preterm labor
incompetent cervix
which is an early indication of decompensation in a pregnant woman with cardiac disease
increase in fatigue
which finding would indicate infection in a pregnant client? select all that apply
1. chills 2. fever 3. diarrhea 4. flank pain 5. burning on urination
which factor in a pregnant clients history would the nurse recognize as a risk factor for abruptio placentae?
hypertension
which are signs and symptoms of withdrawal that might be seen in a postpartum client with a history of opioid abuse
irritability and muscle tremors
which nursing intervention is specific to the client i n active labor who presents with a history of cardiac disease
auscultating the lungs for crackles with assessments
which is the most important nursing intervention for a client who is at 26 weeks gestation with pyelonehpritis
checking for signs of preterm labor
an electronic fetal monitor is applied to a client in labor who is dilated to 4cm. which assessment finding would cause the nurse to notify the health care provider
contractions every 1 to 2 minutes lasting 90 seconds
which orders are appropriate for a client with mild preeclampsia? select all that apply
daily weight monitor deep tendon reflexes
with which problem is a low maternal serum alpha fetoprotein associated?
down syndrome
a primigravida at 39 weeks gestation is admitted to the high risk unit with an acute infection and is to have labor induced. in which sequence would the nurse implement the primary health care providers orders
1. initiate monitoring with an electronic fetal/maternal monitor 2. give the client a 2g loading dose of ampicillin, followed by 1 g every 4 hours 3. start oxytocin 30 units in 1000mL of D5W per protocol 4. call the anesthesia department to evaluate the client for an epidural
which nursing interventions are applicable to a client receiving an infusion of magnesium sulfate for severe preeclampsia? select all that apply
1. restricting visitors 2. limiting fluid intake 3. maintaining a quiet environment
which risk to the fetus is associated with a maternal diagnosis of chorioamnionitis? select all that apply
1. sepsis 2. bacteremia 3. pneumonia 4. cerebral palsy 5. respiratory distress syndrome
women who become pregnant for the first time at a later reproductive age (35 years or older) are at risk for which complications? select all that apply
1. preterm labor 2. multiple gestation 3. chromosomal anomalies 4. bleeding in the first trimester
the health care provider prescribes a contraction stress test for a client at 33 weeks gestation whose non stress test was nonreactive and whose biophysical profile was inconclusive. which maternal conditions would prompt the nurse to question the prescription? elect all that apply
1. preterm labor 2. placenta previa 3. cervical insufficiency 4. premature rupture of membranes
a 37 year ld G3P2001 client with hypertension and type 1 diabetes with good glycemic control is seen in the antepartum testing unit for a non stress test at 36 weeks. her obstetric history includes an intrauterine fetal death at 38 weeks. what risk factors in the clients history indicate the need for an NST? select all that apply
1. age older than 35 years 2. the risk for placental insufficiency 3. a history of stillbirth from her last pregnancy 4. hypertension 5. type 1 diabetes
a woman in labor with no known complications rings the call bell to say she has had a "gush" from her vagina. the nurse identifies a large amount of bright red blood. in which order would the nurse perform the necessary interventions?
1. call for help 2. check fetal heart tones 3. increase the maintenance iv rate 4. start oxygen at 8L via face mask 5. call the PCP
an amniotomy is performed in a laboring client at 42 weeks gestation. place the nursing care actions in their order of priority
1. checking the fetal heart rate tracings 2. inspecting the perineum for umbilical cord prolapse 3. assessing the characteristics of the amniotic fluid 4. monitoring the client for signs of an infection
a client with a history of three spontaneous abortions is now at 16 weeks gestation and expresses a concern about remaining at home during this pregnancy. which questions will elicit responses most helpful to the nurse developing the clients plan of care? select all that apply
1. do you have a support system available to help you 2. have you been told about the status of your pregnancy
which information would the nurse include in the teaching for a client who received methotrexate? select all that apply
1. gastric distress is a possible side effect 2. stools will contain some residual methotrexate for 7 days 3. double flush the toilet with the lid down after urinating
which clinical condition concerns the nurse the most for an obstetrical client with heart disease? select all that apply
1. obesity 2. anemia 3. hypertension 4. emotional distress
a woman who is 34 weeks pregnant is hospitalized for pyelonephritis. which assessments would the nurse include in the plan of care? select all that apply
1. urine output 2. temperature 3. blood pressure 4. uterine contractions
a primary health care provider prescribes carboprost tromethamine to be administered to a postpartum client with intractable vagnal bleeding. the nurse should notify the provider of which current condition in the clients medical history
history of asthma
which would be included in the plan of care for an obstetrical client who has been taking carbamazepine throughout the first trimester of pregnancy?
evaluation for a neural tube defect
a client at 36 weeks gestation presents with severe abdominal pain, heavy vaginal bleeding, a drop in blood pressure, and an increased pulse rate. which complication of pregnancy is suggested by these signs and symptoms?
abrupt placentae
which occurs immediately after birth that increases the risk for cardiac decompensation in a client with a compromised cardiac system?
extravascular fluid is remobilized into the vascular compartment
which action would the nurse take before birth when meconium staining is present
gathering equipment for neonatal resucitation
why would the primary health care provider instruct a woman at 38 weeks gestation with slightly elevated blood pressure to rest in a side lying position
it increases blood flow to the fetus
which guideline regarding sexual intercourse would be given to a client with preterm contractions and cervical dilation of 2 cm
it is prohibited because it may stimulate labor
a contraction stress test result is considered positive when the fetal heart rate shows which during contractions?
late decelerations
which are risk factors of diabetes in pregnancy? select all that apply
1. preterm birth 2. hypertension 3. cesarean birth
which information would the nurse include when counseling a pregnant client at risk for the human immunodeficiency virus regarding HIV testing? select all that apply
1. the risks of passing the virus to the fetus 2. what positive or negative test results indicate 3. the emotional, legal, and medical implications of test results
a client with mild preeclampsia is admitted to the labor and birthing suite. which signs or symptoms would the client be likely to display if she were developing hemolysis, elevated liver enzymes, and low platelet count (HELLP syndrome)? select all that apply
1. headache 2. right upper quadrant abdominal pain 3. nausea and vomiting
which statement from a pregnant client with premature rupture of membranes (PROM) demonstrates an understanding of the infection risk? select all that apply
1. i will report a fever to my doctor 2. i will wipe from front to back when using the bathroom 3. if i have contractions, medications will be administered 4. if i develop chorioamnionitis, my doctor will induce labor 5. i will let my doctor know if i experience foul smelling vaginal discharge
a clients membranes rupture, and the nurse immediately detects the presence of a prolapsed umbilical cord. the primary health care provider has been notified. place the following nursing interventions in the order in which they would be performed
1. moving the presenting part off the cord 2. pacing the client in the trendelenburg position 3. administering oxygen by face mask 4. checking the fetal heart rate
which baseline assessment data would the nurse obtain on a client with preeclampsia before initiation of a magnesium sulfate infusion? select all that apply
1. patellar reflex 2. urine output 3. respiratory rate 4. blood pressure
between which weeks of gestation would a client with type 1 diabetes expect to increase her insulin dosage?
24th and 28th weeks of gestation
which position increases cardiac output in the obstetrical client with cardiac disease?
lateral positioning
where on the maternal abdomen would the nurse place the fetal heart transducer when the fetus is in the left sacrum anterior position?
left upper quadrant
reluctance of a client who is one day postpartum to engage in which activity raises a concern about mother infant bonding?
look at her newborns face
a client in labor is admitted to the birthing unit 20 hours after the membranes have ruptured. which is a possible complication for this client
maternal sepsis
which is the priority initial nursing intervention during the admission of a primigravida in labor?
monitoring the fetal heart rate
for which reason may insulin requirements of a client with type 1 diabetes decrease during the first trimester
morning sickness may result in decreased food intake
which factor will increase the risk for uterine atony in a postpartum client?
multiple gestation pregnancy
which finding would then ruse be most concerned about in the client receiving a bolus of magnesium sulfate intravenously for the treatment of preeclampsia
nausea and vomiting
which assessment would the nurse include in the plan of care for a postpartum client with large, painful varicose veins?
assessing for signs of thrombophlebtitis
which intervention is a priority when a clients membranes spontaneously rupture at 37 weeks and there are no contractions
assessing maternal temperature
when checking the cervical dilation in labor, the nurse notes that the umbilical cord has prolapsed. with action would the nurse take in response to this finding
assist the client into the trendelenburg position
which client would the nurse identify as being at greatest risk for a hypertensive disorder of pregnancy
obese primigravida
a woman in the third trimester of pregnancy presents with vaginal bleeding and states she snorted cocaine approximately 2 hours ago. which complication would this client profile suggest?
abrupt placentae
which condition contraindicates oxytocin induction
active genital herpes infection
which statement would the nurse tell the client in regards to a dinoprostone suppository before having a vacuum curettage abortion for a fetal demise?
after the suppository has been inserted, you will need to lie flat in bed for a set amount of time
a multiparous client with a history of gestational hypertension and previous history of abruption is in the transition phase of labor. the electronic fetal monitor shows bradycardia, and a change is seen in the counter of the clients abdomen. which is the nurses immediate action
alerting staff to the need for immediate cesarean delivery
why would the nurse encourage continued health care supervision for a pregnant woman with pyelonephritis
antibiotic therapy should be administered until the urine is negative
which nursing action is most appropriate for a pregnant client at 23 weeks gestation with pica
determining whether the diet is safe and nutritionally adequate
a client who is admitted for surgery for a ruptured tubal pregnancy tells the nurse that she has shoulder pain. which condition is the nurse concerned about based on these manifestations
blood accumulation under the diaphragm
a client who is admitted for surgery for a ruptured tubal pregnancy tells the nurse that she has shoulder pain. which condition is the nurse concerned about based on these manifestations?
blood accumulation under the diaphragm
the nurse instructs a pregnant woman in labor that she must avoid lying on her back. what is the primary reason for this instruction
decreased placental perfusion is seen in the supine position
which is the nurses concern when caring for a client just diagnosed with a ruptured tubal pregnancy
diminished cardiac output
a postpartum client is being treated with subcutaneous enoxaparin for deep vein thrombosis of the left calf. which client cue is of most concern to the nurse
dyspnea
a pregnant client is admitted with abdominal pain and heavy vaginal bleeding. which is the immediate nursing action
establish iv access
the nurse admits with severe preeclampsia to the high risk prenatal unit. which is the next nursing intervention after the vital signs have been obtained?
establishing an iv line
which client is most likely to require a cesarean birth
multipara with a shoulder presentation
which factor in a clients history suggests a risk for preterm labor
multiple urinary tract infections
a sonogram performed on a client in the third trimester reveals a low lying placenta. which would the nurse teach the client that she is at low risk for?
painless vaginal bleeding
the results of a second trimester fetal sonogram reveal a small for gestational age fetus and a low lying placenta. the nurse recognizes that these result increase the patients risk for which diagnosis
placenta previa
which is the priority nursing care focus for a client tat 34 weeks gestation with contractions every 5 minutes and cervical dilation of 4cm?
promoting maternal/fetal well being during labor
which significant clinical finding would the nurse expect when reviewing the history of a client with preeclampsia
proteinuria
assessment of a primigravida at 32 weeks gestation shows a blood pressure of 170/110, 4+ proteinuria, and edema of the face and extremities. which which complication are these findings consistent?
severe preeclampsia
the nurse is providing immediate postpartum care to a client. the nurse would monitor the client for which condition that is characterized by hemorrhage?
sheehan syndrome
when planning care for a client with type 1 diabetes, which change in insulin requirements would the nurse anticipate on the first postpartum day
sudden decrease
after receiving a diagnosis of placenta previa, the client asks the nurse what this means. which is an appropriate response
the placenta is implanted in the lower uterine segment, and its covering or all fo the cervical opening
which activity would the nurse suggest for a client in labor who is having frequent painful contractions and whose cervix has been dilated 2cm for several hours without progression
therapeutic rest
the pregnant client asks the nurse whether changing the cats litter box is harmful to her or the fetus. how would the nurse reply
there are several factors that determine a persons response to the toxins in cat litter
which is associated with in vitro fertilization embryo transfer?
tubal pregnancy
which is the nurses priority action when caring for an obstetrical client experiencing eclampsia
turn the head to one side
which assessment findings correlate with a diagnosis of enraptured tubal pregnancy? select all that apply
unilateral abdominal pain history of untreated chlamydia
why is it important for the nurse to encourage a client with preeclampsia to lie in the left lateral recumbent position?
uterine and kidney perfusion are maximized, and compression of the major vessels is relieved
while caring for a client who has had a positive contraction stress test, which complication would the nurse suspect?
uteroplacental insufficiency