mcn 2210

The nurse is aware that a neonate of a mother with diabetes is at risk for what complication? Anemia Hypoglycemia Nitrogen loss Thrombosis

Hypoglycemia. Neonates of mothers with diabetes are at risk for hypoglycemia due to increased insulin levels. During gestation, an increased amount of glucose is transferred to the fetus across the placenta. The neonate's liver cannot initially adjust to the changing glucose levels after birth. This may result in an overabundance of insulin in the neonate, resulting in hypoglycemia.

A maternity nurse is preparing for the admission of a client in the 3rd trimester of pregnancy that is experiencing vaginal bleeding and has a suspected diagnosis of placenta previa. The nurse reviews the physician's orders and would question which order? Prepare the client for an ultrasound Obtain equipment for external electronic fetal heart monitoring Obtain equipment for a manual pelvic examination

Obtain equipment for a manual pelvic examination Manual pelvic examinations are contraindicated when vaginal bleeding is apparent in the 3rd trimester until a diagnosis is made and placental previa is ruled out. Digital examination of the cervix can lead to maternal and fetal hemorrhage. A diagnosis of placenta previa is made by ultrasound. The H/H levels are monitored, and external electronic fetal heart rate monitoring is initiated. External fetal monitoring is crucial in evaluating the fetus that is at risk for severe hypoxia.

The physician ordered Betamethasone to a pregnant woman at 34 weeks of gestation with sign of preterm labor. The nurse expects that the drug will: Treat infection. Suppress labor contraction. Stimulate the production of surfactant. Reduce the risk of hypertension.

Stimulate the production of surfactant. Betamethasone, a form of cortisone, acts on the fetal lungs to produce surfactant.

Which of the following is the most common kind of placental adherence seen in pregnant women? Accreta Placenta previa Percreta Increta

accreta Placenta accreta is the most common kind of placental adherence seen in pregnant women and is characterized by slight penetration of myometrium. In placenta previa, the placenta does not embed correctly and results in what is known as a low-lying placenta. It can be marginal, partial, or complete in how it covers the cervical os, and it increases the patient's risk for painless vaginal bleeding during the pregnancy and/or delivery process. Placenta percreta leads to perforation of the uterus and is the most serious and invasive of all types of accrete. Placenta increta leads to deep penetration of the myometrium.

Check all that apply to incompetent cervix: occurs in 2nd trimester dilatation is painless and bloodless shortened cervical length minimal symptoms

all

Risk factors of incompetent cervix: history of incompetent cervix anatomic abnormalities cervical conization or surgeries DES exposure damaged cervix

all

A nurse is providing instructions to a mother who has been diagnosed with mastitis. Which of the following statements if made by the mother indicates a need for further teaching? "I need to take antibiotics, and I should begin to feel better in 24-48 hours." "I can use analgesics to assist in alleviating some of the discomfort." "I need to wear a supportive bra to relieve the discomfort." "I need to stop breastfeeding until this condition resolves."

"I need to stop breastfeeding until this condition resolves." In most cases, the mother can continue to breastfeed with both breasts. If the affected breast is too sore, the mother can pump the breast gently. Regular emptying of the breast is important to prevent abscess formation. Antibiotic therapy assists in resolving the mastitis within 24-48 hours. Additional supportive measures include ice packs, breast supports, and analgesics.

A client in the first trimester of pregnancy arrives at a health care clinic and reports that she has been experiencing vaginal bleeding. A threatened abortion is suspected, and the nurse instructs the client regarding management of care. Which statement, if made by the client, indicates a need for further education? "I will maintain strict bedrest throughout the remainder of pregnancy." "I will avoid sexual intercourse until the bleeding has stopped, and for 2 weeks following the last evidence of bleeding." "I will count the number of perineal pads used on a daily basis and note the amount and color of blood on the pad." "I will watch for the evidence of the passage of tissue."

"I will maintain strict bedrest throughout the remainder of pregnancy." Strict bed rest throughout the remainder of pregnancy is not required. The woman is advised to curtail sexual activities until the bleeding has ceased, and for 2 weeks following the last evidence of bleeding or as recommended by the physician. The woman is instructed to count the number of perineal pads used daily and to note the quantity and color of blood on the pad. The woman also should watch for the evidence of the passage of tissue.

Which of the following symptoms occurs with a hydatidiform mole? Heavy, bright red bleeding every 21 days Fetal cardiac motion after 6 weeks gestation Benign tumors found in the smooth muscle of the uterus "Snowstorm" pattern on ultrasound with no fetus or gestational sac

"Snowstorm" pattern on ultrasound with no fetus or gestational sac The chorionic villi of a molar pregnancy resemble a snowstorm pattern on ultrasound. Bleeding with a hydatidiform mole is often dark brown and may occur erratically for weeks or months.

A nurse instructor is about to administer a vitamin K injection to a newborn. The student nurse asks the instructor regarding the purpose of the injection. The appropriate response would be: "The vitamin K provides active immunity." "The vitamin K will prevent the occurrence of hyperbilirubinemia." "The vitamin K will protect the newborn from bleeding." "The vitamin K will serve as protection against jaundice and anemia."

"The vitamin K will protect the newborn from bleeding." Vitamin K is administered to the newborn in order to prevent bleeding disorders. Vitamin K promotes the formation of clotting factors II, VII, IX & X in which the infants lack because of insufficient intestinal bacteria needed for synthesizing fat-soluble vitamin K. Option A: Vitamin K does not promote the development of immunity. Option B: Vitamin K does not prevent the occurrence of hyperbilirubinemia. Option D: Vitamin K doesn't prevent the newborn from having jaundice or anemia.

The best time to treat incompetent cervix is between ___ and ____ weeks of pregnancy before the dilatation occurs. 12, 18 10,12 2,3 18,25

12, 18 weeks

A nurse educator on the postpartum unit is reviewing risk factors for postpartum hemorrhage with a group of nurses. Which of the following should be included in the discussion? (Select all that apply.) A.Precipitous delivery B.Lacerations C.Inversion of the uterus D.Oligohydramnios E.Retained placental fragments

A. CORRECT: A rapid, precipitous delivery is a risk factor for postpartum hemorrhage B. CORRECT: The presence of lacerations is a risk factor for hemorrhage.C. CORRECT: Inversion of the uterus in a risk factor for postpartum hemorrhage.D. INCORRECT: Oligohydramnios does not place a client at risk for postpartum hemorrhageE. CORRECT: Retained placental fragments is a risk factor for postpartum hemorrhage.

A pregnant client is diagnosed with partial placenta previa. In explaining the diagnosis, the nurse tells the client that the usual treatment for partial placenta previa is which of the following? Activity limited to bed rest Platelet infusion Immediate cesarean delivery Labor induction with oxytocin

Activity limited to bed rest

A pregnant client in the last trimester has been admitted to the hospital with a diagnosis of severe preeclampsia. A nurse monitors for complications associated with the diagnosis and assesses the client for: Any bleeding, such as in the gums, petechiae, and purpura. Enlargement of the breasts Periods of fetal movement followed by quiet periods Complaints of feeling hot when the room is cool

Any bleeding, such as in the gums, petechiae, and purpura. Severe Preeclampsia can trigger disseminated intravascular coagulation because of the widespread damage to vascular integrity. Bleeding is an early sign of DIC and should be reported to the M.D.

A nurse assists in the vaginal delivery of a newborn infant. After the delivery, the nurse observes the umbilical cord lengthen and a spurt of blood from the vagina. The nurse documents these observations as signs of: Hematoma Placenta previa Uterine atony Placental separation

As the placenta separates, it settles downward into the lower uterine segment. The umbilical cord lengthens, and a sudden trickle or spurt of blood appears.

A nurse is preparing a list of self-care instructions for a PP client who was diagnosed with mastitis. Select all instructions that would be included on the list. a.Take the prescribed antibiotics until the soreness subsides. b.Wear supportive bra c.Avoid decompression of the breasts by breastfeeding or breast pump d.Rest during the acute phase e.Continue to breastfeed if the breasts are not too sore.

B, D, and E. Mastitis are an infection of the lactating breast. Client instructions include resting during the acute phase, maintaining a fluid intake of at least 3 L a day, and taking analgesics to relieve discomfort. Antibiotics may be prescribed and are taken until the complete prescribed course is finished. They are not stopped when the soreness subsides. Additional supportive measures include the use of moist heat or ice packs and wearing a supportive bra. Continued decompression of the breast by breastfeeding or pumping is important to empty the breast and prevent formation of an abscess.

A nurse in the postpartum unit is caring for a client who has just delivered a newborn infant following a pregnancy with placenta previa. The nurse reviews the plan of care and prepares to monitor the client for which of the following risks associated with placenta previa? Disseminated intravascular coagulation Chronic hypertension Infection Hemorrhage

Because the placenta is implanted in the lower uterine segment, which does not contain the same intertwining musculature as the fundus of the uterus, this site is more prone to bleeding.

The nurse is caring for a client in labor. The external fetal monitor shows a pattern of variable decelerations in fetal heart rate. What should the nurse do first? Change the client's position. Prepare for emergency cesarean section. Administer oxygen. Check for placenta previa

Change the client's position. Variable decelerations in fetal heart rate are an ominous sign, indicating compression of the umbilical cord. Changing the client's position from supine to side-lying may immediately correct the problem. An emergency cesarean section is necessary only if other measures, such as changing position and amnioinfusion with sterile saline, prove unsuccessful. Administering oxygen may be helpful, but the priority is to change the woman's position and relieve cord compression.

A nurse is caring for a pregnant client with Preeclampsia. The nurse prepares a plan of care for the client and documents in the plan that if the client progresses from Preeclampsia to eclampsia, the nurse's first action is to: Administer magnesium sulfate intravenously Assess the blood pressure and fetal heart rate Clean and maintain an open airway Administer oxygen by face mask

Clean and maintain an open airway. The immediate care during a seizure (eclampsia) is to ensure a patent airway. The other options are actions that follow or will be implemented after the seizure has ceased.

Which of the following would the nurse assess in a client experiencing abruptio placenta? Bright red, painless vaginal bleeding Concealed or external dark red bleeding Palpable fetal outline Soft and nontender abdomen

Concealed or external dark red bleeding. A client with abruptio placentae may exhibit concealed or dark red bleeding, possibly reporting sudden intense localized uterine pain. The uterus is typically firm to boardlike, and the fetal presenting part may be engaged. Bright red, painless vaginal bleeding, a palpable fetal outline and a soft nontender abdomen are manifestations of placenta previa.

Which of the following is the primary predisposing factor related to mastitis? Epidemic infection from nosocomial sources localizing in the lactiferous glands and ducts Endemic infection occurring randomly and localizing in the periglandular connective tissue Temporary urinary retention due to decreased perception of the urge to avoid Breast injury caused by overdistention, stasis, and cracking of the nipples

D. Breast injury caused by overdistention, stasis, and cracking of the nipples. With mastitis, injury to the breast, such as overdistention, stasis, and cracking of the nipples, is the primary predisposing factor. Epidemic and endemic infections are probable sources of infection for mastitis. Temporary urinary retention due to decreased perception of the urge to void is a contributory factor to the development of urinary tract infection, not mastitis.

An ultrasound is performed on a client at term gestation that is experiencing moderate vaginal bleeding. The results of the ultrasound indicate that an abruptio placentae is present. Based on these findings, the nurse would prepare the client for: Complete bed rest for the remainder of the pregnancy Delivery of the fetus Strict monitoring of intake and output The need for weekly monitoring of coagulation studies until the time of delivery

Delivery of the fetus. The goal of management in abruptio placentae is to control the hemorrhage and deliver the fetus as soon as possible. Delivery is the treatment of choice if the fetus is at term gestation or if the bleeding is moderate to severe and the mother or fetus is in jeopardy.

Which of the following is caused by a B5deficiency? Ectopic pregnancy Nausea Dermatitis Fever

Dermatitis

Rho(D) immune globulin (RhoGAM) is given to a pregnant woman after delivery and the nurse is giving information to the patient about the indication of the medication. The nurse determines that the patient understands the purpose of the medication if the patient tells that it will protect her baby from which of the following? Developing German Measles. Developing Pernicious anemia. Developing Rh incompatibility. Having an RH+ blood.

Developing Rh incompatibility. Rh incompatibility can develop when a Rh-negative mother becomes sensitized to the RH antigen. Sensitization may occur when a Rh-negative woman becomes pregnant with a fetus who is Rh positive. Blood cells from the baby may cross the maternal bloodstream, which can happen during pregnancy, labor, and delivery, causing the mother's immune system to form antibodies, against Rh-positive blood. Administration of the Rhogam prevents the mother from developing antibodies against Rh-positive blood by providing passive antibody protection against the Rh antigen. Options A and B are not related to the Rh incompatibility. Option D is not indicated for the administration of Rhogam.

A pregnant woman arrives at the emergency department (ED) with abruptio placentae at 34 weeks' gestation. She's at risk for which of the following blood dyscrasias? Thrombocytopenia. Idiopathic thrombocytopenic purpura (ITP). Disseminated intravascular coagulation (DIC). Heparin-associated thrombosis and thrombocytopenia (HATT).

Disseminated intravascular coagulation (DIC). Abruptio placentae is a cause of DIC because it activates the clotting cascade after hemorrhage. Option A: Thrombocytopenia results from decreased production of platelets. Option B: ITP doesn't have a definitive cause. Option D: A patient with abruptio placentae wouldn't get heparin and, as a result, wouldn't be at risk for HATT.

A 21-year old client, 6 weeks' pregnant is diagnosed with hyperemesis gravidarum. This excessive vomiting during pregnancy will often result in which of the following conditions? Bowel perforation Electrolyte imbalance Miscarriage Pregnancy induced hypertension (PIH)

Electrolyte imbalance. Excessive vomiting in clients with hyperemesis gravidarum often causes weight loss and fluid, electrolyte, and acid-base imbalances.

When assessing a laboring client, the nurse finds a prolapsed cord. The nurse should: Attempt to replace the cord Place the client on her left side Elevate the client's hips Cover the cord with a dry, sterile gauze

Elevate the client's hips The client with a prolapsed cord should be treated by elevating the hips and covering the cord with a moist, sterile saline gauze. The nurse should use her fingers to push up on the presenting part until a cesarean section can be performed. Answers A, B, and D are incorrect. The nurse should not attempt to replace the cord, turn the client on the side, or cover with a dry gauze.

A nurse is monitoring a pregnant client with pregnancy induced hypertension who is at risk for Preeclampsia. The nurse checks the client for which specific signs of Preeclampsia (select all that apply)? Elevated blood pressure Negative urinary protein Facial edema Increased respirations

Elevated blood pressure and Facial edema. The three classic signs of preeclampsia are hypertension, generalized edema, and proteinuria. Increased respirations are not a sign of preeclampsia.

A postpartum patient was in labor for 30 hours and had ruptured membranes for 24 hours. For which of the following would the nurse be alert? Endometritis Endometriosis Salpingitis Pelvic thrombophlebitis

Endometritis. Endometritis is an infection of the uterine lining and can occur after prolonged rupture of membranes. Endometriosis does not occur after a strong labor and prolonged rupture of membranes. Salpingitis is a tubal infection and could occur if endometritis is not treated. Pelvic thrombophlebitis involves a clot formation but it is not a complication of prolonged rupture of membranes.

The fetal membranes are so strong that blunt trauma to the abdomen is unlikely to cause PROM. True False

False. Blunt trauma to the abdomen is a common cause of PROM.

A sudden gush of clear watery fluid from the vagina is always seen in cases of PROM. True False

False. Some cases of PROM occur without a sudden gush of clear watery fluid from the vagina, so you should always take account of other diagnostic signs such as reduction in size of the abdomen and clearly palpable fetal parts.

Hypoxia and asphyxia of the woman in labour is a common complication of prolonged PROM. True False

False. Hypoxia and asphyxia of the fetus (not the woman in labour) is a common complication of prolonged PROM.

The following are common causes of dysfunctional labor. Which of these can a nurse, on her own manage? Pelvic bone contraction Full bladder Extension rather than flexion of the head Cervical rigidity

Full bladder. Full bladder can impede the descent of the fetal head. The nurse can readily manage this problem by doing a simple catheterization of the mother.

When taking an obstetrical history on a pregnant client who states, "I had a son born at 38 weeks gestation, a daughter born at 30 weeks gestation and I lost a baby at about 8 weeks," the nurse should record her obstetrical history as which of the following? G2 T2 P0 A0 L2 G3 T1 P1 A0 L2 G3 T2 P0 A0 L2 G4 T1 P1 A1 L2

G4 T1 P1 A1 L2 The client has been pregnant four times, including current pregnancy (G). Birth at 38 weeks' gestation is considered full term (T), while birth form 20 weeks to 38 weeks is considered preterm (P). A spontaneous abortion occurred at 8 weeks (A). She has two living children (L).

A pregnant client is making her first Antepartum visit. She has a two year old son born at 40 weeks, a 5 year old daughter born at 38 weeks, and 7 year old twin daughters born at 35 weeks. She had a spontaneous abortion 3 years ago at 10 weeks. Using the GTPAL format, the nurse should identify that the client is: G4 T3 P2 A1 L4 G5 T2 P2 A1 L4 G5 T2 P1 A1 L4 G4 T3 P1 A1 L4

G5 T2 P1 A1 L4. 5 pregnancies; 2 term births; twins count as 1; one abortion; 4 living children.

A nurse in the postpartum unit is caring for a client who has just delivered a newborn infant following a pregnancy with placenta previa. The nurse reviews the plan of care and prepares to monitor the client for which of the following risks associated with placenta previa? Disseminated intravascular coagulation Chronic hypertension Infection Hemorrhage

Hemorrhage Because the placenta is implanted in the lower uterine segment, which does not contain the same intertwining musculature as the fundus of the uterus, this site is more prone to bleeding.

When considering assessment history of a G3 P2 admitted for preterm labor, which risk factor in the woman's history places her at greatest risk for preterm labor? Prepregnancy BMI of 18.5 ½ ppd smoker during pregnancy History of preterm labor Previous cesarean delivery

History of preterm labor

Upon assessment the nurse found the following: fundus at 2 fingerbreadths above the umbilicus, last menstrual period (LMP) 5 months ago, fetal heart beat (FHB) not appreciated. Which of the following is the most possible diagnosis of this condition? Hydatidiform mole Missed abortion Pelvic inflammatory disease Ectopic pregnancy

Hydatidiform mole. Hydatidiform mole begins as a pregnancy but early in the development of the embryo degeneration occurs. The proliferation of the vesicle-like substances is rapid causing the uterus to enlarge bigger than the expected size based on ages of gestation (AOG). In the situation given, the pregnancy is only 5 months but the size of the uterus is already above the umbilicus which is compatible with 7 months AOG. Also, no fetal heart beat is appreciated because the pregnancy degenerated thus there is no appreciable fetal heart beat.

A nurse is monitoring a client in labor who is receiving Pitocin and notes that the client is experiencing hypertonic uterine contractions. List in order of priority the actions that the nurse takes. A.Stop of Pitocin infusion B.Perform a vaginal examination C.Reposition the client D.Check the client's blood pressure and heart rate E.Administer oxygen by face mask at 8 to 10 L/min

If uterine hypertonicity occurs, the nurse immediately would intervene to reduce uterine activity and increase fetal oxygenation. The nurse would stop the Pitocin infusion and increase the rate of the nonadditive solution, check maternal BP for hyper or hypotension, position the woman in a side-lying position, and administer oxygen by snug face mask at 8-10 L/min. The nurse then would attempt to determine the cause of the uterine hypertonicity and perform a vaginal exam to check for prolapsed cord.

The most common cause of ectopic pregnancy: Congenital anomalies of the tube Inflammation of the tubes Uterine abnormalities Using OCPs Pelvic adhesions

Inflammation of the tubes. Pelvic Inflammatory Disease (PID), which leads to scarring of the tubes, is the most common cause of ectopic pregnancy.

Which of the following would the nurse identify as the initial priority for a child with acute lymphocytic leukemia? Instituting infection control precautions Encouraging adequate intake of iron-rich foods Assisting with coping with chronic illness Administering medications via IM injections

Instituting infection control precautions. Acute lymphocytic leukemia (ALL) causes leukopenia, resulting in immunosuppression and increasing the risk of infection, a leading cause of death in children with ALL. Therefore, the initial priority nursing intervention would be to institute infection control precautions to decrease the risk of infection. Option B: Iron-rich foods help with anemia, but dietary iron is not an initial intervention. Option C: The prognosis of ALL usually is good. However, later on, the nurse may need to assist the child and family with coping since death and dying may still be an issue in need of discussion. Option D: Injections should be discouraged, owing to increased risk of bleedingdue to thrombocytopenia.

The nurse is caring for a primigravid client in the labor and delivery area. Which condition would place the client at risk for disseminated intravascular coagulation (DIC)? Intrauterine fetal death. Placenta accreta. Dysfunctional labor. Premature rupture of the membranes.

Intrauterine fetal death. Intrauterine fetal death, abruptio placentae, septic shock, and amniotic fluid embolism may trigger normal clotting mechanisms; if clotting factors are depleted, DIC may occur. Placenta accreta, dysfunctional labor, and premature rupture of the membranes aren't associated with DIC.

Which of the following best describes preterm labor? Labor that begins after 20 weeks gestation and before 37 weeks gestation Labor that begins after 15 weeks gestation and before 37 weeks gestation Labor that begins after 24 weeks gestation and before 28 weeks gestation Labor that begins after 28 weeks gestation and before 40 weeks gestation

Labor that begins after 20 weeks gestation and before 37 weeks gestation Preterm labor is best described as labor that begins after 20 weeks' gestation and before 37 weeks' gestation. The other time periods are inaccurate.

Ectopic pregnancy can be reliably diagnosed by: US Laparoscopy Pregnancy test HSG

Laparoscopy

The client with hyperemesis gravidarum is at risk for developing: Respiratory alkalosis without dehydration Metabolic acidosis with dehydration Respiratory acidosis without dehydration Metabolic alkalosis with dehydration

Metabolic acidosis with dehydration. The client with hyperemesis has persistent nausea and vomiting. With vomiting comes dehydration. When the client is dehydrated, she will have metabolic acidosis. Answers A and C are incorrect because they are respiratory dehydration. Answer D is incorrect because the client will not be in alkalosis with persistent vomiting.

A nurse is developing a plan of care for a client experiencing dystocia and includes several nursing interventions in the plan of care. The nurse prioritizes the plan of care and selects which of the following nursing interventions as the highest priority? Keeping the significant other informed of the progress of the labor Providing comfort measures Monitoring fetal heart rate Changing the client's position frequently

Monitoring fetal heart rate. The priority is to monitor the fetal heart rate

A nurse is caring for a pregnant client with severe preeclampsia who is receiving IV magnesium sulfate. Select all nursing interventions that apply in the care for the client. Monitor maternal vital signs every 2 hours Notify the physician if respirations are less than 18 per minute. Monitor renal function and cardiac function closely Keep calcium gluconate on hand in case of a magnesium sulfate overdose Monitor deep tendon reflexes hourly Monitor I and O's hourly Notify the physician if urinary output is less than 30 ml per hour.

Monitor renal function and cardiac function closely Keep calcium gluconate on hand in case of a magnesium sulfate overdose Monitor deep tendon reflexes hourly Monitor I and O's hourly Notify the physician if urinary output is less than 30 ml per hour. When caring for a client receiving magnesium sulfate therapy, the nurse would monitor maternal vital signs, especially respirations, every 30-60 minutes and notify the physician if respirations are less than 12, because this would indicate respiratory depression. Calcium gluconate is kept on hand in case of magnesium sulfate overdose, because calcium gluconate is the antidote for magnesium sulfate toxicity. Deep tendon reflexes are assessed hourly. Cardiac and renal function is monitored closely. The urine output should be maintained at 30 ml per hour because the medication is eliminated through the kidneys.

Nurse Hazel is preparing to care for a client who is newly admitted to the hospital with a possible diagnosis of ectopic pregnancy. Nurse Hazel develops a plan of care for the client and determines that which of the following nursing actions is the priority? Monitoring weight Assessing for edema Monitoring apical pulse Monitoring temperature

Monitoring apical pulse. Nursing care for the client with a possible ectopic pregnancy is focused on preventing or identifying hypovolemic shock and controlling pain. An elevated pulse rate is an indicator of shock.

A nurse is assigned to care for a client with hypotonic uterine dysfunction and signs of a slowing labor. The nurse is reviewing the physician's orders and would expect to note which of the following prescribed treatments for this condition? Medication that will provide sedation Increased hydration Oxytocin (Pitocin) infusion Administration of a tocolytic medication

Oxytocin (Pitocin) infusion. Therapeutic management for hypotonic uterine dysfunction includes oxytocin augmentation and amniotomy to stimulate a labor that slows.

Bleeding and cramping occur with the cervix closed and membranes intact. complete inevitable habitual missed threatened

threatened

A nurse in the labor room is performing a vaginal assessment on a pregnant client in labor. The nurse notes the presence of the umbilical cord protruding from the vagina. Which of the following would be the initial nursing action? Place the client in Trendelenburg's position Call the delivery room to notify the staff that the client will be transported immediately Gently push the cord into the vagina Find the closest telephone and stat page the physician

Place the client in Trendelenburg's position. When cord prolapse occurs, prompt actions are taken to relieve cord compression and increase fetal oxygenation. The mother should be positioned with the hips higher than the head to shift the fetal presenting part toward the diaphragm. The nurse should push the call light to summon help, and other staff members should call the physician and notify the delivery room. No attempt should be made to replace the cord. The examiner, however, may place a gloved hand into the vagina and hold the presenting part off of the umbilical cord. Oxygen at 8 to 10 L/min by face mask is delivered to the mother to increase fetal oxygenation.

Which of the following is the nurse's initial action when umbilical cord prolapse occurs? Begin monitoring maternal vital signs and FHR Place the client in a knee-chest position in bed Notify the physician and prepare the client for delivery Apply a sterile warm saline dressing to the exposed cord

Place the client in a knee-chest position in bed The immediate priority is to minimize pressure on the cord. Thus the nurse's initial action involves placing the client on bed rest and then placing the client in a knee-chest position or lowering the head of the bed, and elevating the maternal hips on a pillow to minimize the pressure on the cord. Monitoring maternal vital signs and FHR, notifying the physician and preparing the client for delivery, and wrapping the cord with sterile saline soaked warm gauze are important. But these actions have no effect on minimizing the pressure on the cord.

Maureen in her third trimester arrives at the emergency room with painless vaginal bleeding. Which of the following conditions is suspected? Placenta previa Abruptio placentae Premature labor

Placenta previa Placenta previa with painless vaginal bleeding.

A pregnant client is admitted to the labor room. An assessment is performed, and the nurse notes that the client's hemoglobin and hematocrit levels are low, indicating anemia. The nurse determines that the client is at risk for which of the following? A loud mouth Low self-esteem Hemorrhage Postpartum infections

Postpartum infections. Anemic women have a greater likelihood of cardiac decompensation during labor, postpartum infection, and poor wound healing. Anemia does not specifically present a risk for hemorrhage.

While assessing a primipara during the immediate postpartum period, the nurse in charge plans to use both hands to assess the client's fundus to: Prevent uterine inversion Promote uterine involution Hasten the puerperium period Determine the size of the fundus

Prevent uterine inversion Using both hands to assess the fundus is useful for the prevention of uterine inversion.

In evaluating the effectiveness of IV Pitocin for a client with secondary dystocia. the nurse should expect: A painless delivery Cervical effacement Infrequent contractions Progressive cervical dilation

Progressive cervical dilation. The expected effect of Pitocin is cervical dilation. Pitocin causes more intense contractions. which can increase the pain. making answer A incorrect. Cervical effacement is caused by pressure on the presenting part. so answer B is incorrect. Answer C is opposite the action of Pitocin.

A patient is in labor and has just been told she has a breech presentation. The nurse should be particularly alert for which of the following? Quickening Ophthalmia neonatorum Pica Prolapsed umbilical cord

Prolapsed umbilical cord In a breech position, because of the space between the presenting part and the cervix, prolapse of the umbilical cord is common. Quickening is the woman's first perception of fetal movement. Ophthalmia neonatorum usually results from maternal gonorrhea and is conjunctivitis. Pica refers to the oral intake of nonfood substances.

The nurse is assessing for stoma prolapse in a client with a colostomy. The nurse would observe which of the following if stoma prolapse occurred? Sunken and hidden stoma Dark- and bluish-colored stoma Narrowed and flattened stoma Protruding stoma

Protruding stoma A prolapsed stoma is one which the bowel protruded through the stoma. A stoma retraction is characterized by sinking of the stoma. Ischemia of the stoma would be associated with dusky or bluish color. A stoma with a narrowed opening at the level of the skin or fascia is said to be stenosed.

A nurse in the labor room is preparing to care for a client with hypertonic uterine dysfunction. The nurse is told that the client is experiencing uncoordinated contractions that are erratic in their frequency, duration, and intensity. The priority nursing intervention would be to: Monitor the Pitocin infusion closely Provide pain relief measures Prepare the client for an amniotomy Promote ambulation every 30 minutes

Provide pain relief measures. Management of hypertonic labor depends on the cause. Relief of pain is the primary intervention to promote a normal labor pattern.

Which of the following complications can be potentially life threatening and can occur in a client receiving a tocolytic agent? diabetic ketoacidosis hyperemesis gravidarum pulmonary edema sickle cell anemia

Pulmonary edema. Tocolytics are used to stop labor contractions. The most common adverse effect associated with the use of these drugs is pulmonary edema. Option A: Clients who dont have diabetes dont need to be observed for diabetic ketoacidosis. Option B: Hyperemesis gravidium doesnt result from tocolytic use. Option D: Sickle cell anemia is an inherited genetic condition and doesnt develop spontaneously

A client in the 28th week of gestation comes to the emergency department because she thinks that she's in labor. To confirm the diagnosis of PRETERM LABOR, the nurse would expect the physical examinations to reveal: Client's needs category: Physiological integrity Client's need subcategory: Physiological adaptation Cognitive level: Knowledge a.irregular uterine contractions with no cervical dilation b.painful contractions with cervical dilation c. regular uterine dilation with cervical dilation d.regular uterine contractions without cervical dilation

Regular uterine contractions (every 10 minutes or more) along with cervical dilation before 36 weeks' gestation or rupture of fluids indicates preterm labor.

A pregnant client is receiving magnesium sulfate therapy for the control of preeclampsia. A nurse discover that the client is encountering toxicity from the medication in which of the following assessment? Urine output of 25 ml/hr. The presence of deep tendon reflex. Respirations of 10 breaths per minute. Serum magnesium level of 7 mEq/L.

Respirations of 10 breaths per minute. Magnesium sulfate is a central nervous system depressant and anticonvulsant. It can cause smooth muscle relaxation. Signs of magnesium sulfate toxicity relate to the central nervous system depressant effects of the medication and include respiratory depression, decreased urine output, loss of deep tendon reflexes, hypotension and a decrease maternal and fetal heart rate. Option A: Urine output should be maintained at 25-30ml/hr. Option B: Deep tendon reflexes must be present. Option D: Normal range for magnesium is between 4-7 mEq/L

A woman with preeclampsia is receiving magnesium sulfate. The nurse assigned to care for the client determines that the magnesium therapy is effective if: Ankle clonus in noted The blood pressure decreases Seizures do not occur Scotomas are present

Seizures do not occur. For a client with preeclampsia, the goal of care is directed at preventing eclampsia (seizures). Magnesium sulfate is an anticonvulsant, not an antihypertensive agent. Although a decrease in blood pressure may be noted initially, this effect is usually transient. Ankle clonus indicated hyperreflexia and may precede the onset of eclampsia. Scotomas are areas of complete or partial blindness. Visual disturbances, such as scotomas, often precede an eclamptic seizure.

Gina a postpartum client is diagnosed with endometritis. Which position would you expect to place her based on this diagnosis? Supine Left side lying Trendelenburg Semi-fowlers

Semi-fowlers

Which of the following statements best describes hyperemesis gravidarum? Severe anemia leading to electrolyte, metabolic, and nutritional imbalances in the absence of other medical problems. Severe nausea and vomiting leading to electrolyte, metabolic, and nutritional imbalances in the absence of other medical problems. Loss of appetite and continuous vomiting that commonly results in dehydration and ultimately decreasing maternal nutrients Severe nausea and diarrhea that can cause gastrointestinal irritation and possibly internal bleeding

Severe nausea and vomiting leading to electrolyte, metabolic, and nutritional imbalances in the absence of other medical problems. The description of hyperemesis gravidarum includes severe nausea and vomiting, leading to electrolyte, metabolic, and nutritional imbalances in the absence of other medical problems. Hyperemesis is not a form of anemia. Loss of appetite may occur secondary to the nausea and vomiting of hyperemesis, which, if it continues, can deplete the nutrients transported to the fetus. Diarrhea does not occur with hyperemesis.

Which of the following is the most likely effect on the fetus if the woman is severely anemic during pregnancy? Large for gestational age (LGA) fetus Hemorrhage Small for gestational age (SGA) baby Erythroblastosis fetalis

Small for gestational age (SGA) baby. Anemia is a condition where there is a reduced amount of hemoglobin. Hemoglobin is needed to supply the fetus with adequate oxygen. Oxygen is needed for normal growth and development of the fetus.

Which of the following techniques during labor and delivery can lead to uterine inversion? Fundal pressure applied to assist the mother in bearing down during delivery of the fetal head Strongly tugging on the umbilical cord to deliver the placenta and hasten placental separation Massaging the fundus to encourage the uterus to contract Applying light traction when delivering the placenta that has already detached from the uterine wall

Strongly tugging on the umbilical cord to deliver the placenta and hasten placental separation. When the placenta is still attached to the uterine wall, tugging on the cord while the uterus is relaxed can lead to inversion of the uterus. Light tugging on the cord when placenta has detached is alright in order to help deliver the placenta that is already detached.

Which drug is used to manage preterm labor by causing smooth muscle relaxation? oxytocin prostaglandin ritodrine estrogen

ritodrine Ritodrine is used to arrest uterine contractions in preterm labor. Oxytocin is used to stimulate labor.

The nurse is taking care of a multipara who is at 42 weeks of gestation and in active labor, her membranes ruptured spontaneously 2 hours ago. While auscultating for the point of maximum intensity of fetal heart tones before applying an external fetal monitor, the nurse counts 100 beats per minute. The immediate nursing action is to: Start oxygen by mask to reduce fetal distress. Examine the woman for signs of a prolapsed cord. Turn the woman on her left side to increase placental perfusion. Take the woman's radial pulse while still auscultating the FHR.

Take the woman's radial pulse while still auscultating the FHR. Taking the mother's pulse while listening to the FHR will differentiate between the maternal and fetal heart rates and rule out fetal Bradycardia.

A homecare nurse visits a pregnant client who has a diagnosis of mild Preeclampsia and who is being monitored for pregnancy induced hypertension (PIH). Which assessment finding indicates a worsening of the Preeclampsia and the need to notify the physician? Blood pressure reading is at the prenatal baseline Urinary output has increased The client complains of a headache and blurred vision Dependent edema has resolved

The client complains of a headache and blurred vision. If the client complains of a headache and blurred vision, the physician should be notified because these are signs of worsening Preeclampsia.

The main reason for an expected increased need for iron in pregnancy is: The mother may have physiologic anemia due to the increased need for red bloodcell mass as well as the fetal requires about 350-400 mg of iron to grow The mother may suffer anemia because of poor appetite The fetus has an increased need for RBC which the mother must supply The mother may have a problem of digestion because of pica

The mother may have physiologic anemia due to the increased need for red blood cell mass, as well as the fetal, requires about 350-400 mg of iron to grow. About 400 mgs of Iron is needed by the mother in order to produce more RBC mass to be able to provide the needed increase in blood supply for the fetus. Also, about 350-400 mgs of iron is need for the normal growth of the fetus. Thus, about 750-800 mgs iron supplementation is needed by the mother to meet this additional requirement.

The nurse in charge is reviewing a patient's prenatal history. Which finding indicates a genetic risk factor? The patient is 25 years old The patient has a child with cystic fibrosis The patient was exposed to rubella at 36 weeks' gestation The patient has a history of preterm labor at 32 weeks' gestation

The patient has a child with cystic fibrosis Cystic fibrosis is a recessive trait; each offspring has a one in four chance of having the trait or the disorder. Maternal age is not a risk factor until age 35, when the incidence of chromosomal defects increases. Maternal exposure to rubella during the first trimester may cause congenital defects. Although a history or preterm labor may place the patient at risk for preterm labor, it does not correlate with genetic defects.

Molar pregnancies may be complete, partial, invasive, or malignant. True False

True

Tyra experienced painless vaginal bleeding has just been diagnosed as having a placenta previa. Which of the following procedures is usually performed to diagnose placenta previa? Amniocentesis Digital or speculum examination External fetal monitoring Ultrasound

Ultrasound Once the mother and the fetus are stabilized, ultrasound evaluation of the placenta should be done to determine the cause of the bleeding. Amniocentesis is contraindicated in placenta previa. A digital or speculum examination shouldn't be done as this may lead to severe bleeding or hemorrhage. External fetal monitoring won't detect a placenta previa, although it will detect fetal distress, which may result from blood loss or placenta separation.

Which of the following complications during a breech birth the nurse needs to be alarmed? Abruption placenta. Caput succedaneum. Pathological hyperbilirubinemia. Umbilical cord prolapse.

Umbilical cord prolapse. Because umbilical cord's insertion site is born before the fetal head, the cord may be compressed by the after-coming head in a breech birth.

Check all that cause a "complete" molar pregnancy: placenta grows and produces hCG some fetal components sperm fertilizes empty egg two sperm fertilize one egg no fetus is formed

placenta grows and produces hCG sperm fertilizes empty egg no fetus is formed

Maureen, a primigravida client, age 20, has just completed a difficult, forceps-assisted delivery of twins. Her labor was unusually long and required oxytocin (Pitocin) augmentation. The nurse who's caring for her should stay alert for: Uterine inversion Uterine atony Uterine involution Uterine discomfort

Uterine atony. Multiple fetuses, extended labor stimulation with oxytocin, and traumatic delivery commonly are associated with uterine atony, which may lead to postpartum hemorrhage. Uterine inversion may precede or follow delivery and commonly results from apparent excessive traction on the umbilical cord and attempts to deliver the placenta manually. Uterine involution and some uterine discomfort are normal after delivery.

The nurse is completing an obstetric history of a woman in labor. Which event in the obstetric history will help the nurse suspects dysfunctional labor in the current pregnancy? Total time of ruptured membranes was 24 hours with the second birth. First labor lasting 24 hours. Uterine fibroid noted at time of cesarean delivery. Second birth by cesarean for face presentation.

Uterine fibroid noted at time of cesarean delivery. An abnormality in the uterine muscle could reduce the effectiveness of uterine contractions and lengthen the duration of subsequent labors.

During the period of induction of labor, a client should be observed carefully for signs of: Severe pain Uterine tetany Hypoglycemia Umbilical cord prolapse

Uterine tetany Uterine tetany could result from the use of oxytocin to induce labor. Because oxytocin promotes powerful uterine contractions, uterine tetany may occur. The oxytocin infusion must be stopped to prevent uterine rupture and fetal compromise.

All of the products of conception are expelled. inevitable complete threatened habitual missed

complete

The nurse who provides teaching to the female patient regarding prevention of recurrent urinary tract infections includes which of the following statements? Void immediately after sexual intercourse. Take tub baths instead of showers. Increase intake of coffee, tea, and colas. Void every 5 hours during the day.

correct Void immediately after sexual intercourse. (Voiding will serve to flush the urethra, expelling contaminants.) -Take tub baths instead of showers.Showers are encouraged rather than tub baths because bacteria in the bath water may enter the urethra. -Increase intake of coffee, tea, and colas.Coffee, tea, colas, alcohol, and other fluids that are urinary tract irritants should be avoided. -Void every 5 hours during the day.The patient should be encouraged to void every 2-3 hours during the day and completely empty the bladder.

Which of the following terms refers to difficult or painful sexual intercourse?

correct: Dyspareunia Dyspareunia is a common problem of the aged female. Amenorrhea Amenorrhea refers to absence of menstrual flow. DysmenorrheaDysmenorrhea refers to painful menstruation. EndometriosisEndometriosis is a condition in which endometrial tissue seeds in other areas of the pelvis.

Which of the following conditions is associated with elevated serum chloride levels? cystitis diabetes eclampsia hypertension

eclampsia. Eclampsia is associated with increased levels of serum chloride.

Any of the 5 spontaneous abortions occurring with 3 consecutive pregnancies. This condition is a result of weakened cervix that dilates in the 2nd trimester, and expels the fetus. This condition is call INCOMPLETE CERVIX. habitual missed incomplete complete threatened

habitual

Some of the products are expelled, but the placenta remains attached. Heavy bleeding and cramping doesn't subside until entire placenta is removed. habitual missed incomplete complete threatened

incomplete

Embryo or fetus dies but isn't expelled. It's often discovered by the physician when no FHT is present. Fetus must be expelled within 6wks or DIC and/or infections can occur. habitual missed incomplete inevitable threatened

missed

Cervical incompetence in combination with PROM can be a cause of umbilical cord prolapse. True False

True. Cervical incompetence in combination with PROM can be a cause of umbilical cord prolapse.

Infection in the uterus may cause PROM and may also be a complication following PROM. True False

True. Infection in the uterus may cause PROM and may also be a complication following PROM.

Which of the following are not treated with Methotrexate? Sarcomas Leukemias Ectopic pregnancy Rheumatic fever

Rheumatic fever

The common normal site of nidation/implantation in the uterus is: Upper uterine portion Mid-uterine area Lower uterine segment Lower cervical segment

Upper uterine portion

Check all that apply to the treatment of molar pregnancies: frequent follow ups evacuation of molar pregnancy radiation possible chemotherapy serial hCG levels

frequent follow ups evacuation of molar pregnancy radiation serial hCG levels

Of the following terms, which is used to refer to a type of gestational trophoblastic neoplasm? Hydatidiform mole Dermoid cyst Doderlein's bacilli Bartholin's cyst

A. Hydatidiform mole A: Hydatidiform mole occurs in 1 in 1000 pregnancies. B: A dermoid cyst is an ovarian tumor of undefined origin that consists of undifferentiated embryonal cells. C: Doderlein's bacilli is one component of normal vaginal flora. D. Bartholin's cyst is a cyst in a paired vestibular gland in the vulva

A postpartum client has a temperature of 101.4ºF, with a uterus that is tender when palpated, remains unusually large, and not descending as normally expected. Which of the following should the nurse assess next? Lochia Breasts Incision Urine

A. Lochia. The data suggests an infection of the endometrial lining of the uterus. The lochia may be decreased or copious, dark brown in appearance, and foul smelling, providing further evidence of a possible infection. All the client's data indicate a uterine problem, not a breast problem. Typically, transient fever, usually 101ºF, may be present with breast engorgement. Symptoms of mastitis include influenza-like manifestations. Localized infection of an episiotomy or C-section incision rarely causes systemic symptoms, and uterine involution would not be affected. The client data do not include dysuria, frequency, or urgency, symptoms of urinary tract infections, which would necessitate assessing the client's urine.

A maternity nurse is caring for a client with abruptio placentae and is monitoring the client for disseminated intravascular coagulopathy. Which assessment finding is least likely to be associated with disseminated intravascular coagulation? Swelling of the calf in one leg Prolonged clotting times Decreased platelet count Petechiae, oozing from injection sites, and hematuria

A. Swelling of the calf in one leg. DIC is a state of diffuse clotting in which clotting factors are consumed, leading to widespread bleeding. Platelets are decreased because they are consumed by the process; coagulation studies show no clot formation (and are thus normal to prolonged); and fibrin plugs may clog the microvasculature diffusely, rather than in an isolated area. The presence of petechiae, oozing from injection sites, and hematuria are signs associated with DIC. Swelling and pain in the calf of one leg are more likely to be associated with thrombophlebitis.

A 39-year-old at 37 weeks gestation is admitted to the hospital with complaints of vaginal bleeding following the use of cocaine 1 hour earlier. Which complication is most likely causing the client's complaint of vaginal bleeding? Placenta previa Abruptio placentae Ectopic pregnancy Spontaneous abortion

Abruptio placentae The major maternal adverse reactions from cocaine use in pregnancy include spontaneous abortion first, not third, trimester abortion and abruptio placentae.

Which of the following is described as premature separation of a normally implanted placenta during the second half of pregnancy, usually with severe hemorrhage? Placenta previa Ectopic pregnancy Incompetent cervix Abruptio placentae

Abruptio placentae is described as premature separation of a normally implanted placenta during the second half of pregnancy, usually with severe hemorrhage. Placenta previa refers to implantation of the placenta in the lower uterine segment, causing painless bleeding in the third trimester of pregnancy. Ectopic pregnancy refers to the implantation of the products of conception in a site other than the endometrium. Incompetent cervix is a conduction characterized by painful dilation of the cervical os without uterine contractions.

Which of the following is described as premature separation of a normally implanted placenta during the second half of pregnancy, usually with severe hemorrhage? Placenta previa Ectopic pregnancy Incompetent cervix Abruptio placentae

Abruptio placentae. Abruptio placentae is described as premature separation of a normally implanted placenta during the second half of pregnancy, usually with severe hemorrhage. Placenta previa refers to implantation of the placenta in the lower uterine segment, causing painless bleeding in the third trimester of pregnancy. Ectopic pregnancy refers to the implantation of the products of conception in a site other than the endometrium. Incompetent cervix is a conduction characterized by painful dilation of the cervical os without uterine contractions.

Which of the following is described as premature separation of a normally implanted placenta during the second half of pregnancy, usually with severe hemorrhage? Placenta previa Ectopic pregnancy Incompetent cervix Abruptio placentae

Abruptio placentae. Abruptio placentae is described as premature separation of a normally implanted placenta during the second half of pregnancy, usually with severe hemorrhage. Placenta previa refers to implantation of the placenta in the lower uterine segment, causing painless bleeding in the third trimester of pregnancy. Ectopic pregnancy refers to the implantation of the products of conception in a site other than the endometrium. Incompetent cervix is a conduction characterized by painful dilation of the cervical os without uterine contractions.

A 39-year-old at 37 weeks gestation is admitted to the hospital with complaints of vaginal bleeding following the use of cocaine 1 hour earlier. Which complication is most likely causing the client's complaint of vaginal bleeding? Placenta previa Abruptio placentae Ectopic pregnancy Spontaneous abortion

Abruptio placentae. The major maternal adverse reactions from cocaine use in pregnancy include spontaneous abortion first, not third, trimester abortion and abruptio placentae.

A 39-year-old at 37 weeks gestation is admitted to the hospital with complaints of vaginal bleeding following the use of cocaine 1 hour earlier. Which complication is most likely causing the client's complaint of vaginal bleeding? Placenta previa Abruptio placentae Ectopic pregnancy Spontaneous abortion

Abruptio placentae. The major maternal adverse reactions from cocaine use in pregnancy include spontaneous abortion first, not third, trimester abortion and abruptio placentae.

A client in preterm labor (32 weeks) who is dilated to 5cm has been given magnesium sulfate and the contractions have stopped. If the labor can be delayed for the next 2 days, which of the following medication does the nurse expect that will be prescribed? Fentanyl (Sublimaze). Sufentanil (Sufenta). Betamethasone (Celestone). Butorphanol tartrate (Stadol).

Betamethasone (Celestone). Glucocorticoids such as betamethasone and dexamethasone are being used to increase the production of surfactant to aid in fetal lung maturation. It is being given to patients who are in preterm labor at 28-32 weeks of gestation if the labor can be stopped for 2 days. Fentanyl, Sufentanil, Butorphanol tartrate are all opioid analgesic.

An infant born at 33 weeks' gestation has anemia of prematurity, which is characterized by an inadequate response to erythropoietin. The healthcare provider expects that microscopic examination of this infant's red blood cells would reveal. Normal hemoglobin in each cell. Large, pale cells. Small and immature cells. Cells of normal size. Small, irregularly shaped cells.

Cells of normal size. Erythropoietin is a hormone that stimulates bone marrow to make red blood cells. Anemia of prematurity does not involve impaired hemoglobin production. The bone marrow will make an inadequate amount of red blood cells, but they will be of normal size, shape, and color. Anemia of prematurity is a normocytic, normochromic anemia.

When the bag of waters ruptures spontaneously, the nurse should inspect the vaginal introitus for possible cord prolapse. If there is part of the cord that has prolapsed into the vaginal opening the correct nursing intervention is: Push back the prolapse cord into the vaginal canal Place the mother on semifowler's position to improve circulation Cover the prolapse cord with sterile gauze wet with sterile NSS and place the woman on trendellenberg position Push back the cord into the vagina and place the woman on sims position

Cover the prolapse cord with sterile gauze wet with sterile NSS and place the woman on trendellenberg position. The correct action of the nurse is to cover the cord with sterile gauze wet with sterile NSS. Observe strict asepsis in the care of the cord to prevent infection. The cord has to be kept moist to prevent it from drying. Don't attempt to put back the cord into the vagina but relieve pressure on the cord by positioning the mother either on trendellenberg or sims position

A client with a missed abortion at 29 weeks gestation is admitted to the hospital. The client will most likely be treated with: Magnesium sulfate Calcium gluconate Dinoprostone (Prostin E.) Bromocrystine (Pardel)

Dinoprostone (Prostin E.) The client with a missed abortion will have induction of labor. Prostin E. is a form of prostaglandin used to soften the cervix. Magnesium sulfate is used for preterm labor and preeclampsia, calcium gluconate is the antidote for magnesium sulfate, and Pardel is a dopamine receptor stimulant used to treat Parkinson's disease; therefore, answers A, B, and D are incorrect. Pardel was used at one time to dry breast milk.

A client with a missed abortion at 29 weeks gestation is admitted to the hospital. The client will most likely be treated with: Magnesium sulfate Calcium gluconate Dinoprostone (Prostin E.) Bromocrystine (Pardel)

Dinoprostone (Prostin E.). The client with a missed abortion will have induction of labor. Prostin E. is a form of prostaglandin used to soften the cervix. Magnesium sulfate is used for preterm labor and preeclampsia, calcium gluconate is the antidote for magnesium sulfate, and Pardel is a dopamine receptor stimulant used to treat Parkinson's disease; therefore, answers A, B, and D are incorrect. Pardel was used at one time to dry breast milk.

Upon assessment the nurse found the following: fundus at 2 fingerbreadths above the umbilicus, last menstrual period (LMP) 5 months ago, fetal heart beat (FHB) not appreciated. Which of the following is the most possible diagnosis of this condition? Hydatidiform mole Missed abortion Pelvic inflammatory disease Ectopic pregnancy

Hydatidiform mole. Hydatidiform mole begins as a pregnancy but early in the development of the embryo degeneration occurs. The proliferation of the vesicle-like substances is rapid causing the uterus to enlarge bigger than the expected size based on ages of gestation (AOG). In the situation given, the pregnancy is only 5 months but the size of the uterus is already above the umbilicus which is compatible with 7 months AOG. Also, no fetal heart beat is appreciated because the pregnancy degenerated thus there is no appreciable fetal heart beat.

Maureen is admitted with a diagnosis of ectopic pregnancy. Which of the following would you anticipate? NPO Bed rest Immediate surgery Enema

Immediate surgery

Restriction of activities and cervical cerclage are the treatments for __________ . Abruptio Placenta Placenta Previa Incompetent Cervix H-mole

Incompetent Cervix

A client in her third trimester tells the nurse, "I'm constipated all the time!" Which of the following should the nurse recommend? Daily enemas Laxatives Increased fiber intake Decreased fluid intake

Increased fiber intake During the third trimester, the enlarging uterus places pressure on the intestines. This coupled with the effect of hormones on smooth muscle relaxation causes decreased intestinal motility (peristalsis). Increasing fiber in the diet will help fecal matter pass more quickly through the intestinal tract, thus decreasing the amount of water that is absorbed. As a result, stool is softer and easier to pass. Enemas could precipitate preterm labor and/or electrolyte loss and should be avoided. Laxatives may cause preterm labor by stimulating peristalsis and may interfere with the absorption of nutrients. Use for more than 1 week can also lead to laxative dependency. Liquid in the diet helps provide a semisolid, soft consistency to the stool. Eight to ten glasses of fluid per day are essential to maintain hydration and promote stool evacuation.

When the uterus is firm and contracted after delivery but there is vaginal bleeding, the nurse should suspect Laceration of soft tissues of the cervix and vagina Uterine atony Uterine inversion Uterine hypercontractility

Laceration of soft tissues of the cervix and vagina. When uterus is firm and contracted it means that the bleeding is not in the uterus but other parts of the passageway such as the cervix or the vagina.

To prevent preterm labor from progressing, drugs are usually prescribed to halt the labor. The drugs commonly given are: Magnesium sulfate and terbutaline Prostaglandin and oxytocin Progesterone and estrogen Dexamethasone and prostaglandin

Magnesium sulfate and terbutaline Magnesium sulfate acts as a CNS depressant as well as a smooth muscle relaxant. Terbutaline is a drug that inhibits the uterine smooth muscles from contracting. On the other hand, oxytocin and prostaglandin stimulates contraction of smooth muscles.

Which of the following signs will require a mother to seek immediate medical attention? When the first fetal movement is felt No fetal movement is felt on the 6th month Mild uterine contraction Slight dyspnea on the last month of gestation

No fetal movement is felt on the 6th month. Fetal movement is usually felt by the mother during 4.5 - 5 months. If the pregnancy is already in its 6th month and no fetal movement is felt, the pregnancy is not normal either the fetus is already dead intra-uterine or it is an H-mole.

Which of the following would be the priority nursing diagnosis for a client with an ectopic pregnancy? Risk for infection Pain Knowledge Deficit Anticipatory Grieving

Pain. For the client with an ectopic pregnancy, lower abdominal pain, usually unilateral, is the primary symptom. Thus, pain is the priority. Although the potential for infection is always present, the risk is low in ectopic pregnancy because pathogenic microorganisms have not been introduced from external sources. The client may have a limited knowledge of the pathology and treatment of the condition and will most likely experience grieving, but this is not the priority at this time.

Which of the following signs and symptoms will most likely make the nurse suspect that the patient is having hydatidiform mole? Slight bleeding Passage of clear vesicular mass per vagina Absence of fetal heart beat Enlargement of the uterus

Passage of clear vesicular mass per vagina. Hydatidiform mole (H-mole) is characterized by the degeneration of the chorionic villi wherein the villi becomes vesicle-like. These vesicle-like substances when expelled per vagina and is a definite sign that the woman has H-mole.

The nurse is reviewing orders on a patient admitted for preterm premature rupture of membranes. Which physician order will the nurse question? Perform a vaginal exam every shift Monitor maternal temperature every 4 hours Continuous fetal heart rate monitoring Ampicillin 1 gm IVPB q 6 hours

Perform a vaginal exam every shift

Methergine or pitocin are prescribed for a client with PP hemorrhage. Before administering the medication(s), the nurse contacts the health provider who prescribed the medication(s) in which of the following conditions is documented in the client's medical history? Peripheral vascular disease Hypothyroidism Hypotension Type 1 diabetes

Peripheral vascular disease. These medications are avoided in clients with significant cardiovascular disease, peripheral disease, hypertension, eclampsia, or preeclampsia. These conditions are worsened by the vasoconstriction effects of these medications.

Which of the following conditions is common in pregnant women in the 2nd trimester of pregnancy? Mastitis Metabolic alkalosis Physiologic anemia Respiratory acidosis

Physiologic anemia. Hemoglobin and hematocrit levels decrease during pregnancy as the increase in plasma volume exceeds the increase in red blood cell production.

Which of the following increases the risk of placental abruption? Age < 35 years Gestational diabetes Previous placental abruption Strenuous exercise

Previous placental abruption. The risk of placental abruption is increased 15- to 20-fold if an earlier pregnancy had been complicated by placental abruption.6 Other risk factors include chronic hypertension, cocaine use, preeclampsia, age over 35 years, trauma, thrombophilia, cigarette smoking, preterm premature rupture of membranes, chorioamnionitis, and multiparity

Which of the following increases the risk of placental abruption? Age < 35 years Gestational diabetes Previous placental abruption Strenuous exercise

Previous placental abruption. The risk of placental abruption is increased 15- to 20-fold if an earlier pregnancy had been complicated by placental abruption.6 Other risk factors include chronic hypertension, cocaine use, preeclampsia, age over 35 years, trauma, thrombophilia, cigarette smoking, preterm premature rupture of membranes, chorioamnionitis, and multiparity

Which of the following is the most common kind of placental adherence seen in pregnant women? Accreta Placenta previa Percreta Increta

Question 1 Explanation: Placenta accreta is the most common kind of placental adherence seen in pregnant women and is characterized by slight penetration of myometrium. In placenta previa, the placenta does not embed correctly and results in what is known as a low-lying placenta. It can be marginal, partial, or complete in how it covers the cervical os, and it increases the patient's risk for painless vaginal bleeding during the pregnancy and/or delivery process. Placenta percreta leads to perforation of the uterus and is the most serious and invasive of all types of accrete. Placenta increta leads to deep penetration of the myometrium.

A pregnant client is receiving magnesium sulfate for the management of preeclampsia. A nurse determines the client is experiencing toxicity from the medication if which of the following is noted on assessment? Presence of deep tendon reflexes Serum magnesium level of 6 mEq/L Proteinuria of +3 Respirations of 10 per minute

Respirations of 10 per minute. Magnesium toxicity can occur from magnesium sulfate therapy. Signs of toxicity relate to the central nervous system depressant effects of the medication and include respiratory depression, loss of deep tendon reflexes, and a sudden drop in the fetal heart rate and maternal heart rate and blood pressure. Therapeutic levels of magnesium are 4-7 mEq/L. Proteinuria of +3 would be noted in a client with preeclampsia.

Which of the following would the nurse Sandra most likely expect to find when assessing a pregnant client with abruption placenta? Excessive vaginal bleeding Rigid, boardlike abdomen Titanic uterine contractions Premature rupture of membranes

Rigid, boardlike abdomen. The most common assessment finding in a client with abruption placenta is a rigid or boardlike abdomen. Pain, usually reported as a sharp stabbing sensation high in the uterine fundus with the initial separation, also is common.

Which of the following statements best describes hyperemesis gravidarum? Severe anemia leading to an electrolyte, metabolic, and nutritional imbalances in the absence of other medical problems. Severe nausea and vomiting leading to an electrolyte, metabolic, and nutritional imbalances in the absence of other medical problems. Loss of appetite and continuous vomiting that commonly results in dehydration and ultimately decreasing maternal nutrients Severe nausea and diarrhea that can cause gastrointestinal irritation and possibly internal bleeding

Severe nausea and vomiting leading to the electrolyte, metabolic, and nutritional imbalances in the absence of other medical problems. The description of hyperemesis gravidarum includes severe nausea and vomiting, leading to the electrolyte, metabolic, and nutritional imbalances in the absence of other medical problems. Option A: Hyperemesis is not a form of anemia. Option C: Loss of appetite may occur secondary to nausea and vomiting of hyperemesis, which, if it continues, can deplete the nutrients transported to the fetus. Option D: Diarrhea does not occur with hyperemesis.

A client is being admitted to the antepartum unit for hypovolemia secondary to hyperemesis gravidarum. Which of the following factors predisposes a client to the development of this? trophoblastic disease maternal age > 35 y.o. malnourished or underweight clients low levels of HCG

Trophoblastic disease . Trophoblastic disease is associated w/ hyperemesis gravidarum obesity and maternal age younger than 20 y.o. are risk factors too. High levels of estrogen HCG have also been associated with the development.

PROM may occur if the uterus is over-stretched by malpresentation of the fetus, multiple pregnancy or excess amniotic fluid. True False

True. Prom may occur if the uterus is over-stretched by malpresentation of the fetus, multiple pregnancy or excess amniotic fluid.

A pregnant woman who is at term is admitted to the birthing unit in active labor. The client has only progressed from 2cm to 3 cm in 8 hours. She is diagnosed with hypotonic dystocia and the physician ordered Oxytocin (Pitocin) to augment her contractions. Which of the following is the most important aspect of nursing intervention at this time? Timing and recording length of contractions. Monitoring. Preparing for an emergency cesarean birth. Checking the perineum for bulging.

Timing and recording length of contractions. The oxytocic effect of Pitocin increases the intensity and durations of contractions; prolonged contractions will jeopardize the safetyof the fetus and necessitate discontinuing the drug.

A client is admitted to the L & D suite at 36 weeks' gestation. She has a history of C-section and complains of severe abdominal pain that started less than 1 hour earlier. When the nurse palpates tetanic contractions, the client again complains of severe pain. After the client vomits, she states that the pain is better and then passes out. Which is the probable cause of her signs and symptoms? Hysteria compounded by the flu Placental abruption Uterine rupture Dysfunctional labor

Uterine rupture. Uterine rupture is a medical emergency that may occur before or during labor. Signs and symptoms typically include abdominal pain that may ease after uterine rupture, vomiting, vaginal bleeding, hypovolemic shock, and fetal distress. With placental abruption, the client typically complains of vaginal bleeding and constant abdominal pain.

A nurse is assessing a pregnant client in the 2nd trimester of pregnancy who was admitted to the maternity unit with a suspected diagnosis of abruptio placentae. Which of the following assessment findings would the nurse expect to note if this condition is present? Absence of abdominal pain A soft abdomen Uterine tenderness/pain Painless, bright red vaginal bleeding

Uterine tenderness/pain. In abruptio placentae, acute abdominal pain is present. Uterine tenderness and pain accompany placental abruption, especially with a central abruption and trapped blood behind the placenta. The abdomen will feel hard and board-like on palpation as the blood penetrates the myometrium and causes uterine irritability. Observation of the fetal monitoring often reveals increased uterine resting tone, caused by the failure of the uterus to relax in an attempt to constrict blood vessels and control bleeding.

During the period of induction of labor, a client should be observed carefully for signs of: Severe pain Uterine tetany Hypoglycemia Umbilical cord prolapse

Uterine tetany. Uterine tetany could result from the use of oxytocin to induce labor. Because oxytocin promotes powerful uterine contractions, uterine tetany may occur. The oxytocin infusion must be stopped to prevent uterine rupture and fetal compromise.

A client makes a routine visit to the prenatal clinic. Although she's 14 weeks pregnant, the size of her uterus approximates that in an 18- to 20-week pregnancy. Dr. Diaz diagnoses gestational trophoblastic disease and orders ultrasonography. The nurse expects ultrasonography to reveal: an empty gestational sac. grapelike clusters. a severely malformed fetus. an extrauterine pregnancy.

grapelike clusters. In a client with gestational trophoblastic disease, an ultrasound performed after the 3rd month shows grapelike clusters of transparent vesicles rather than a fetus. The vesicles contain a clear fluid and may involve all or part of the decidual lining of the uterus. Usually no embryo (and therefore no fetus) is present because it has been absorbed. Because there is no fetus, there can be no extrauterine pregnancy. An extrauterine pregnancy is seen with an ectopic pregnancy.

Risk factor of trophoblastic disease: over 40 low economic status previous molar pregnancy women living in far eastern countries diets deficient in protein and folic acid 30 or younger

over 40 low economic status previous molar pregnancy women living in far eastern countries diets deficient in protein and folic acid