OB Chapters 19 and 20

A client with preeclampsia is receiving magnesium sulfate to suppress or control seizures. Which nursing intervention should a nurse perform to determine the effectiveness of therapy? A. Assess deep tendon reflexes B. Monitor intake and output C. Assess the client's mucous membrane D. Assess client's skin turgor

A. Assess deep tendon reflexes

A nurse is caring for a pregnant client. The initial interview reveals that the client is accustomed to drinking coffee at regular intervals. For which increased risk should the nurse make the client aware? A. Heart Disease B. Anemia C. Rickets D. Scurvy

B. Anemia

A nurse is caring for a pregnant client with asthma. Which intervention would the nurse perform first? A. Monitoring temperature frequently B. Assessing oxygen saturation C. Monitoring frequency of headache D. Assessing for feeling nauseated

B. Assessing oxygen saturation

Gestational Trophoblastic Disease (GTD)

Spectrum of neoplastic disorders that originate in the human placenta

First

The most common cause for _____ trimester abortions is fetal genetic abnormalities, usually unrelated to the mother

Clonus

The presence of rhythmic involuntary contractions, most often at the foot or ankle

Latent

The time interval from rupture of membranes to the onset of regular contractions is termed the _______ period

When caring for a client with premature rupture of membranes (PROM), the nurse observes an increase in the client's pulse. What should the nurse do next? A. Assess the client's temperature B. Monitor the client for preterm labor C. Assess for cord compression D. Monitor the fetus for respiratory distress

A. Assess the client's temperature

Hyperrelexia (brisk reflexes)

A common presenting symptom of preeclampsia and is the result of an irritable cortex

Rh Imcompatibility

A condition that develops when a women with Rh-negative blood type is exposed to Rh-positive blood cells and subsequently develops circulation titers of Rh antibodies

Oligohydramnios

A decreased amount of amniotic fluid (<500 mL) between 32 and 36 weeks' gestation

Infection

A foul odor of amniotic fluid indicates ______

The nurse is caring for a pregnant client who indicates that she is fond of meat, works with children, and has a pet cat. Which instructions should the nurse give this client to prevent toxoplasmosis? SATA A. Eat meat cooked at 160 F (71 C) B. Avoid cleaning the cat's litter box C. Keep the cat outdoors at all times D. Avoid contact with children when they have a cold E. Avoid outdoor activities such as gardening

A. Eat meat cooked at 160 F (71 C) B. Avoid cleaning the cat's litter box E. Avoid outdoor activities such as gardening

What important instruction should the nurse give a pregnant client with tuberculosis? A. Maintain adequate hydration B. Avoid direct sunlight C. Avoid red meat D. Wear light, cotton clothes

A. Maintain adequate hydration

The nurse is caring for an Rh-negative nonimmunized clients at 14 weeks' gestation. What information would the nurse provide to the client? A. Obtain RhoGAM at 28 weeks' gestation B. Consume a well-balanced, nutritional diet C. Avoid sexual activity until after 28 weeks D. Undergo periodic transvaginal ultrasounds

A. Obtain RhoGAM at 28 weeks' gestation

The nurse is caring for a 2-day-old newborn whose mother was diagnosed with cytomegalovirus during the first trimester. On which health care provider order should the nurse place the priority? A. Perform a hearing screen test B. Obtain a urine specimen C. Monitor growth and development D. Assess pulse rate

A. Perform a hearing screen test

A nursing is caring for a client undergoing treatment for ectopic pregnancy. Which symptom is observed in a client if rupture or hemorrhaging occurs before the ectopic pregnancy is successfully treated? A. Phrenic nerve irritation B. Painless bright red vaginal bleeding C. Fetal distress D. Tetanic contractions

A. Phrenic nerve irritation

A pregnant client is brought to the health care facility with signs of premature rupture of membranes (PROM). Which conditions and complications are associated with PROM? SATA A. Prolapsed cord B. Abruptio placenta C. Spontaneous abortion D. Placenta previa E. Preterm labor

A. Prolapsed cord B. Abruptio placenta E. Preterm labor

During the assessment of a laboring client, the nurse learns the client has cardiovascular disease (CVD). Which assessment would be priority for the newborn? A. Respiratory function B. Heart rate C. Temperature D. Urine output

A. Respiratory function

A nurse is caring for a newborn with fetal alcohol spectrum disorder. What characteristic of the fetal alcohol spectrum disorder should the nurse assess for in the newborn? A. Small head circumference B. Decreased blood glucose level C. Abnormal breathing pattern D. Wide eyes

A. Small head circumference

The nurse is caring for a pregnant client who is in her 30th week of gestation and has genital heart disease. Which should the nurse recognize as a symptom of cardiac decompensation with this client? A. Swelling of the face B. Dry, rasping cough C. Slow, labored respiration D. Elevated temperature

A. Swelling of the face

A nurse is caring for a pregnant client with sickle cell anemia. What should the nursing care for the client include? SATA A. Teach the client meticulous hand-washing B. Assess serum electrolyte levels of the client at each visit C. Instruct client to consume protein-rich food D. Assess hydration status of the client at each visit E. Urge the client to drink 8 to 10 glasses of fluid daily

A. Teach the client meticulous hand-washing D. Assess hydration status of the client at each visit E. Urge the client to drink 8 to 10 glasses of fluid daily

A nurse is monitoring a client with spontaneous abortion who has been prescribed misoprostol. Which symptoms are common adverse effects associated with misoprostol? SATA A. Constipation B. Dyspepsia C. Headache D. Hypotension E. Tachycardia

B. Dyspepsia D. Hypotension E. Tachycardia

The nurse is required to assess a client for HELLP syndrome. Which are the signs and symptoms of this condition? SATA A. Blood pressure higher than 160/110 B. Epigastric pain C. Oliguria D. Upper right quadrant pain E. Hyperbilirubinemia

B. Epigastric pain D. Upper right quadrant pain E. Hyperbilirubinemia

A nurse is monitoring a client with PROM who is in labor and observes meconium in the amniotic fluid. What does this indicate? A. Cord Compression B. Fetal distress related to hypoxia C. Infection D. Central nervous system "CNS" involvement

B. Fetal distress related to hypoxia

A nurse is documenting a dietary plan for a pregnant client with progestational diabetes. What instructions should the nurse include in the dietary plan for this client? A. Include more dairy products in the diet B. Include complex carbohydrates in the diet C. Eat only two meals per day D. Eat at least one egg per day

B. Include complex carbohydrates in the diet

A client is seeking advise for his pregnant wife who is experiencing mild elevations in blood pressure. In which positions should a nurse recommend the pregnant client rest? A. Supine position B. Lateral recumbent position C. Left lateral lying position D. Head of the bed slightly elevated

B. Lateral recumbent position

A nurse caring for a pregnant client suspected substance use during pregnancy. What is the priority nursing intervention for this client? A. Determine how long the client has been using drugs B. Obtain a urine specimen for a drug screening C. Determine if the client has emotional support D. Provide education material on cessation of substance use

B. Obtain a urine specimen for a drug screening

What is the role of the nurse during the preconception counseling of a pregnant client with chronic hypertension? A. Stressing the avoidance of dairy products B. Stressing the positive benefits of a healthy lifestyle C. Stressing the increased use of Vitamin D supplements D. Stressing regular walks and exercise

B. Stressing the positive benefits of a healthy lifestyle

A nurse has been assigned to assess a pregnant client for abruptio placenta. For which classic manifestation of this condition should the nurse assess? A. Painless bright red vaginal bleeding B. Increased fetal movement C. "Knife-like" abdominal pain with vaginal bleeding D. Generalized vasospasm

C. "Knife-like" abdominal pain with vaginal bleeding

A nurse is caring for a pregnant client with gestational diabetes. Which meal should the nurse recommend for this client? A. Baked chicken, green beans, and chocolate cake B. Pizza, corn, and orange slices C. Baked turkey, brown rice, and strawberries D. Steak, baked potato with butter, and ice cream

C. Baked turkey, brown rice, and strawberries

Gestational Hypertension

Characterized by hypertension without proteinuria after 20 weeks' gestation and a return of the blood pressure to normal postpartum

A nurse is care for a 45-year-old pregnant client with a cardiac disorder, who has been instructed by her physician to follow class I functional activity recommendations. The nurse correctly instructs the client to follow which limitations? A. "You will need to be on bedrest for the remainder of your pregnancy." B. "It is important for you to rest after my physical activity in order to prevent any cardiac complications." C. "It will be beneficial if you plan rest periods throughout the day." D. "You do not need to limit your physical activity unless you experience any problems such as fatigue, chest pain, or shortness of breath."

D. "You do not need to limit your physical activity unless you experience any problems such as fatigue, chest pain, or shortness of breath."

A nurse is assessing pregnant clients for the risk of placenta previa. Which of the following clients faces the greatest risk for this condition? A. A 23-year-old multigravida client B. A client with a history of alcohol abuse C. A client with a structurally defective cervix D. A client who had a myomectomy to remove fibroids

D. A client who has a myomectomy to remove fibroids

A nurse is caring for a client with hyperemesis gravidarum. Which nursing action is the priority for this client? A. Administer total parental nutrition B. Administer an antiemetic C. Set up for a percutaneous endoscopic gastrostomy D. Administer IV NS with vitamins and electrolytes

D. Administer IV NS with vitamins and electrolytes

A nursing is caring for a pregnant client with heart disease in a labor unit. Which intervention is most important in the first 48 hours postpartum? A. Limiting sodium intake B. Inspecting the extremities for edema C. Ensuring that the client consumes a high-fiber diet D. Assessing for cardiac decompensation

D. Assessing for cardiac decompensation

The nurse is required to assess a pregnant client who is reporting vaginal bleeding. Which nurse action is the priority? A. Monitoring uterine contractility B. Assessing signs of shock C. Determining the amount of funneling D. Assessing the amount and color of the bleeding

D. Assessing the amount and color of the bleeding

A nurse is caring for a pregnant adolescent client, who is in her first trimester, during a visit to the maternal child clinic. Which important area should the nurse address during assessment of the client? A. Sexual development of the client B. Whether sex was consensual C. Options for birth control in the future D. Knowledge of child development

D. Knowledge of child development

A nurse is caring for a pregnant client who is human immunodeficiency virus (HIV) positive. What is a priority issue that the nurse should discuss with the client? A. The client's relationship with the spouse B. The amount of physical contact that should occur with the infant C. The client's plan for future pregnancies D. The need for the client to avoid breast-feeding

D. The need for the client to avoid breast-feeding

Monozygotic Twins

Develop when a single, fertilized ovum splits during the first 2 weeks after conception

Placenta Previa

Painless bleeding condition that occurs in the last two trimesters of pregnancy

Ectopic Preganancy

Pregnancy in which the fertilized ovum implants outside the uterine cavity

Spontaneous Abortion

Refers to the loss of a fetus resulting from natural causes- that is not elective or therapeutically induced by a procedure (usually before the 20th week of gestation)

Cervical Insufficiency (Incompetent Cervix)

Weak, structurally defective cervix that spontaneously dilates in the absence of contractions in the second trimester, resulting in the loss of the pregnancy

A nurse is caring for a client with CVD who has just delivered. What nursing interventions should the nurse perform when caring for this client? SATA A. Assess for shortness of breath B. Assess for a moist cough C. Assess for edema and note any pitting D. Auscultate heart sounds for abnormalities E. Monitor the client's hemoglobin and hematocrit

A. Assess for shortness of breath C. Assess for edema and note any pitting D. Auscultate the heart sounds for abnormalities

A nurse is caring for a pregnant client with eclamptic seizure. Which is a characteristic of eclampsia? A. Muscle rigidity is followed by facial twitching B. Respirations are rapid during the seizure C. Coma occurs after the seizure D. Respiration fails after the seizure

C. Coma occurs after the seizure

A pregnant client with hyperemesis gravidarum need advice on how to minimize nausea and vomiting. Which instruction should the nurse give this client? A. Lie down or recline for at least 2 hours after eating B. Avoid dry crackers, toast, and soda C. Eat small, frequent meals throughout the day D. Decrease intake of carbonated beverages

C. Eat small, frequent meals throughout the day

The nurse is caring for a pregnant client with fallopian tube rupture. Which intervention is the priority for this client? A. Monitor the client's beta-hCG level B. Monitor the mass with transvaginal ultrasound C. Monitor the client's vital signs and bleeding D. Monitor the fetal heart rate (FHR)

C. Monitoring the client's vital signs and bleeding

A pregnant client has been diagnosed with gestational diabetes. Which are risk factors for developing gestational diabetes? SATA A. Maternal age less than 18 years B. Genitourinary tract abnormalities C. Obesity D. Hypertension E. Previous large for gestational age (LGA) infant

C. Obesity D. Hypertension E. Previous large for gestational age (LGA) infant

Which should the nurse identify as a risk associated with anemia during pregnancy? A. Newborn with heart problems B. Fetal asphyxia C. Preterm birth D. Newborn with an enlarged liver

C. Preterm birth

A nurse is assessing a pregnant client with preeclampsia for suspected dependent edema. Which description of dependent edema is most accurate? A. Dependent edema leaves a small depression or pit after finger pressure is applied to a swollen area B. Dependent edema occurs only in client's on bed rest C. Dependent edema can be measured when pressure is applied D. Dependent edema may be seen in the sacral area if the client is on bed rest

D. Dependent edema may be seen in the sacral area if the client is on bed rest

The nurse is caring for a pregnant client with severe preeclampsia. Which nursing interventions should a nurse perform to institute and maintain seizure precautions in this client? A. Provide a well-lit room B. Keep head of bed slightly elevated C. Place the client in supine position D. Keep the suction equipment readily available

D. Keep the suction equipment readily available