Ch 16 Pregnancy at Risk: Conditions That Complicate Pregnancy

The nurse is caring for a pregnant client in the first trimester with a preexisting condition of rheumatic heart disease. The client reports mild shortness of breath with strenuous activity. When teaching the client, which statement(s) will the nurse include? Select all that apply.

"Be sure to drink an adequate amount of fluids." "Be sure to receive an influenza vaccine." "Perform moderate exercises as tolerated."

The maternal health nurse is caring for a pregnant client with sickle cell anemia. Which statement(s) will the nurse include in the teaching specific to this condition? Select all that apply.

"Try to avoid extreme temperatures." "Try to avoid large crowds." "Inspect your legs daily for the development of ulcers."

The nurse is caring for a pregnant client with asthma that is well managed with long- and short-acting bronchodilators. Which statement(s) does the nurse associate with the client's condition? Select all that apply.

Adequate analgesia decreases the woman's risk for exacerbation during labor. The woman should receive her regularly scheduled bronchodilators during labor. Adequate hydration decreases the woman's risk for exacerbation during labor.

A patient with type 2 diabetes mellitus is planning to become pregnant within the next several months. What should the nurse instruct the patient to support the 2020 National Health Goals of reducing the complications of pregnancy from diabetes

Avoid episodes of hyperglycemia.

The nurse is caring for a pregnant client who has a history of asthma, which is poorly controlled. Which clinical finding(s) might alert the nurse to a complication associated with the client's medical history? Select all that apply.

Blood pressure 140/94 mmHg Client-reported headache

The maternal health nurse is caring for a pregnant client with sickle cell disease. Which action(s) will the nurse take to help the client prevent complications related to her disease? Select all that apply.

Obtain a urine sample at every prenatal visit. Instruct the client on the warning signs of stroke. Observe the client's lower extremities for ulcers at every prenatal visit.

A woman with epilepsy who is taking phenytoin sodium has just learned that she is pregnant. When planning this woman's care, which intervention would the nurse most likely include?

Teaching about vitamin K during the last 4 weeks of pregnancy

A woman arrives at the prenatal clinic and is accompanied by her partner. Which behaviors would be suggestive of intimate partner violence (IPV)? Select all that apply.

The partner answers questions for the pregnant client. The partner is overly protective of the pregnant client. Poor weight gain during the pregnancy and low birth weight infant

A client who is 10 weeks' pregnant reports during a social assessment interview that she has two indoor cats, lives alone, fixes her own meals and enjoys gardening. What precautions would the nurse recommend the woman take to prevent the possibility of contracting toxoplasmosis? Select all that apply.

Use gloves when planting her vegetable garden. Make sure meats are cooked to 152ºF (66.7℃); do not eat raw or rare meats.

The clinic nurse teaches a pregestational type 1 diabetic client that constant insulin levels are very important during pregnancy. The nurse tells the client that the best way to maintain a constant insulin level is to use:

an insulin pump.

The maternal health nurse is caring for a group of pregnant clients with heart disease. Which client will the nurse see first?

6-week pregnant client with pulmonary hypertension

A woman with known cardiac disease is in labor. In what position would the nurse place the client?

Semi-recumbent with a pillow under one hip

A patient in the second trimester of pregnancy is diagnosed with cervical cancer. For which treatment should the nurse instruct the patient as causing the least harm to the developing fetus?

Chemotherapy

A patient with type 2 diabetes mellitus is planning to become pregnant within the next several months. What should the nurse instruct the patient to support the 2020 National Health Goals of reducing the complications of pregnancy from diabetes?

Avoid episodes of hyperglycemia.

A nurse is teaching a prenatal client with class III heart failure the signs and symptoms which should be reported to the health care provider. The nurse determines the teaching has been effective when the client states which statement?

"I will call the clinic when I have a cough at night."

The maternal health nurse is caring for a pregnant client with preexisting heart disease. Which concept will the nurse identify as priority?

Balancing weight gain

The maternal health nurse is caring for a pregnant client with iron-deficiency anemia who reports "extreme fatigue and shortness of breath" during a prenatal checkup at the outpatient clinic. The nurse prepares to educate the client regarding proper nutrition for this condition. Which dietary choice(s) will the nurse suggest? Select all that apply.

Beef stew with potatoes and milk Fortified dried cereal with milk and orange juice Dark leafy green salad with sunflower seeds and water Red beans and rice with cranberry juice

The maternal health nurse cares for a homeless pregnant woman who presented to the emergency room in precipitous labor. The woman has not had prenatal care. Upon delivery, her infant weighs 4.6 kg and notes the infant appears to be jittery. Which nursing action will the nurse perform first?

Check the infant's blood glucose level

A 20-year-old pregnant client is positive for hemoglobin S. The nurse explains to the client that she will need perform which actions during her pregnancy? Select all that apply.

Drink lots of fluids. Avoid conditions of low oxygen tension, such as high altitudes.

The maternal health nurse is caring for a pregnant client with a history of epilepsy. The client's antiepileptic drug (AED) levels have been in the non-therapeutic range the last two times the labs were drawn. Which factor does the nurse associate with this finding

Drug metabolism changes during pregnancy

A woman in her 20s has a long history of sickle cell anemia and is 18 weeks' pregnant. What precautions would the nurse recommend the woman take to minimize the chance of experiencing a sickle cell crisis?

Get at least 8 hours sleep each night.

A patient with diabetes who is in the second trimester of pregnancy notes that the usual dose of insulin to maintain blood glucose levels has been increasing over the last few weeks. What should the nurse explain to the patient about insulin during pregnancy?

Insulin resistance develops because of human placental lactogen hormone and other hormones.

A woman with known cardiac disease from childhood presents at the obstetrician's office 6 weeks' pregnant. What recommendations would the nurse make to the client to address the known cardiac problems for this pregnancy? Select all that apply.

Plan periods of rest into the workday. Receive pneumococcal and influenza vaccines. Let the physician know if you become short of breath or have a nighttime cough.

The health care provider has diagnosed a pregnant client with megaloblastic anemia and has prescribed treatment. When questioned by the client as to what this means, which is the best response from the nurse?

folic acid deficiency anemia