Ch. 20 Prepu OB

The nurse is helping an indigent HIV-positive pregnant client set up a postdelivery care plan for her baby. What is an appropriate question or statement during that discussion?

"HIV can be passed to the baby from breastfeeding, so it's important that you give the baby formula. Formula's pretty expensive, so I'll give you some information for places you can contact if you ever need some help getting it."

A pregnant woman with diabetes is having a glycosylated hemoglobin (HbA1C) level drawn. Which result would require the nurse to revise the client's plan of care?

8.5% An HbA1C level of more than 8% indicates poor control and the need for intervention, necessitating a revision in the woman's plan of care.

A woman with a long history of controlled asthma has just had her first antenatal visit for her fourth child. She is late for a meeting and says she knows what to do. What is the best action the nurse can take?

Acknowledge her need to leave but ask her to demonstrate the use of her inhaler and her peak flow meter before she goes; make any necessary corrections to her technique. Remind her to take her regular medications.

The nurse encourages a woman with gestational diabetes to maintain an active exercise period during pregnancy. Prior to this exercise period, the nurse would advise her to do which action?

Eat a sustaining-carbohydrate snack.

A young woman with scoliosis has just learned that she is pregnant. Several years ago, she had stainless-steel rods surgically implanted on both sides of her vertebrae to strengthen and straighten her spine. However, her pelvis is unaffected by the condition. Which of the following does the nurse anticipate in this woman's pregnancy?

Potential for greater than usual back pain

A woman with cardiac disease gave birth to a 7 lb (3.2 kg) baby by cesarean birth. Which intervention should be implemented during the immediate postpartum period?

Rest, use stool softeners, and monitor tolerance of activity.

A nurse is caring for a pregnant client with heart disease in a labor unit. Which intervention is most important in the first 48 hours postpartum?

assessing for cardiac decompensation

A nurse is interviewing a pregnant woman who has come to the clinic for her first prenatal visit. During the interview, the client tells the nurse that she works in a day care center with 2- and 3-year olds. Based on the client's history, the nurse would be alert for the development of which condition?

cytomegalovirus

When caring for a pregnant woman with cardiac problems, the nurse must be alert for signs and symptoms of cardiac decompensation (congestive heart failure), which include:

dyspnea, crackles, and irregular weak pulse.

A pregnant woman with sickle cell anemia comes to the emergency department in crisis. Which finding would the nurse expect? Select all that apply.

fever joint pain

The nurse is assessing a woman with class III heart disease who is in for a prenatal visit. What would be the first recognizable sign that this client is in heart failure?

persistent rales in the bases of the lungs

A client in her fifth month of pregnancy is having a routine clinic visit. The nurse should assess the client for which common second trimester condition?

physiological anemia

A 40-year-old woman comes to the clinic reporting having missed her period for two months. A pregnancy test is positive. What is she and her fetus at increased risk for?

placental abnormalities

The nurse is providing education to women who had diabetes prior to pregnancy. The nurse is discussing pregnancy-related complications from diabetes. Which factor is a potential complication?

polyhydramnios

A client is diagnosed with peripartum cardiomyopathy (PPCM). Which therapy would the nurse expect to administer to the client?

restricted sodium intake

The nurse is providing care to a neonate whose mother abuses heroin. Which finding would the nurse expect to assess?

sneezing

Which factor would contribute to a high-risk pregnancy?

type 1 diabetes

A nurse is assessing a client in her seventh month of pregnancy who has an artificial valve prosthesis. The client is taking an oral anticoagulant to prevent the formation of clots at the valve site. Which of the following nursing interventions is most appropriate in this situation?

Observe the client for signs of petechiae and premature separation of the placenta

A nurse is client teaching with a 28 weeks' gestation woman who has tested positive for gestational diabetes mellitus (GDM). What would be important for the nurse to include in the client teaching?

She is at increased risk for type II diabetes mellitus after her baby is born.