Ch. 20 Special Pop Coursepoint

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A pregnant woman is determined to be at high risk for gestational diabetes. At which time would the nurse expect the client to undergo rescreening?

24 to 28 weeks

An alert, diabetic, pregnant woman in the hospital experiences some shakiness and diaphoresis with a fasting blood sugar of 60 mg/dL when she awakens in the morning. Which action should the nurse take first?

Administer the patient's glucose tablets.

A woman with no previous history of heart disease begins to have symptoms of myocardial failure a few weeks before the delivery of her first child. Findings include shortness of breath, chest pain, and edema, with her heart also showing enlargement. Which disease should the nurse suspect?

Peripartal cardiomyopathy can occur in pregnancy without any previous history of heart disease. Symptoms include shortness of breath, chest pain, and edema; also, the heart begins to increase. Treatment is with a diuretic, an antidysrhythmic agent, digitalis, low weight heparin, and bed rest

When developing a plan of care for a pregnant woman who is HIV-positive and in labor, which of the following is essential?

Using Standard Precautions For the pregnant woman who is HIV-positive, nurses must always use Standard Precautions to reduce the risk of HIV transmission. Educating the woman about family planning methods is not as important as adhering to Standard Precautions. The decision about the mode of delivery is based on the woman's viral load, duration of ruptured membranes, progress of labor, and other clinical factors. Breast-feeding is contraindicated, so helping her choose a feeding method would be inappropriate

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?

anemia The nurse should make the client aware of increased risk of anemia as a possible effect of maternal coffee consumption during pregnancy, as it decreases iron absorption. Maternal coffee consumption during pregnancy does not increase the risk of heart disease, rickets, or scurvy.

You are doing patient teaching with a 30-year-old gravida 1 who has sickle cell anemia. She is not currently in crisis. Providing education on which topic is the highest nursing priority?

avoidance of infection

The nurse is caring for a pregnant client who is in her 30th week of gestation and has congenital heart disease. Which should the nurse recognize as a symptom of cardiac decompensation with this client?

face swelling Swelling of the face is a symptom of cardiac decompensation, along with moist, frequent cough and rapid respirations. Dry, rasping cough; slow, labored respiration; and an elevated temperature are not symptoms of cardiac decompensation.

Which should the nurse identify as a risk associated with anemia during pregnancy?

preterm birth

A pregnant patient with mitral stenosis needs to begin taking an anticoagulant. The nurse identifies the drug of choice, which is used in early pregnancy and again during the last month of pregnancy, to be which of the following?

heparin If an anticoagulant is required, heparin is the drug of choice for the beginning and the end of pregnancy. Heparin does not cross the placenta barrier.


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