Chapter 19: Conditions Existing Before Conception

A nurse is talking to a newly pregnant woman who had a mitral valve replacement in the past. Which statement by the client reveals an understanding about the preexisting condition?

"I understand that my fetus and I both are at risk for complications."

A 32-year-old woman with epilepsy mentions to the nurse during a routine well-visit that she would like to have children and asks the nurse for advice. Which response is most appropriate from the nurse?

"I'll let the doctor know so you can discuss your medications. In the meantime, I'll give you a list of folate-rich foods you can add to your diet."

Your patient is very conscious of the weight she gained during her pregnancy. She has decided to breastfeed her baby and asks you how many calories a day extra she should be eating so that she and her baby are healthy. She states she does not want to gain any extra weight from over-eating. What would be your best response?

"You should be eating an extra 200 kcal over what you were eating while you were pregnant."

When evaluating fetal well-being, what is the maximum score on a biophysical profile?

10

A nurse should instruct a client who has a very low sperm count to make which lifestyle modification?

Abstain from intercourse for 8 days at a time.

A patient with asthma who is 32 weeks' pregnant is concerned that the health care provider has reduced the doses of asthma maintenance medications. How should the nurse respond to this patient's concern?

Asthma medication may reduce labor contractions and should be reduced.

A pregnant woman with sickle cell anemia is very concerned her infant will also develop the disease and questions the nurse about that possibility. Which is the best response from the nurse?

Both parents have to carry the trait.

A woman with cardiac disease at 32 weeks' gestation reports she has been having spells of light-headedness and dizziness every few days. Which instruction should the nurse prioritize?

Decrease activity and rest more often.

Which response is most appropriate for a client with diabetes who wants to breast-feed but is concerned about the effects of breastfeeding on her health?

Diabetic clients may breast-feed; insulin requirements may decrease from breast-feeding

A woman's obstetrician prescribes vitamin K supplements for a client who is on anti-epileptic medications beginning at 36 weeks' gestation. The mother asks the nurse why she is taking this medication. The nurse's best response would be:

anti-epileptic therapy can lead to vitamin K-deficient hemorrhage of the newborn.

A pregnant woman with a history of mitral stenosis is to be prescribed medication as treatment. Which of the following medication classes would the nurse expect the patient to begin taking?

anticoagulant

When preparing a schedule of follow-up visits for a pregnant woman with chronic hypertension, which schedule would be most appropriate?

bi-monthly visits until 28 weeks, then weekly visits

After teaching a pregnant woman with iron deficiency anemia about nutrition, the nurse determines that the teaching was successful when the woman identifies which foods as being good sources of iron in her diet? Select all that apply.

dried fruits peanut butter meats

A nursing instructor is teaching students about anemia during pregnancy. Which type of anemia does the instructor teach students is most prevalent during pregnancy?

iron-deficiency anemia

During the assessment of a laboring client, the nurse learns that the client has cardiovascular disease (CVD). Which assessment would be priority for the newborn?

respiratory function