Chapter 20
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."
CV system
Due to increase in BV Class 1 - not compromised, stress of pregnancy, everything is good Class 2 - vague symptoms, fatigue, heart palpations Class 3 - more fatigue when doing simple activities, walking can cause stress Class 4 - severely compromised, no physical activity Help to predict pregnancy outcomes of mom and fetus
Renal system
Elevated BP due to poor renal function Flank pain - if infection Edema - inability for kidneys to evacuate fluid Proteinuria Elevated creatinine level from poor function
Many women develop iron-deficient anemia during pregnancy. What diagnostic criteria would the nurse monitor for to determine anemia in the pregnant woman?
Hematocrit of 32% or less
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 pregnant woman with diabetes at 10 weeks' gestation has a glycosylated hemoglobin (HbA1c) level of 13%. At this time the nurse should be most concerned about which possible fetal outcome?
congenital anomalies
A pregnant client with cystic fibrosis (CF) comes to the office for a prenatal visit. She asks the nurse for information on breast-feeding. The best response by the nurse is:
"Breast-feeding is not a good idea. Because your breast milk is high in sodium due to CF, there is a risk of the infant receiving too much sodium."
The nurse is teaching a client with gestational diabetes about complications that can occur either following birth or at delivery for her baby. Which statement by the mother indicates that further teaching is needed by the nurse?
"If my blood sugars are elevated, my baby's lungs will mature faster, which is good."
A pregnant woman with type 2 diabetes is scheduled for a laboratory test of glycosylated hemoglobin (HbA1C). What does the nurse tell the client is a normal level for this test?
6%
Right sided HF
Distended liver and spleen Ascites (fluid in abdomen) Peripheral edema Jugular vein distention
The nurse is preparing information for a client who has just been diagnosed with gestational diabetes. Which instruction should the nurse prioritize in this information?
Maintain a daily blood glucose log
Endocrine system
May need to increase all drugs for endocrine problems (diabetes and thyroid issues) May need to come in more often for tests
Left sided HF
Orthopnea Paroxysmal nocturnal dyspnea (difficulty breathing at night) Pulmonary edema (crackles) Pink sputum with cough
Fasting levels in pregnancy
Recommended fasting blood glucose levels in pregnant clients with diabetes are 60 to 95 mg/dL. A fasting blood glucose level of 45 g/dL is low and may result in symptoms of hypoglycemia. A blood glucose level below 120 mg/dL is recommended for 2-hour postprandial values. A blood glucose level above 136 mg/dL in a pregnant client indicates hyperglycemia.
Neurological system
Risk for injury** For seizure precautions: watch, pads, oxygen, suction Put precautions at the end of the hall and decrease environmental stimulation
CV conditions
Valve damage Congenital anomalies Coronary artery disease (CAD) Chronic hypertensive vascular disease Venous thromboembolic disease