Lippincott - High Risk Pregnancy

Which statement by the client indicates an understanding of the teaching regarding the use of magnesium sulfate and corticosteroids for preterm labor?

"The magnesium sulfate is to stop contractions while the corticosteroids increase lung surfactant in my baby so he can breathe better if he is born early."

After instructing a multigravid client diagnosed with mild preeclampsia how to keep a record of fetal movement patterns at home, the nurse determines that the teaching has been effective when the client says that she will count the number of times the baby moves during which of the following time spans?

1-hour period each day

After suction and evacuation of a complete hydatiform mole, the 28-year-old multigravid client asks the nurse when she can become pregnant again. The nurse would advise the client not to become pregnant again for at least which of the following time spans?

12 months

A primigravid client with severe preeclampsia exhibits hyperactive, very brisk patellar reflexes with two beats of ankle clonus present. The nurse documents the patellar reflexes at which of the following?

4+

In which of the following maternal locations would the nurse place the ultasound transducer of the external electronic fetal heart rate monitor if a fetus at 34 weeks' gestation is in the left occipitoanterior (LOA) position?

Below the umbilicus on the left side

A primigravid at 34 weeks gestation is experiencing contractions every 3 to 4 minutes lasting for 35 seconds. Her cervix is 2 cm dilated and 50% effaced. While the nurse is assessing the client's vital signs, the client says, "I think my bag of waters just broke." Which of the following would the nurse do FIRST?

Check the status of the fetal heart rate.

The nurse is reviewing the chart of multigravid client at 39 weeks' gestation with suspected HELLP syndrome. The nurse should notify the health care provider about which of the following test results?

Lactate dehydrogenase (LDH) greater than 200 U/L (3.34 pkat/L)

When teaching a primigravid client with diabetes about common causes of hyperglycemia during pregnancy, which of the following would the nurse include?

Maternal infection

A 38-year-old client at about 14 weeks' gestation is admitted to the hospital with a diagnosis of complete hyaditiform mole. Soon after admission, the nurse would assess the client for signs and symptoms of which of the following?

Pregnancy-induced hypertension

A multigravid client diagnosed with a probable ruptured ectopic pregnancy is scheduled for emergency surgery. In addition to monitoring the client's blood pressure before surgery, which of the following would the nurse assess?

Pulse rate

At 38 weeks' gestation, a primigravid client with poorly controlled diabetes and severe preeclampsia is admitted for a cesarean birth. The nurse explains to the client that childbirth helps to prevent which of the following?

Stillbirth

The nurse is caring for a 22-year-old G 2, P 2 client who has disseminated intravascular coagulation after delivering a dead fetus. Which finding is the highest priority to report to the health care provider?

Urinary output of 25 mL in the past hour

A client has just had a cesarean section for a prolapsed cord. In reviewing the client's history, which of the following factors places a client at risk for cord prolapse? Select all that apply.

(1). 2 station (2). Low birth weight infant (3). Rupture of membranes (4) Breech presentation

A client at 28 weeks' gestation presents to the emergency department with a "splitting headache." What actions are indicated by the nurse at this time? Select all that apply.

(1). Assess the client for vision changes or epigastric pain. (2). Obtain a NST. (3). Assess the client's reflexes and presence of a clonus.

The nurse is assessing a multigravid client at 12 weeks' gestation who has been admitted to the emergency department with sharp right-sided abdominal pain and vaginal spotting. Which of the following should the nurse obtain about the client's history? Select all that apply.

(1). History of sexually transmitted infections (2). Number of sexual partners (3). Last menstrual cycle (4). Contraceptive use

The nurse is administering intravenous magnesium sulfate as prescribed for a client at 34 weeks' gestation with severe preeclampsia. Which of the following are desired outcomes of this therapy? Select all that apply.

(1). T 98 (36.7), P72, R14 (2). DTR 2+ (3). Magnesium level = 5.6 mg/dL (2.8 mmol/L)

A client presents to the OB triage unit with a report of bright red vaginal bleeding that has saturated a peripad over the last hour. The nurse observes the fetal heart rate with a baseline of 130 decreasing to 100 for 60 seconds and then returning to 130. There are no contractions present. Which are the priority nursing interventions?

Ask client time of last oral intake and prepare to start an IV

When preparing a multigravid client who has undergone evacuation of hyaditdform mole for discharge, the nurse explains the need for follow-up care. The nurse determines that the client understands the instruction when she says that she is at risk for developing which of the following?

Choriocarcinoma

When developing the collaborative plan of care with the health care provider for a multigravid client at 10 weeks' gestation with a history of cardiac disease who was being treated with digitalis therapy before this pregnancy. The nurse should instruct the client about which of the following regarding the client's drug therapy regimen?

Continuation of the same dosage

A client at 15 weeks' gestation is admitted with dark brown vaginal bleeding and continuous nausea and vomiting. Her blood pressure is 142/98 and fundal height is 19 cm. The nurse should prepare to do which of the following?

Obtain an ultrasound

A laboring client at -2 station has a spontaneous rupture of the membranes and a cord immediately protrudes from the vagina. The nurse should FIRST:

Place gentle pressure upward on the fetal head.

Following a cesarean birth for abruptio placentae, a multigravid client tells the nurse, "I feel like a failure such a failure. None of my other childbirths were like this." The nurse's response to the client is based on the understanding of which of the following?

The client's feeling of grief is a normal reaction.

The nurse is planning care for a multigravid client hospitalized at 36 weeks' gestations with confirmed rupture of membranes and no evidence of labor. Which of the following would the nurse expect the primary health care provider to prescribe?

Vaginal culture for Nisseria gonorrhea

The primary health care provider prescribes whole blood replacement for a multgravid client with abruptio placentate. Before administering the intravenous blood product, the nurse should FIRST:

Validate client information and the blood product with another nurse