MATERNAL NEWBORN EXAM 2

A patient who is at 30 weeks gestation is involved in car crash. The nurse recognizes that which initial testing will be used to assess fetal well-being? A) Fetal movement counting B) Contraction stress test C) Ultrasonography D) Non-stress testing

Non-stress testing

A pregnant client has a systolic blood pressure that exceeds 160 mm Hg. Which action should the nurse take for this client?

Obtain a prescription for antihypertensive medications

A pill that is used to induce labor to soften the cervix and cannot be remove it once its in place....

Misoprostol (Cytotec)

The nurse is teaching a pregnant client how to recognize signs of preeclampsia and when to report to the primary health care provider. Which statements by the client indicate effective learning? Select all that apply. "I should report if I see an increase in urinary output." "I should report if a dipstick test shows proteinuria less than 1+." "I should report if I experience blurred vision or headache." "I should report if I feel a decrease in the baby's movements."

"I should report if I experience blurred vision or headache." "I should report if I feel a decrease in the baby's movements." "I should sit and use my right arm to accurately measure my blood pressure."

A nurse is caring for a patient during a prenatal visit. Which factors put the patient at increase risk for preeclampsia.

- Family or personal hx of the disease - Obesity - Maternal age <19; >40 - Multiple gestation - Diabetes - Chronic Hypertension - Renal or Collagen disease - Periodontal disease / Infection (UTI) - IUGR - Fetal death

A nurse is assessing her patients. Which maternal factors based on the assessment of the patient could put increase risk of IUGR?

Age; young or old Cigarette smoking, Illicit drug use Genetics ;short stature,weight Preclampsia, Eclampsia DM, chronic hypertension Intrauterine infections Oligohydramnios Poor nutrtion Lack of good prenatal care African American

The nurse is providing care for a 45 year old woman who has just learned she is in the second trimester of pregnancy. The patient thought she was experiencing manifestations of menopause until she recognized fetal movement. Which diagnostic test does the nurse expect to be prescribed for this patient? A) Chorionic villi sampling B) Daily fetal movement count C) Ultrasonography D) Amniocentesis

Amniocentesis

A patient is scheduled for a transvaginal ultrasound testing. Which preparation by the nurse is appropriate? A) Place the patient on her side with a pillow beneath her head B) Request that the patient's partner leave the room C) Explain that pain at 4 or less on a scale of 0-10 is expected D) Ascertain whether the patient has a latex or banana allergy

Ascertain whether the patient has a latex or banana allergy

A nurse in labor and delivery is providing care for a client who is in preterm labor at 32 weeks of gestation. Which of the following medications should the nurse anticipate the provider will prescribe to hasten fetal lung maturity? A. Calcium gluconate B. Indomethacin (Indocin) C. Nifedipine (Procardia) D. Betamethasone (Celestone)

Betamethasone (Celestone)

Which statement best describes chronic hypertension? a.Chronic hypertension is defined as hypertension that begins during pregnancy and lasts for the duration of the pregnancy b.Chronic hypertension is considered severe when the systolic BP is higher than 140 mm Hg or the diastolic BP is higher than 90 mm Hg c.Chronic hypertension is general hypertension plus proteinuria d.Chronic hypertension can occur independently of or simultaneously with preeclampsia.

Chronic hypertension can occur independently of or simultaneously with preeclampsia.

The nurse is caring for a woman who is at 24 weeks of gestation with suspected severe preeclampsia. Which signs and symptoms should the nurse expect to observe? Select all that apply.

Decreased urinary output and irritability Ankle clonus and epigastric pain Platelet count of less than 100,000/mm3 and visual problems

After receiving a confirmation that her patient indeed has HELLP syndrome the nurse should immediately prepare for:

Emergency C-Section

The patient is in her first trimester of her second pregnancy. The patient's first child was born with Trisomy 21. The patient is requesting testing to determine whether the current fetus has the same condition. Which initial testing does the nurse expect the HCP to prescribe? A) Magnetic resonance imaging B) Amniocentesis C) Chorionic villi sampling D) Fetal ultrasound

Fetal Ultrasound

The patient in her second trimester of pregnancy is scheduled for a doppler flow studies because the HCP is concerned about an assessment finding during a routine prenatal visit. Which finding of concern does the nurse suspect? A) Fetal movement count is less than 8 per hour B) Patient shows no weight gain in 2 weeks C) Fetal growth is below expectation for gestational age D) Patient exhibits mild lower extremity edema

Fetal growth is below expectation for gestational age

What are the most common causes for subinvolution of the uterus?

Retained placental fragments and infection

A pregnant client has a sudden onset of seizures during the 3rd trimester of pregnancy. After reviewing the client's medical history, the nurse learns that the client had hypertension and proteinuria since 21 weeks of gestation. What will the nurse infer from these findings?

The client has eclampsia

An Eastern European Jewish couple has two children who died from tay-sachs disease. The couple is currently pregnant and have asked from genetic confirmation about this fetus with the intention of early termination if the fetus tests positively. For which reason does the nurse expect chorionic villus sampling to be prescribed? A) This is the only testing that is disease specific B) A positive result allows termination during the test C) A test is performed as early as 10 weeks gestation D) Risks to the mother & fetus are less than other tests

A test is performed as early as 10 weeks gestation

The labor of a pregnant woman with preeclampsia is going to be induced. Before initiating the oxytocin (Pitocin) infusion, the nurse reviews the woman's latest laboratory test findings, which reveal a platelet count of 90,000 mm3, an elevated aspartate aminotransaminase (AST) level, and a falling hematocrit. The laboratory results are indicative of which condition? a. Eclampsia b. Disseminated intravascular coagulation (DIC) syndrome c. Hemolysis, elevated liver enzyme levels, and low platelet levels (HELLP) syndrome d. Idiopathic thrombocytopenia

Hemolysis Elevated liver enzyme levels Low platelet levels (HELLP) syndrome

What are the manifestations of HELLP syndrome? Select all that apply.

Hemolysis Elevated liver enzymes Low platelet count

The nurse is caring for a pregnant client with preeclampsia. The client reports severe and persistent epigastric pain. The primary health care provider orders a blood test. What result may indicate a worsening liver function?

Increased liver transaminase levels

What does the nurse assess to detect the presence of a hypertensive disorder in a pregnant client? Select all that apply.

Proteinuria Epigastric pain Presence of edema Blood pressure (BP)

The nurse is assisting a patient who is pregnant to prepare for an MRI scheduled to assess fetal brain development. Which situation causes the nurse to notify the radiology department personnel? A) The patient has breakfast prior to arriving for the test B) The patient reports having an iodine allergy C) The patient expresses concern about pain D) The patient has a permanent body piercing

The patient has a permanent body piercing

A patient is scheduled for a contract stress test (CST) at 36 weeks gestation. The nurse is aware that a successful testing is dependent upon which factor? A) Whether Braxton-Hicks contractions are occurring B) Whether uterine contractions can be stimulated C) If the fetus is in an awake cycle & active D) If the mother is not overly tired or anxious

Whether uterine contractions can be stimulated