Maternity 2a
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%
A patient informs the nurse that she believes she has premenstrual syndrome and is having physical symptoms as well as moodiness. What physical symptoms does the nurse recognize are consistent with PMS? Select all that apply.
Fluid retention, Low back pain, Headache
Current research indicates that supplementation with what before pregnancy may reduce the risk of placental abruption?
Folic Acid
A pregnant client with type I diabetes asks the nurse about how to best control her blood sugar while she is pregnant. The best reply would be for the woman to:
check her blood sugars frequently and adjust insulin accordingly.
A 29-year-old client has gestational diabetes. The nurse is teaching her about managing her glucose levels. Which therapy would be most appropriate for this client?
diet
A pregnant client has been admitted with reports of brownish vaginal bleeding. On examination there is an elevated hCG level, absent fetal heart sounds, and a discrepancy between the uterine size and the gestational age. The nurse interprets these findings to suggest which condition?
gestational trophoblastic disease
A client has been admitted with abruptio placentae. She has lost 1,200 mL of blood, is normotensive, and ultrasound indicates approximately 30% separation. The nurse documents this as which classification of abruptio placentae?
grade 2
What would be the physiologic basis for a placenta previa?
low placental implantation
A pregnant client has tested positive for cytomegalovirus. What can this cause in the newborn?
microcephaly
A pregnant woman with diabetes is having a glycosylated hemoglobin (HbA1C) level drawn. Which result would require the nurse to revise the client's plan of care?
more than 8
Which change in insulin is most likely to occur in a woman during pregnancy?
less effective than normal
The clinic nurse teaches a pregestational type 1 diabetic client that constant insulin levels are very important during pregnancy. The nurse tells the client that the best way to maintain a constant insulin level is to use:
insulin pump
A nurse who has been caring for a pregnant client understands that the client has pica and has been regularly consuming soil. For which condition should the nurse monitor the client?
iron-deficiency anemia
A pregnant client at 28 weeks' gestation in preterm labor has received a dose of betamethasone IM today at 1400. The client is scheduled to receive a second dose. At which time would the nurse expect to administer that dose?
1400
Which of the following teenage girls is most likely to have secondary amenorrhea?
17-year-old, gymnast preparing for competition
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 woman has been in labor for the past 8 hours, and she has progressed to the second stage of labor. However, after 2 hours with no further descent, the provider diagnoses "arrest of labor." The woman asks, "Why is this happening?" Which response is the best answer to this question?
"More than likely you have cephalopelvic disproportion (CPD) where baby's head cannot make it through the canal."
A client in the postpartum period complains of constipation. The nurse should inform the client of which of the following that contributes to postpartum constipation?
Discomfort due to hemorrhoids
Sometimes an ectopic pregnancy occurs outside the woman's uterus. This usually occurs in one of the fallopian tubes. If the embryo continues to grow, it may rupture the tube. What are the signs and symptoms of a ruptured fallopian tube?
Shoulder pain
In returning to the hospital floor after a weekend off, the nurse takes over care of a pregnant patient who is resting in a darkened room. The patient is receiving betamethasone and magnesium sulfate. What could the nurse deduce from those findings?
The patient is suffering from severe preeclampsia and the care team is attempting to prevent advancement of the disorder to eclampsia; they are attempting to help the baby's lungs mature quickly so that they can deliver as soon as possible.
Based on the nurse's knowledge about the postpartum period and an increase in blood coagulability during the first 48 hours, the nurse closely assesses the client for which of the following?
Thromboembolism
A woman in preterm labor at 30 weeks of gestation receives two 12-mg intramuscular (IM) doses of betamethasone. What is the purpose of this pharmacologic intervention?
To stimulate fetal surfactant production
The nurse is planning care for four mothers and their newborns. After reviewing the clients' medical records, the nurse should make rounds on which client first?
a 35-year-old G4 P4 with an uncomplicated vaginal birth 4 hours ago; the nurse's notes indicated she soaked two peripads over the last 2 hours; fundus is firm
The nurse is caring for a client experiencing a prolonged second stage of labor. The nurse would place priority on preparing the client for which intervention?
a forceps and vacuum assisted birth
When providing nutritional counseling to a pregnant woman with diabetes, the nurse would urge the client to obtain most of her calories from which source?
complex carbs
A fetus is experiencing shoulder dystocia during birth. The nurse would place priority on performing which fetal assessment postbirth?
brachial plexus assessment
A 16-year-old unmarried primigravid client at 37 weeks' gestation with severe preeclampsia is in early active labor. The client's blood pressure is 164/110 mm Hg. Which finding would alert the nurse that the client may be about to experience a seizure?
epigastric pain
Which finding provides the most evidence that a fetus might have a gastrointestinal tract anomaly?
increased amount of amniotic fluid
A nurse is interviewing a pregnant woman who has come to the clinic for her first prenatal visit. During the interview, the client tells the nurse that she works in a day care center with 2- and 3-year olds. Based on the client's history, the nurse would be alert for the development of which condition?
cytomegalovirus
A client in the triage area who is at 19 weeks' gestation states that she has not felt her baby move in the past week, and no fetal heart tones are found. While evaluating this client, the nurse identifies her as being at the highest risk for developing which problem?
disseminated intravascular coagulation
The nurse is monitoring the uterine contractions of a woman in labor. The nurse determines the woman is experiencing hypotonic uterine dysfunction based on which contraction finding?
poor in quality, brief, and lack sufficient intensity to dilate and efface the cervix
A woman is experiencing dystocia that appears related to psyche problems. Which intervention would be most appropriate for the nurse to initiate?
provide a comfortable environment with dim lighting
What is the role of the nurse during the preconception counseling of a pregnant client with chronic hypertension?
stressing the positive benefits of a healthy lifestyle
A nurse is caring for a pregnant client who is human immunodeficiency virus (HIV) positive. What is a priority issue that the nurse should discuss with the client?
the need for the client to avoid breastfeeding
When developing a plan of care for a pregnant woman who is HIV-positive and in labor, the nurse recognizes that which measure is essential?
using standard precautions
The perinatal nurse understands that maternal antibodies pass through the placenta by which mechanism?
pinocytosis
After a regular prenatal visit, a pregnant client asks the nurse to describe the differences between abruptio placentae and placenta previa. Which statement should the nurse include in the teaching?
"Placenta previa causes painless, bright red bleeding during pregnancy due to an abnormally implanted placenta that is too close to or covers the cervix; abruptio placenta is associated with dark red painful bleeding caused by premature separation of the placenta from the wall of the uterus before the end of labor."
A client with a history of cervical insufficiency is seen for reports of pink-tinged discharge and pelvic pressure. The primary care provider decides to perform a cervical cerclage. The nurse teaches the client about the procedure. Which client response indicates that the teaching has been effective?
"Purse-string sutures are placed in the cervix to prevent it from dilating."
A nurse has been assigned to assess a pregnant client for abruptio placenta. For which classic manifestation of this condition should the nurse assess?
"knife-like" abdominal pain with vaginal bleeding
A pregnant client is brought to the health care facility with signs of premature rupture of the membranes (PROM). Which conditions and complications are associated with PROM? Select all that apply.
-Prolapsed cord -Abruptio placenta -Preterm labor
When teaching a primigravid client at 24 weeks' gestation about the diagnostic tests to determine fetal well-being, which information should the nurse include?
A fetal biophysical profile involves assessments of breathing movements, body movements, tone, amniotic fluid volume, and fetal heart rate reactivity
A nurse is assigned to care for a client who has to undergo a forceps and vacuum-assisted birth. The nurse understands that which of the following factors has contributed to a forceps and vacuum-assisted birth?
A prolonged second stage of labor
A woman who is 31 weeks pregnant presents at the emergency room with bright red vaginal bleeding. She says the onset of the bleeding was sudden and she has no pain. The nurse is most likely to assist the physician or technician with which exam?
A transvaginal ultrasound
During prenatal class, the nurse teaches expectant couples about the importance of the amniotic fluid and its functions. What functions does the nurse describe? (Select all that apply.)
A. Cushions the fetus from mechanical injury B. Facilitates symmetrical growth of fetal limbs C. Helps regulate fetal body temperature E. Prevents the amnion from adhering to the fetus
The birthing center nurse caring for a 21-year-old laboring woman is given a report about the patient's cocaine use throughout pregnancy. This history prompts the labor nurse to assess for which condition?
Abruptio placentae
The nurse is caring for a laboring client with a known history of cocaine abuse. What complication is most likely for this client?
Abruptio placentae.
A pregnant client is admitted to a health care unit with disseminated intravascular coagulation (DIC). Which of the following orders is the nurse most likely to receive regarding the therapy for such a client?
Administer cryoprecipitate and platelets.
When caring for a client with premature rupture of membranes (PROM), the nurse observes an increase in the client's pulse. What should the nurse do next?
Assess the client's temperature
A nurse in the maternity triage unit is caring for a client with a suspected ectopic pregnancy. Which nursing intervention should the nurse perform first?
Assess the client's vital signs.
A pregnant woman is admitted to the hospital with a diagnosis of placenta previa. Which action would be the priority for this woman on admission?
Assessing fetal heart tones by use of an external monitor
The perinatal nurse explains to a childbirth class that which of the following are the primary functions of the placenta? (Select all that apply.)
B. Protects the fetus from pathogens C. Provides hormones that maintain the pregnancy D. Removes waste products from the fetus E. Transfers nutrients to the fetus
The patient under your care is complaining she has not had a bowel moment since her infant was born 2 days ago. She asks the nurse what she can do to help her have a bowel movement. What intervention is appropriate to encourage having a bowel movement?
Encourage the patient to eat more fiber rich foods
When a woman is pregnant she often craves specific things, like pickles or ice cream. There is one craving that is associated with iron deficiency anemia and should be reported to the registered nurse if it occurs. What is this craving called?
Pica craving
The perinatal nurse explains the function of Wharton's jelly to a class of expectant parents. What description is most accurate?
Protects the umbilical cord from compression
Nursing care for the patient with endometriosis includes several factors. What is one aspect of nursing care for the woman with endometriosis?
Provide information on likely outcomes of treatment options
When caring for a client with preeclampsia, which action is a priority?
Reducing visual and auditory stimulation
A nurse assesses a client in labor and suspects hypotonic uterine dysfunction. Which intervention would the nurse expect to include in the plan of care for this client?
administering oxytocin
A client's membranes rupture. The nurse observes the fetal heart rate drop from 156 to 110. The nurse inspects the client's perineum and sees a loop of umbilical cord. What is the nurse's priority concern in this situation?
decreased fetal oxygenation
A client in preterm labor is receiving magnesium sulfate IV and appears to be responding well. Which finding on assessment should the nurse prioritize?
depressed deep tendon reflexes
A G2P1 woman with type 1 diabetes is determined to be at 8 weeks' gestation by her health care provider. The nurse should point out which factor will help the client maintain glycemic control?
excercise
A nurse is monitoring a client with PROM who is in labor and observes meconium in the amniotic fluid. What does the observation of meconium indicate?
fetal distress related to hypoxia
When assessing the fetal heart rate tracing, a nurse becomes concerned about the fetal heart rate pattern. In response to the loss of variability, the nurse repositions the client to her left side and administers oxygen. These actions are likely to improve:
fetal hypoxia
A novice nurse asks to be assigned to the least complex antepartum client. Which condition would necessitate the least complex care requirements?
gestational hypertension
A woman at 35 weeks' gestation with severe hydramnios is admitted to the hospital. The nurse recognizes that which concern is greatest regarding this client?
preterm rupture of membranes followed by preterm birth
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
A pregnant woman determined to be at high risk for gestational diabetes is undergoing a 1-hour glucose challenge test. The nurse schedules the client for a 3-hour glucose tolerance test based on which result?
result above 140
A nurse is caring for a client with postpartum hemorrhage. Which of the following should the nurse identify as the significant cause of postpartum hemorrhage?
uterine atony
A nurse is teaching a pregnant woman with preterm prelabor rupture of membranes about caring for herself after she is discharged home (which is to occur later this day). Which statement by the woman indicates a need for additional teaching?
"It's okay for my husband and me to have sexual intercourse."
A client has been admitted to the birthing suite in labor. She has been in labor for 12 hours and is dilated to 4 cm. The primary care provider notes that the client is in hypotonic labor. What does this mean?
The uterine contractions may or may not be regular, but the quantity or quality or strength is insufficient to dilate the cervix.
For which reason will betamethasone IM be administered to the mother in premature labor?
To stimulate lung maturity in the fetus
When a nurse is counseling a woman for primary dysmenorrhea, which nonpharmacologic intervention might be recommended?
Using a heating pad on the abdomen to relieve cramping
A woman in active labor with a history of two previous cesarean births is being monitored frequently as she tries to have a vaginal birth. Suddenly, the woman grabs the nurse's hand and states, "Something inside me is tearing." The nurse notes her blood pressure is 80/50 mm Hg, pulse rate is 130 bpm and weak, the skin is cool and clammy, and the fetal monitor shows bradycardia. The nurse activates the code team because the nurse suspects the client may be experiencing which complication?
uterine rupture
A woman at 36 weeks' gestation and in preterm labor is being sent home. Which statements about home management would the nurse include in the patient education?Select all that apply.
"Avoid sex during this time." "Notify the health care provider if your temperature is greater than 100° F." "Only move around your house when necessary."
A female client tells the nurse that she may be experiencing premenstrual syndrome. An appropriate question for the nurse to ask the client is:
"Do you experience mood swings or bloating?"
The nurse encourages a woman with gestational diabetes to maintain an active exercise period during pregnancy. Prior to this exercise period, the nurse would advise her to take which action?
Eat a sustaining-carbohydrate snack.
A woman who had preterm labor and preterm PROM successfully halted has reached week 36 of pregnancy and is doing well on home care. Which of the following nursing diagnoses should the nurse prioritize for this client?
Risk for fetal infection related to early rupture of membranes
The nurse through assessment can best differentiate between placenta previa and abruptio placentae by which of the following signs and or symptoms.
Uterine tone and contractions of the uterus.
A primigravida 21-year-old client at 24 weeks' gestation has a 2-year history of HIV. As the nurse explains the various options for delivery, which factor should the nurse point out will influence the decision for a vaginal birth?
viral load
Because of the diuretic effect, the nurse suggest to a patient with primary dysmenorrhea to include in her diet: (select all that apply)
watermelon asparagus cranberries
The nursing student demonstrates an understanding of dystocia with which statement?
"Dystocia is diagnosed after labor has progressed for a time"
A patient with diabetes is in the first trimester of pregnancy and is currently having difficulty keeping blood glucose levels within normal limits. The patient explains that she has been "eating for two" so the baby is healthy. How should the nurse respond to the patient?
"Elevated blood glucose levels in the first trimester have been linked to congenital anomalies."
You are the home health nurse making an initial call on a new mother who delivered her third baby five days ago. The woman says to you "I just feel so down this time. Not at all like when I had my other babies. And this one just doesn't sleep. I feel so inadequate." What is the best response to this new mother?
"It sounds like you have the 'baby blues.' They are common after having a baby when you are not getting enough sleep, are busy with your other children, and are still a bit uncomfortable from the delivery. They will most likely go away in a day or two."
The nurse is caring for a primipara with PROM who appears extremely anxious and reveals that she is scared her birthing process will be extremely painful because it will be "dry". Which is the best response from the nurse?
"No birth is ever really dry, because amniotic fluid continues to be manufactured."
A 43-year-old, physically fit, healthy woman who is newly married tells the nurse that she and her husband would like to have a child. What is an appropriate first response?
"Well, I'm sure you know there are some risks involved so it's helpful that you've been taking such good care of yourself."
A pregnant single mom living alone tells the nurse she is considering getting a cat for her 2-year-old daughter. Which is the best response by the nurse?
. "You should wait until after you give birth to obtain the cat for your daughter."
A client is admitted to the unit in preterm labor. In preparing the client for tocolytic drug therapy, the nurse anticipates that the client's pregnancy may be prolonged for how long when this therapy is used?
2 to 7 days
At an obstetrics and gynecology physician's office, a nurse and a nursing student discuss the prioritization of returning client phone messages. Which of the following clients would be a priority to call? Select all that apply.
A client at 34 weeks reporting transient blurred vision and shoulder pain A client at 36 weeks reporting feeling anxious and short of breath A client at 30 weeks reporting her morning sickness has suddenly returned
Which pregnant women are at risk for PPROM?Select all that apply.
A woman who is bearing twins A woman who is depressed over losing her job A woman with a Gardnerella vaginalis infection
When caring for a client with PROM, the nurse observes an increase in the client's pulse. What does this increase in pulse indicate?
Infection
Over the past 20 weeks, the following blood pressure readings are documented for a pregnant client with chronic hypertension: week 16 - 124/86 mm Hg; week 20 - 138/90 mm Hg; week 24 - 140/92 mm Hg; and week 28 - 142/94 mm Hg. The nurse interprets these findings as indicating which classification of her blood pressure?
A. mild hypertensive
A nurse is caring for a client in the postpartum period. The client is emotionally sensitive, feels a sense of failure, and attempts to hurt herself and the baby. The nurse understands that the client is exhibiting symptoms of which of the following conditions?
Postpartum depression
A multigravida client at 31 weeks' gestation is admitted with confirmed preterm labor. As the nurse continues to monitor the client now receiving magnesium sulfate, which assessment findings will the nurse prioritize and report immediately to the RN or health care provider?
respiratory depression, hypotension, absent deep tendon reflexes
A woman in labor is at risk for abruptio placentae. Which assessment would most likely lead the nurse to suspect that this has happened?
sharp fundal pain and discomfort between contractions
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 complication?
stillbirth
The nurse is administering intravenous magnesium sulfate as prescribed for a client at 34 weeks' gestation with severe preeclampsia. What are desired outcomes of this therapy? Select all that apply.
temperature, 98° F (36.7° C); pulse, 72 beats/min; respiratory rate, 14 breaths/min deep tendon reflexes 2+ magnesium level = 5.6 mg/dL (2.8 mmol/L)
A young woman experiencing contractions arrives at the emergency department. After examining her, the nurse learns that the client is at 33 weeks' gestation. What treatment can the nurse expect this client to be prescribed?
tocolytic therapy
A pregnant woman in her second trimester comes to the prenatal clinic for a routine visit. She reports that she has a new kitten. The nurse would have the woman evaluated for which infection?
toxoplasmosis
A shoulder dystocia situation is called in room 4. The nurse enters the room to help and the health care provider says to the nurse, "McRoberts maneuver." What does the nurse do next?
Bring the client's knees back toward the shoulders, causing hyperflexion of the hips and rotation of the pubic symphysis
The nurse is assisting with a G2P1, 24-year-old client who has experienced an uneventful pregnancy and is now progressing well through labor. Which action should be prioritized after noting the fetal head has retracted into the vagina after emerging?
use mcroberts manuver
After conducting a refresher class on possible congenital infections with a group of perinatal nurses, the nurse recognizes the class was successful when the group identifies which congenital viral infection as the most common?
CMV
A primigravid client at 37 weeks' gestation has been hospitalized for several days with severe preeclampsia. While caring for the client, the nurse observes that the client is beginning to have a seizure. Which action should the nurse do first?
Call for immediate assistance in the client's room.
A woman at 32 weeks' gestation just experienced rupture of her membranes. She asks the nurse what could cause this to happen and the nurse's explanation would include which risk factors? Select all that apply.
Cigarette smoking Multifetal pregnancies Amniocentesis
Between her regularly scheduled visits, a woman in her first trimester of pregnancy who is taking iron supplements for anemia calls the nurse at her obstetrician's office reporting constipation. She reports that she has never had this problem before and asks for some advice about how to get relief. What is the best advice the nurse can give her?
Continue taking iron supplements but increase fluids and high-fiber foods; exercise more.
A G2P1 woman is in labor attempting a VBAC, when she suddenly complains of light-headedness and dizziness. An increase in pulse and decrease in blood pressure is noted as a change from the vital signs obtained 15 minutes prior. The nurse should investigate further for additional signs or symptoms of which complication?
uterine rupture
The nurse assessing a newborn's umbilical cord stump would document which finding as normal anatomy?
D. One vein, two arteries
A 28-year-old woman presents in the emergency room with severe abdominal pain. She has not had a normal period for 2 months but she reports that that is not abnormal for her. She has a history of endometriosis. What might the nurse suggest to the physician as a possible cause of the patient's abdominal pain?
Ectopic pregnancy
A woman in labor is experiencing hypotonic uterine dysfunction. Assessment reveals no fetopelvic disproportion. Which group of medications would the nurse expect to administer?
uterine stimulants
The nurse assessing a multigravida at 36 weeks' gestation plans to assess the client for symptoms of preeclampsia. The nurse determines the highest priority assessment would be of the client's:
Face
At 31 weeks' gestation, a 37-year-old woman who has a history of preterm birth reports cramps, vaginal pain, and low, dull backache accompanied by vaginal discharge and bleeding. Her cervix is 2.1 cm long; she has fetal fibronectin in her cervical secretions, and her cervix is dilated 3 to 4 cm. For what do you prepare her?
Hospitalization, tocolytic therapy, and IM corticosteroids
A woman is admitted with a diagnosis of ectopic pregnancy. For which of the following would you anticipate beginning preparation?
Immediate surgery.
An infant is born to a mother with gestational diabetes. Which long-term maternal complication is associated with this diagnosis?
Increased risk of development of type 2 diabetes
A client with a complex medical history is considering the use of oral contraceptives. The nurse should be aware that many antibiotics and antiseizure medications cause what effect when combined with oral contraceptives?
Increased risk of pregnancy
The nurse is identifying nursing diagnoses for a client with gestational hypertension. Which diagnosis would be the most appropriate for this client?
Ineffective tissue perfusion related to vasoconstriction of blood vessels
A pregnant client is admitted to a health care facility with a diagnosis of premature rupture of membranes (PROM). Which of the following tests would the nurse expect to be used to predict fetal lung maturity when the client goes into labor?
Lecithin/sphingomyelin ratio
Some women experience a rupture of their membranes before going into true labor. A nurse recognizes that a woman who presents with PPROM has completed how many weeks of gestation?
Less than 37 weeks
A pregnant woman with diabetes is having her glycosylated hemoglobin level evaluated. The nurse determines that the woman's glucose is under control and continues the woman's plan of care based on which result?
Less than 7
A nurse is caring for a client at 30 weeks' gestation who had preterm premature rupture of membranes (PROM) 25 hours ago. The client has a temperature of 102°F (38.9°C) and a foul-smelling odor from the vagina. Which medication order should the nurse question?
Magnesium sulfate 2 GM IV/hr
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
Which of the following would the nurse prepare to administer if ordered as treatment for an unruptured ectopic pregnancy?
Methotrexate
The nurse is caring for a pregnant client with fallopian tube rupture. Which intervention is the priority for this client?
Monitor the client's vital signs and bleeding.
Management of primary dysmenorrhea often requires a multifaceted approach. Which pharmacologic therapy provides optimal pain relief for this condition?
Nonsteroidal antiinflammatory drugs (NSAIDs)
A woman who delivered a healthy baby 5 days ago is experiencing fatigue and weepiness, lasting for short periods each day. Which of the following factors/conditions does the nurse believe is causing this experience?
Postpartum baby blues
A 35-year-old woman visits her family doctor and reports mood swings, swelling of her breasts, acne, bloating, and weight gain every month, starting about 2 weeks prior to her period. What disorder is this patient describing?
Premenstrual syndrome (PMS)
A G3P2 woman at 39 weeks' gestation presents highly agitated, reporting something "came out" when her membranes just ruptured. Which action should the nurse prioritize after noting the umbilical cord is hanging out of the vagina?
Put the client in bed immediately, call for help, and lift the presenting part of the fetus off the cord.
A nurse should instruct a client who has premenstrual syndrome (PMS) to make which of these lifestyle modifications?
Reduce caffeine, walk several times a week, use relaxation techniques, and maintain a regular sleep schedule.
When assessing a woman with an ectopic pregnancy, which of the following would lead the nurse to suspect that the tube has ruptured?
Referred shoulder pain
A client at 37 weeks' gestation presents to the emergency department with a BP 150/108 mm Hg, 1+ pedal edema, 1+ proteinuria, and normal deep tendon reflexes. Which assessment should the nurse prioritize as the client is administered magnesium sulfate IV?
Respiratory rate
Charting on the nursing care plan patient care, which nursing diagnosis has the highest priority for a postpartum patient?
Risk for injury: postpartum hemorrhage related to uterine atony
A nurse is providing education to a woman at 28 weeks' gestation who has tested positive for gestational diabetes mellitus (GDM). What would be important for the nurse to include in the client teaching?
She is at increased risk for type 2 diabetes mellitus after her baby is born.
A nurse is caring for a patient at 30 weeks' gestation who had preterm premature rupture of membranes (PROM) 25 hours ago. The patient has a temperature of 102 degrees F and a foul-smelling odor from the vagina. Which medication order should the nurse question?
Terbutaline 0.25 mg subcutaneous
A client at 33 weeks' gestation is admitted in preterm labor. She is given betamethasone 12 mg IM q 24 hours × 2. What is the expected outcome of this drug therapy?
The neonate will be born with mature lungs.
A woman at 8 weeks' gestation is admitted for ectopic pregnancy. She is asking why this has occurred. The nurse knows that which of the following is a known risk factor for ectopic pregnancy?
Use of IUD for contraception
A nurse is assessing pregnant clients for the risk of placenta previa. Which client faces the greatest risk for this condition?
a client who had a myomectomy to remove fibroids
A client reports to her obstetrician complaining of a significant amount of bright red, painless vaginal bleeding. A sonogram reveals that her placenta has implanted low in the uterus and is partially covering the cervical os. Which of the following immediate care measures should the nurse initiate?
a) Determine from the client the time the bleeding began and about how much blood has been lost b) Attach external monitoring equipment to record fetal heart sounds c) Continue to assess blood pressure every 5 to 15 minutes e) Place the woman on bed rest in a side-lying position f) Obtain baseline vital signs
A woman experiences an amniotic fluid embolism as the placenta is delivered. The nurse's first action would be to:
administer oxygen by mask
A nurse is conducting an assessment of a woman who has experienced PROM. Which finding would lead the nurse to suspect infection as the cause of a client's PROM?
foul odor
A woman at 10 weeks gestation comes to the clinic for an evaluation. Which assessment finding should the nurse prioritize?
fundal height measurement of 18 cm
The nursing instructor is pointing out the various complcations which can occur during pregnancy in women with diabetes mellitus. The instructor determines the session is successful after the students correctly choose which complication that can occur if the diabetes is not kept under control?
hydramnios
A client has been in labor for 10 hours, with contractions occurring consistently about 5 minutes apart. The resting tone of the uterus remains at about 9 mm Hg (no more than 10), and the strength of the contractions averages 21 mm Hg. The nurse recognizes which condition in this client?
hypotonic contractions
A client has been in labor for 10 hours, with contractions occurring consistently about 5 minutes apart. The resting tone of the uterus remains at about 9 mm Hg, and the strength of the contractions averages 21 mm Hg. The nurse recognizes which condition in this client?
hypotonic contractions
A client in her sixth week postpartum reports general weakness. The client has stopped taking iron supplements that were prescribed to her during pregnancy. The nurse would assess the client for which condition?
hypovolemia
A client at 33 weeks' gestation is calling the office with various reports and is very concerned. The nurse recognizes which report(s) as indicating the client is potentially going into preterm labor? Select all that apply.
low, dull backachegeneral sense of discomfortGI upset (nausea, vomiting, diarrhea)achiness in the thighs There are various subtle symptoms of preterm labor that a woman may experience. They include change or increase in vaginal discharge; pelvic pressure; low, dull backache; menstrual-like cramps; feeling of pelvic pressure or fullness; GI upset; general sense of discomfort or unease; heaviness or aching in the thighs; uterine contractions, with or without pain; more than six contractions per hour; intestinal cramping, with or without diarrhea; and persistent contractions.
A primary care provider prescribes intravenous tocolytic therapy for a woman in preterm labor. Which agent would the nurse expect to administer?
magnesium sulfate
A nurse is caring for a client undergoing treatment for ectopic pregnancy. Which symptom is observed in a client if rupture or hemorrhaging occurs before the ectopic pregnancy is successfully treated?
phrenic nerve irritation
A patient who experiences premature rupture of membranes can expect to be put on pelvic rest. The nurse should explain to the patient that pelvic rest involves which of the following?
placing nothing in the vagina
A 38-year-old client at about 14 weeks' gestation is admitted to the hospital with a diagnosis of complete hydatidiform mole. Soon after admission, the nurse would assess the client for signs and symptoms of which signs and symptoms?
pregnancy-induced hypertension(Hydatidiform mole is suspected when the following are present: gestational hypertension before the 24th week of gestation, brownish or prune-colored vaginal bleeding, anemia, absence of fetal heart tones, passage of hydropic vessels, uterine enlargement greater than expected for gestational age, and increased human chorionic gonadotropin levels.)
A patient who is at 7 months' gestation presents to the emergency department with reports of a large gush and continuous leaking of fluid from her vagina. She does have some slight pelvic pressure but denies any contractions. This patient is showing clinical signs of which of the following?
premature rupture of membranes
A woman having contractions comes to the emergency department. She tells the nurse that she is at 34 weeks' gestation. The nurse examines her and finds that she is already effaced and dilated 2 cm. What is this woman demonstrating?
preterm labor
When teaching a multigravid client diagnosed with mild preeclampsia about nutritional needs, which type of diet should the nurse discuss?
regular diet
The nurse explains to the patient suffering form dysmenorrhea that the pelvic rock exercise will decrease pain by: (select all that apply)
releasing endorphins suppressing prostaglandins relieving pelvic congestion
