Antepartal Care: The Pregnant Client with Risk Factors

A woman who has had asthma since she was a child and it is under control when the client takes her medication correctly and consistently is now pregnant for the first time. Which of the following client statements concerning asthma during pregnancy indicates the need for further instruction?

"Bronchodilators should be used only when necessary because of the risk they present to the fetus."

A 40-year-old client at 8 weeks' gestation has a 3-year-old child with Down syndrome. The nurse is discussing amniocentesis and chorionic villus sampling as genetic screening methods for the expected baby. The nurse is confi dent that the teaching has been understood when the client states which of the following?

"Chorionic villus sampling can be performed earlier in pregnancy."

On entering the room of a client who has undergone a dilatation and curettage (D&C) for a spontaneous abortion, the nurse fi nds the client cry- ing. Which of the following comments by the nurse would be most appropriate?

"I'm truly sorry you lost your baby."

A primigravid client has completed her fi rst prenatal visit and blood work. Her laboratory test for the hepatitis B surface antigen (HBsAg) is posi- tive. The nurse can advise the client that the plan of care for this newborn will include? Select all that apply.

1. Hepatitis B immune globulin at birth. 2. Series of three hepatitis B vaccinations per recommended schedule. 5. Universal precautions for mother and infant.

A multigravid client at 36 weeks' gestation has been diagnosed with condylomata acuminata. Which of the following should the nurse include when teaching the client about the disorder and cur- rent therapies?

Cryotherapy may be used to remove the warts.

While caring for a 24-year-old primigravid client scheduled for emergency surgery because of a probable ectopic pregnancy, the nurse should:

Dark.

Rho(D) immune globulin (RhoGAM) is ordered for a client before she is discharged after a spontaneous abortion. The nurse instructs the cli- ent that this drug is used to prevent which of the following?

Development of Rh-positive antibodies.

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 identifi es her as being at the highest risk for developing which problem?

Disseminated intravascular coagulation.

A dilatation and curettage (D&C) is scheduled for a primigravid client admitted to the hospital at 10 weeks' gestation with abdominal cramping, bright red vaginal spotting, and passage of some of the products of conception. The nurse should assess the client further for the expression of which of the following feelings?

Guilt.

A primigravid client at 8 weeks' gestation tells the nurse that since having had sexual relations with a new partner 2 weeks ago, she has noticed fl u-like symptoms, enlarged lymph nodes, and clusters of vesicles on her vagina. The nurse refers the client to a physician because the nurse suspects which of the following sexually transmitted diseases?

Herpes genitalis.

A multigravid client at 32 weeks' gestation has experienced hemolytic disease of the newborn in a previous pregnancy. The nurse should prepare the client for frequent antibody titer evaluations obtained from which of the following?

Maternal blood.

A woman at 22 weeks' gestation has right upper quadrant pain radiating to her back. She rates the pain as 9 on a scale of 1 to 10 and says that it has occurred 2 times in the last week for about 4 hours at a time. She does not associate the pain with food. Which of the following nursing measures is the highest priority for this client?

Refer the client to her health care provider for evaluation and treatment of the pain.

A multigravid client who stands for long peri- ods while working in a factory visits the prenatal clinic at 35 weeks' gestation, stating, "The varicose veins in my legs have really been bothering me lately." Which of the following instructions would be helpful?

Take frequent rest periods with the legs elevated above the hips.

When providing care to the client who has undergone a dilatation and curettage (D&C) after a spontaneous abortion, the nurse administers hydroxyzine (Vistaril) as ordered. Which of the fol- lowing is an expected outcome?

Absence of nausea.

A client with a past medical history of ventricular septal defect repaired in infancy is seen at the prenatal clinic. She is complaining of dyspnea with exertion and being very tired. Her vital signs are 98, 80, 20, BP 116/72. She has + 2 pedal edema and clear breath sounds. As the nurse plans this client's care, which of the following is her cardiac classification according to the New York Heart Association Cardiac Disease classification?

Class II.

After conducting a presentation to a group of adolescent parents on the topic of adolescent pregnancy, the nurse determines that one of the parents needs further instruction when the parent says that adolescents are at greater risk for which of the following?

Congenital anomalies.