Chapter 19: Prepu OB
A woman of 16 weeks' gestation telephones the nurse because she has passed some "berry-like" blood clots and now has continued dark brown vaginal bleeding. Which action would the nurse instruct the woman to do?
"Come to the health facility with any vaginal material passed."
A pregnant client at 32 weeks' gestation calls the clinic and informs the nurse that she thinks her membranes are leaking. She states that some clear fluid has run down her leg. What is the best response by the nurse?
"It is best for you to visit a hospital immediately. They can use a nitrazine strip to determine if it is amniotic fluid."
Which medication would the nurse prepare to administer if prescribed as treatment for an unruptured ectopic pregnancy?
A: Methotrexate Methotrexate, a folic acid antagonist that inhibits cell division in the developing embryo, is most commonly used to treat ectopic pregnancy. Oxytocin is used to stimulate uterine contractions and would be inappropriate for use with an ectopic pregnancy. Promethazine and ondansetron are antiemetics that may be used to treat hyperemesis gravidarum
A woman with severe preeclampsia is receiving magnesium sulfate. The woman serum magnesium level is 9.0mEq/L. Which finding would the nurse most likely note?
A: diminished reflexes Diminished or absent reflexes occur when a client develops magnesium toxicity, serum levels greater than 8.0 mEq/L. Elevated liver enzymes are unrelated to magnesium toxicity and may indicate the development of HELLP syndrome. The onset of seizure activity indicates eclampsia. A serum magnesium level of 6.5 mEq/L would fall within the therapeutic range of 4 to 7 mEq/L.
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 woman who is Rh negative asks the nurse how many children she will be able to have before Rh incompatibility causes them to die in utero. The nurse's best response would be that:
as long as she receives RhoGAM, there is no limit.
Rho(D) immune globulin will be prescribed for an Rh negative mother undergoing which test?
amniocentesis
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
A 28-year-old woman presents in the emergency department 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 primary care provider as a possible cause of the client's abdominal pain?
ectopic pregnancy
A woman with an incomplete abortion is to receive misoprostol. The woman asks the nurse, "Why am I getting this drug?" The nurse responds to the client, integrating understanding that this drug achieves which effect?
ensures passage of all the products of conception
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
A woman is admitted with a diagnosis of ectopic pregnancy. For which procedure should the nurse prepare?
immediate surgery
What would be the physiologic basis for a placenta previa?
low placental implantation
The nurse is caring for a pregnant client with fallopian tube rupture. Which intervention is the priority for this client?
monitor client's vital signs and bleeding
A woman in labor has sharp fundal pain accompanied by slight vaginal bleeding. What would be the most likely cause of these symptoms?
premature separation of the placenta
A client is admitted to labor and birth for management of severe preeclampsia. An IV infusion of magnesium sulfate is started. What is the primary goal for magnesium sulfate therapy?
prevent maternal seizures
A young mother gives birth to twin boys who shared the same placenta. What serious complication are they at risk for?
twin-to-twin transfusion syndrome (TTTS)