complications of pregnancy

A pregnant client at 32 weeks' gestation is treated with magnesium sulfate for seizure management. The nurse assesses which of the following for evidence of magnesium toxicity? Absence of knee jerk response Frequency of micturition Increased blood pressure Increased rate of respiration

absence of knee jerk response (Magnesium sulfate toxicity is characterized by absence of deep tendon reflexes like the knee jerk reflex)

After teaching a woman who has had an evacuation for gestational trophoblastic disease (hydatidiform mole or molar pregnancy) about her condition, which statement indicates that the nurse's teaching was successful? "My blood pressure will continue to be increased for about 6 more months." "I will be sure to avoid getting pregnant for at least 1 year." "I won't use my birth control pills for at least a year or two." "My intake of iron will have to be closely monitored for 6 months."

be sure to avoid getting pregnant for at least 1 year

A primipara at 36 weeks' gestation is being monitored in the prenatal clinic for risk of preeclampsia. Which sign or symptom should the nurse prioritize? A dipstick value of 2+ for protein Pedal edema Weight gain of 1.2 lb (0.54 kg) during the past 1 week A systolic blood pressure increase of 10 mm Hg

dipstick value of 2+ for protein

Which medication would the nurse prepare to administer if prescribed as treatment for an unruptured ectopic pregnancy? ondansetron oxytocin methotrexate promethazine

methotrexate (Methotrexate, a folic acid antagonist that inhibits cell division in the developing embryo, is most commonly used to treat ectopic pregnancy.)

A client is 20 weeks pregnant. At a prenatal visit, the nurse begins the prenatal assessment. Which finding would necessitate calling the primary care provider to assess the client? The client has pink vaginal discharge and pelvic pressure. The client vomited. The client has a white vaginal discharge. The client has rhinitis and epistaxis.

pink vaginal discharge and pelvic pressure

A client at 27 weeks' gestation is admitted to the OB unit afer reporting headaches and edema of her hands. Review of the prenatal notes reveals BP consistently above 136/90 mm Hg. The nurse anticipates the health care provider will order magneisum sulfate to accomplish which primary goal? Prevent maternal seizures Decrease blood pressure Decrease protein in urine Reverse edema

prevent seizures

The nurse is concerned that a pregnant patient is experiencing abruptio placentae. What did the nurse assess in this patient? Sharp fundal pain and discomfort between contractions Pain in a lower quadrant and increased pulse rate Painless vaginal bleeding and a fall in blood pressure Increased blood pressure and oliguria

sharp fundal pain and discomfort between contractions

A young woman presents at the emergency department reporting lower abdominal cramping and spotting at 12 weeks' gestation. The primary care provider performs a pelvic examination and finds that the cervix is closed. What does the care provider suspect is the cause of the cramps and spotting? Habitual abortion Threatened abortion Cervical insufficiency Ectopic pregnancy

threatened abortion

The nurse is teaching a prenatal class on potential problems during pregnancy to a group of expectant parents. The risk factors for placental abruption are discussed. What comment validates accurate learning by the parents? "If I develop this complication, I will have bright red vaginal bleeding," "I need a cesarean section if I develop this problem." "Since I am over 30, I run a much higher risk of developing this problem." "Placental abruption is quite painful and I will need to let the doctor know if I begin to have abdominal pain."

"Placental abruption is quite painful and I will need to let the doctor know if I begin to have abdominal pain.

A 16-year-old client gave birth to a 12 weeks' gestation fetus last week. The client has come to the office for follow-up and while waiting in an examination room notices that on the schedule is written her name and "follow-up of spontaneous abortion." The client is upset about what is written on the schedule. How can the nurse best explain this terminology? "Abortion is a medical term for any interruption of pregnancy before a fetus is viable." "Spontaneous abortion is the medical name for a miscarriage." "Oh, that just means it was a miscarriage." "Spontaneous abortion is a more specific term used to describe a spontaneous miscarriage, which is a loss of pregnancy before 20 weeks. This term does not imply that you did anything to affect the pregnancy."

"Spontaneous abortion is a more specific term used to describe a spontaneous miscarriage, which is a loss of pregnancy before 20 weeks. This term does not imply that you did anything to affect the pregnancy."

A client suffering a miscarriage at 12 weeks' gestations is very upset that the health care provider has ordered a D&C. How should the nurse respond after the client states she didn't have a D&C the time she lost a previous baby at 5 weeks' gestation? "Having the D&C will make it easier to get pregnant next time." "This is the procedure ordered by the doctor." "This procedure is needed to adequately remove all the fetal tissue." "You have the option to refuse the surgery."

"This procedure is needed to adequately remove all the fetal tissue."

A client in her first trimester arrives at the emergency room with reports of severe cramping and vaginal spotting. On examination, the health care provider informs her that no fetal heart sounds are evident and orders a dilatation and curettage. The client looks frightened and confused and states that she does not believe in abortion. Which statement by the nurse is best? "The choice is up to you but the healthcare provider is recommending an abortion." "You have experienced an incomplete miscarriage and must have the placenta and any other tissues cleaned out." "Unfortunately, the pregnancy is already lost. The procedure is to clear the uterus to prevent further complications." "I know that it is sad but the pregnancy must be terminated to save your life."

"Unfortunately, the pregnancy is already lost. The procedure is to clear the uterus to prevent further complications."

A client is 11 weeks pregnant after many years trying to conceive. After arriving home from a normal prenatal visit, she experiences mild cramping and has a gush of bright red vaginal bleeding. She calls the nurse and reports having soaked a pad with fresh blood in fewer than 30 minutes. The uterine cramping is worsening. What is the most appropriate response from the nurse? "You need to seek immediate attention from the primary care provider." "This is nothing to worry about. Many women bleed during pregnancy." "I am sorry. There is nothing you can do because you are likely miscarrying." "Lie down and call your health care provider tomorrow if symptoms continue."

"You need to seek immediate attention from the primary care provider." (Pregnancy loss during the early weeks of pregnancy may seem like a heavy menstrual period. A primary care provider should assess blood loss of this amount with or without uterine cramping as soon as possible.)

A woman at 10 weeks gestation comes to the clinic for an evaluation. Which assessment finding should the nurse prioritize? report of frequent mild nausea blood pressure of 120/84 mm Hg history of bright red spotting 6 weeks ago fundal height measurement of 18 cm

18 cm fundal height (A fundal height of 18 cm is larger than expected and should be further investigated for gestational trophoblastic disease (hydatidiform mole).

A pregnant client is admitted to a health care unit with disseminated intravascular coagulation (DIC). Which prescription is the nurse most likely to receive regarding the therapy for such a client? Aim at keeping the client's hematocrit above 20%. Give each unit of blood to raise the hematocrit by 3 g/dL. Administer a ratio of 1 unit of blood to 4 units of frozen plasma. Administer cryoprecipitate and platelets.

Administer cryoprecipitate and platelets.

A 24-year-old client presents in labor. The nurse notes there is an order to administer RhoGAM after the birth of her infant. When asked by the client the reason for this injection, which reason should the nurse point out? prevent maternal D antibody formation. promote maternal D antibody formation. prevent fetal Rh blood formation. stimulate maternal D immune antigens.

PREVENT maternal d antibody formation

A client reporting she recently had a positive pregnancy test has reported to the emergency department stating one-sided lower abdominal pain. The health care provider has presribed a series of tests. Which test will provide the most definitive confirmation of an ectopic pregnancy? Quantitative human chorionic gonadotropin (hCG) test. Pelvic examination. Qualitative human chorionic gonadotropin (hCG) test. Abdominal ultrasound.

QUAL human chorionic gonad. test

A pregnant patient is diagnosed with placenta previa. Which action should the nurse implement immediately for this patient? Help the patient remain ambulatory to reduce bleeding. Prepare for a vaginal examination to assess the extent of bleeding. Assess fetal heart sounds with an external monitor. Assess uterine contractions by an internal pressure gauge.

assess fetal heart sounds w external monitor

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? Obtain a surgical consent from the client. Assess the client's vital signs. Provide emotional support to the client and significant other. Administer oxygen to the client.

assess vitals (at risk for hypovolemic shock)

It is determined that a client's blood Rh is negative and her partner's is positive. To help prevent Rh isoimmunization, the nurse would expect to administer Rho(D) immune globulin at which time? 24 hours before birth and 24 hours after birth in the first trimester and within 2 hours of birth at 32 weeks' gestation and immediately before discharge at 28 weeks' gestation and again within 72 hours after birth

at 28 weeks gestation and again within 72 hours after birth

A client reports bright red, painless vaginal bleeding during her 32nd week of pregnancy. A sonogram reveals that the placenta has implanted low in the uterus and is partially covering the cervical os. Which immediate care measures are initiated? Select all that apply. Obtain baseline vital signs and compare to those vital signs previously obtained. Place the woman on bedrest maintaining the supine position. Determine the time the bleeding began and about how much blood has been lost. Assist the client in stirrups and perform a pelvic examination. Attach external monitoring equipment to record fetal heart sounds and kick counts.

baseline vitals/compare them determine the time the bleeding began/how much was lost attach external monitoring to record fetal heart sounds/kick counts

A nurse is preparing a nursing care plan for a client who is admitted at 22 weeks' gestation with advanced cervical dilatation to 5 cm, cervical insufficiency, and a visible amniotic sac at the cervical opening. Which primary goal should the nurse prioritize at this point? Give birth vaginally Notification of social support for loss of pregnancy Bed rest to maintain pregnancy as long as possible Education on causes of cervical insufficiency for the future

bed rest to maintain pregnancy as long as possible

A client tells that nurse in the doctor's office that her friend developed high blood pressure on her last pregnancy. She is concerned that she will have the same problem. What is the standard of care for preeclampsia? Take low-dose antihypertensive prophylactically. Have her blood pressure checked at every prenatal visit. Take one aspirin every day. Monitor the client for headaches or swelling on the body.

bp checked every visit

A woman has been diagnosed as having gestational hypertension. Which symptom for this condition is the most typical? susceptibility to infection increased perspiration weight loss blood pressure elevation

bp elevation

The nurse is comforting and listening to a young couple who just suffered a miscarriage. When asked why this happened, which reason should the nurse share as a common cause? The age of the mother Lack of prenatal care Maternal smoking Chromosomal abnormality

chromosomal

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? "Continue normal activity, but take the pulse every hour." "Come to the health facility with any vaginal material passed." "Come to the health care facility if uterine contractions begin." "Maintain bed rest, and count the number of perineal pads used."

come to the health facility with any vaginal material passed

A client is diagnosed with gestational hypertension and is receiving magnesium sulfate. Which finding would the nurse interpret as indicating a therapeutic level of medication? deep tendons reflexes 2+ urinary output of 20 mL per hour respiratory rate of 10 breaths/minute difficulty in arousing

deep tendon reflexes 2+

A nurse suspects that a client is developing HELLP syndrome. The nurse notifies the health care provider based on which finding? elevated liver enzymes elevated platelet count hyperglycemia disseminated intravascular coagulopathy (DIC)

elevated liver enzymes

A patient is admitted with a diagnosis of ectopic pregnancy. For what should the nurse anticipate preparing the patient? Bed rest for the next 4 weeks Immediate surgery Intravenous administration of a tocolytic Internal uterine monitoring

immediate surgery (An ectopic pregnancy is one in which implantation occurred outside the uterine cavity, usually within the fallopian tube. As the embryo grows, the fallopian tube can rupture. The therapy for ruptured ectopic pregnancy is laparoscopy to ligate the bleeding vessels and to remove or repair the damaged fallopian tube.)

A 24-year-old woman presents with vague abdominal pains, nausea, and vomiting. An urine hCG is positive after the client mentioned that her last menstrual period was 2 months ago. The nurse should prepare the client for which intervention if the transvaginal ultrasound indicates a gestation sac is found in the right lower quadrant? Bed rest for the next 4 weeks Intravenous administration of a tocolytic Immediate surgery Internal uterine monitoring

immediate surgery (s/s of ectopic pregnancy)

What would be the physiologic basis for a placenta previa? a placenta with multiple lobes low placental implantation a uterus with a midseptum a loose placental implantation

low placental implantation

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: she will have to ask her primary care provider. as long as she receives RhoGAM, there is no limit. no more than three children is recommended. only her next child will be affected.

no limit as long as she receives RhoGAM

When assessing a pregnant woman with vaginal bleeding, the nurse would suspect a threatened abortion based on which finding? cervical dilation slight vaginal bleeding passage of fetal tissue strong abdominal cramping

slight vaginal bleeding (Slight vaginal bleeding early in pregnancy, no cervical dilation, and a closed cervical os are associated with a threatened abortion)

A prenatal client who is 6 weeks' gestation calls the clinic to report vaginal bleeding. For what concern will the nurse further assess the client? Nuchal cord Urinary tract infection Braxton Hicks contractions Spontaneous abortion

spontaneous abortion

The nurse is monitoring a pregnant patient who is receiving intravenous magnesium sulfate for eclampsia. During the last assessment, the nurse was unable to elicit a patellar reflex. What should the nurse do? Stop the current infusion. Check fetal heart rate. Increase the infusion rate. Measure blood pressure.

stop the current infusion (When infusing magnesium sulfate, the nurse should stop the infusion if deep tendon reflexes are absent)

A pregnant patient with a history of premature cervical dilatation undergoes cervical cerclage. Which outcome indicates that this procedure has been successful? The client delivers a full-term fetus at 39 weeks' gestation. The client's membranes spontaneously rupture at week 30 of gestation. The client has reduced shortness of breath and abdominal pain during the pregnancy. The client experiences minimal vaginal bleeding throughout the pregnancy.

the client delivers a full term fetus at 39 weeks

The obstetric nurse is caring for a pregnant client who has been diagnosed with hydatidiform mole. What assessment should the nurse prioritize? Vaginal bleeding Blood pressure Severe nausea and vomiting Pain

vaginal bleeding