Maternal Childhood Ch 6 Review

A teenager at 32 weeks' gestation is hospitalized with preeclampsia. She is anorexic and appears depressed. Which comment indicates to the nurse that further exploration of the client's emotionsal status is indicated?

"I was really happy before I got pregnant."

A client visiting the prenatal clinic for the first time asks a nure about the probability of having twins becuase her husband is one of a pair of fraternal twins. What is the appropriate response by the nurse?

"There is no greater probability of having twins than in the general population."

A patient is admitted to the birthing suite with a blood pressure of 150/90 mm Hg, 3+ proteinuria, and edema of the hands and face. A diagnosis of severe preeclampsia is made. What other clinical findings support this diagnosis? Select all that apply.

- Headaches - Abdominal pain - Visual disturbances -

women who become pregnant for the first time at a later reproductive age (35 years of age or older) are at risk for what complications? Select all that apply.

1,2,4,5 - Preterm labor - Multiple gestation - Chiromosomal anomalites - Bleeding in the first trimester

A nurse is caring for a wamn with cholelithiasis and obstructive jaundice. When assessing this patient, the nurse should be alert for which common clinical indicators associated with these conditions? Select all that apply.

1,2,5 - Ecchymosis - Yellow sclera - Pain in right upper quadrant

What should a nurse anticipate about the insulin requirments of a woman with diabetes on her first pospartum day?

A sharp and sudden decrease

Which sign or symptom leads a nurse to suspect that a patient has a tubal pregnancy?

A sharp lower right or left abdominal pain radiating to the shoulder.

A nurse is obtaining the health history from a patient with a diagnosis of a ruptured tubal pregnancy. At what point in the pregnancy does the nurse exect the patient to state when the low abdominal pain and vaginal bleeding started?

About the sixth week of pregnancy

What nursing intervention is specific for patients with cardiac problems who are in active labor.

Auscultating the lungs for crackles every 30 minutes.

A nurse is preparing a teaching plan for a pregnant patient with a history of cholelithiasis. Which information about why the ingestion of fatty foods will cause discomfort should the nurse include in the teaching plan?

Bile flow into the intestine is obstructed.

Which clinical indicatir should the nurse identify beofre scheduling a patient for an endoscopic retrograde cholangiopancreatography (ERCP)?

Bilirubin level

A few hours after being admitted to the hospital with a diagnosis of inevitable abortion, a patient at 16 weeks' gestation begins to experience bearing-down sensations and suddenly expels the products of conception in bed. What should the nurse do first

Check the patients' fundus for firmess.

A patient is scheduled for a sonogram at 36 weeks' gestation. Shortly before the test she tells the nurse that she has severe abdominal pain. Assessment reveals heavy vaginal bleeding, a drop in blood pressure, and an increased pluse rate. Whta complication does the nurse suspect?

Complete abruptio placentae

What nursing intervention should be included when caring for a patient with placenta previa?

Documentation of the amount of bleeding.

Sonography of a primigravida who is at 15 weeks' gestation reveals a twin pregnancy. The nurse reviews with the client the risks of a multiple pregnancy that were explained by the health care provider. Which condition does the client identify that indicates the need for further instruction about complications associated with the multiple gestation?

Down syndrome

A nurse is caring for a patient who had a spontaneous abortion. The patient asks why spontaneous abortions occur. The nurse repsonds that they are most commonly caused by what?

Embryonic defects

What is the initial responsibility of a nurse when teaching the pregnant adolescent?

Encouraging her to continue regulaarly scheduled prenatal care.

A nurse is reviewing the obstetric history of a patient who had an abruptio placentae. What prenatal condition does the nurse expect the patient to have had?

Gestational hypertension

A pregnant patient with class II heart disease is concerned that her pregnancy will be an added burden on her already compromised heart. A nurse explains that during her pregnancy the cardiax system is most compromised during the what?

First 2 days after the birth

What assessment finding of a pregnant patient should alert the nurse to notify the health care provider

Fundal height at the umbilicus at 16 weeks' gestation

A nurse in the prentatl clinic is caring for a patient with heart disease who is in the second trimester. What hemodynamic of pregnancy may affect the patient this time?

Heart rate acceleration in the last half of pregnancy

A nurse is caring for a patient who had a spontaneous abortion. For what complication should the nurse assess this patient

Hemorrhage

A patient who had a severe abruptio placentae asks the nurse why there was so much bleedng. What should the nurse consider is the cause of the heavy bleeding before resonding in language the patient will understand?

Hypofibrinogenemia

A nurse anticipates that newborns of mothers who have diabetes often have tremors, periods of apnea, cyanosis, and poor ability. With what omplication are these signs associated?

Hypoglycemia

The nurse is counseling a pregnant patient with type 1 diabetes about medication changes as the pregnancy progresses. Which medication will be needed in increased dosages during the second half of her pregnancy.

Insulin

A patient is recieving magnesium sulfate therapy for severe preeclampsia. What initial sign of toxicity should alert the nurse to intervene?

Lack of the knee-jerk reflex

A patient with class I heart disease is admitted to the birthing suite in active labor. In what position should the nurse place the patient.

Left lateral with head elevated

A patient with the disagnosis of severe preeclampsia is admitted to the hospital from the emergency department. What precaution shoulf the nurse initiate?

Pas rhe side rails on the bed.

A nurse is counseling a woman who was just diagnosed with a multiple gestation. Why does the nurse consider this pregnancy high risk?

Perinatal mortality is two to three tomes greater in multiple than in single births.

A patient arrives at the hospital at 38 weeks' gestation with profuse vaginal bleeding. She states that it occured suddenly without any contractions. Which condition may the patient be experiencing that requires immediate notification of the health care provider

Placenta previa

Which woman should the nurse identify is at risk for developing a hypertensive disorder of pregnancy

Primigravida who is obese

An 18-year-old pregnant woman in her first trimester is admitted with an acute onset of right lower quadrant pain at the McBurney point. Appendicitis is suspected. For which clinical indicator should the nurse assess the patient to determine wheather the pain is secondary to appendicitis?

Rebound tenderness

A nurse is monitoring a patient with severe preeclampsia for the onset of eclampsia. Whar clinical findings indicates an impending seizures

Rolling of the eyes to one side with a fixed stare

What does a nurse inticipate will be provided for a newborn of a mother with a history of long-standing diabetes?

Special high-risk care

A nurse is monitoring a patient with severe preeclampsia who is recieving an infusion of magnesium sulfate. Assessment reveals a pulse rate of 55/minute, respirations of 12/minute, and a flushes face. What is the next nursing action?

Stop the infusion and start an infusion of dextrose and water.

How should a nurse screen a newborn of a diabetic mother for hypoglycemia?

Test heel blood with a glucose-oxidase strip.

A patient tells a nurse in the prenatak clinic that she has vaginal staining but no pain. Her history reveals amenirrhea for the last 2 months and pregnancy confirmation after her first missed period. She is admitted to the high-risk unit because she may be having a spontaneous abortion. What type od abortion is suspected?

Threatened

A nurse in the birthing unti is caring for several clients. Which factor should the nurse anticipate will increase the risk for hypotonic uterube dystocia?

Twin gestation

A nurse is assessing a patient with a tentative diagnosis of hydatidiform mole. Which clinical finding should the nurse anticipate?

Unusual uterine enlargement

A client pregnant with twins is told by the health care provider that she is at risk fpr postpartum hemorrhage. Later, the client asks the nurse whys he is at risk for hemorrhage. What should the nurse consider is the cause of the postpartum hemorrhage before responding in language the client will understand

Uterine atony

A patient admitted with preeclampsia is recieving magnesium sulfate. Which assessment indicates that a therapeutic level of the medication has been reached?

Deep tendon reflexes of +2

After an incomplete abortion, a patient tells a nurse that although her health care provider explained what an incomplete abortion was, she did not understand. What is the nurse's best repsonse

"This is when the fetus is expelled but other parts of the pregnancy remain in the uterus.

A 16-year-old adolescent-visits the prenatal clinic because she has missed three mesnstrual periods. Before her examination she says, "I don't know what the problem is, but I can't be pregnant." What is the nurse's msot therapeutic response?

"Why did tou decide to come to the prenatal clinic?"

A pregnant patient with a history of rheumatic heart disease since childhood is concerned about the birth of her baby and asks what is expected. What should a nurse explain about the birth? Select all that applies.

- Labor may be induced - Birth may be vacuum extraction assisted - Regional anesthesia may be administered

A patient is discharged the same day after ambulatory surgery for a laparoscopic cholecystectomy. The nurse is providing discharge teaching about how many days the patient should wait to engage in certain activities. Place in order the activities from the first time to the last in which the patient may engage.

4,3,1,2,5 - Getting out of bed in a chair - Performing light exercise - Showering - Driving a car - Lifting objects of more than 10 pounds

When does a nurse caring for a patient with eclampsia determine that the risk for another seizure has subsided?

48 hours postpartum

A nurse notifies the health care provider that a patient has been admitted tp the high-risk unit in her 36th week of gestation. She is bleeding, has severe abdominal pain and a rigid fundus, and is demonstrating signs of shock. For what intervention should the nurse prepare?

An immediate cesarean birth

A patient at 37 weeks' is admitted to the birthing unti from the emergency department. She had arrived by ambulance after a motor wehicle accident. Her vital signs are BP: 90/60; P:108; R:24. She is reporting sharp abdminal pain. What is the priority nursing intervention at this time?

Apply an electronic fetal monitor

A patient in the prenatal clinic is diagnosed with preeclampsia. What clinic findings support this diagnosis?

Blood pressure more than 140mm Hg systolic accompanied by proteinuria

A patient at 37 weeks' gestation arrives at the emergency department stating that she has abdominal paint but no vaginal bleeding. The health care provider diagnoses abruptio placentae. The patient sks the nurse why it is so painful. What should the nurse consider is the inital cause of the abdominal pain before repsonding in language the patient will understand?

Concealed hemorrhage

a patient at 28 weeks' gestation has a sonogram. The results reveal a small-for-gestation-age (SGA) fetus and a low-lying placenta. For what complication should the nurse assess this patient during the last trimester of pregnancy?

Placenta previa