ob exam #2 ch 19

Approximately _____ of all women with diabetes will develop hydramnios during their pregnancy

18%

The nurse recognizes that documenting accurate blood pressures is vital in the diagnosing of preeclampsia and eclampsia. The nurse suspects preeclampsia based on which finding?

BP of 140/90 mm Hg on two occasions 6 hours apart

This syndrome is a variant of preeclampsia/eclampsia syndrome that occurs in 10% to 20% of clients whose diseases are labeled as severe.

HELLP syndrome

elvated liver may indicate

HELLP syndrome

mild preeclampsia

Mild facial edema or hand edema occurs

A nurse is working as part of a community group focusing efforts on preventing isoimmunization during pregnancy at the local women's health clinic. Which measure would the group encourage?

RhoGAM administration to Rh-negative women

just know this part 1

When hospitalization is necessary, oral food and fluids are withheld to allow the gut to rest. Antiemetic agents are ordered to help control nausea and vomiting. The woman is likely to be dehydrated, so the nurse would obtain baseline blood electrolyte levels and administer intravenous fluid .

placenta accreta

a condition where the placenta attaches itself too deeply into the wall of the uterus. According to the literature, a cesarean birth increases the possibility of a future placenta accreta; the more cesarean births that are done, the greater the incidence.

Fetal distress or absent fetal heart rate may be noted,usually experiences constant uterine tenderness on palpation

abruptio placenta

The uterus is firm to rigid to the touch with

abrupto placenta

least 6 hours apart

bp measurment for GH

Preterm premature rupture of membranes (PPROM

defined as the rupture of the membranes prior to the onset of labor in a woman who is less than 37 weeks' gestation.

A nurse is assessing a pregnant client for the possibility of preexisting conditions that could lead to complications during pregnancy. The nurse suspects that the woman is at risk for hydramnios based on which preexisting condition?

diabetes

A woman is being closely monitored and treated for severe preeclampsia with magnesium sulfate. Which finding would alert the nurse to the development of magnesium toxicity in this client?

diminshed reflexes

Vaginal spotting, nausea, and breast tenderness are typical findings of

early pregnancy

The onset of seizure activity indicates

eclampsia

A woman with a recent incomplete abortion is to receive therapeutic misoprostol. The nurse understands that the rationale for administering this drug to?

ensure passage of all the products of conception

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 pregnant woman is diagnosed with abruptio placentae. When reviewing the woman's physical assessment in her medical record, which finding would the nurse expect?

firm, rigid uterus on palpation

The acronym HELLP represent

hemolysis, elevated liver enzymes, and low platelets

A nurse is providing care to a client who has been diagnosed with a common benign form of gestational trophoblastic disease. The nurse identifies this as:

hydatidiform mole

two types of gestional tropholastic disease

hydatidiform mole (partial or complete) and choriocarcinoma

Which measure would the nurse include in the plan of care for a woman with premature rupture of membranes if her fetus's lungs are mature?

labor induction

when does placenta previa occur?

later weeks of gestation

After an examination, a client has been determined to have an unruptured ectopic pregnancy. Which medication would the nurse anticipate being prescribed?

methotrexate

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

methotrexate

Referred pain to the shoulder area indicates bleeding into the abdomen caused by

phrenic nerve irritation when a tubal pregnancy ruptures.

A nurse is providing care to a multiparous client. The client has a history of cesarean births. The nurse anticipates the need to closely monitor the client for which condition?

placenta accreta

Amniocentesis would be appropriate for treatment of ?

polyhydramnios

A woman has presented to the emergency department with symptoms that suggest an ectopic pregnancy. Which finding would lead the nurse to suspect that the fallopian tube has ruptured?

referred pain

When assessing a woman with an ectopic pregnancy, the nurse would suspect that the tube has ruptured based on which finding?

referred shoulder pain

A nurse is describing the use of RhoGAM as the therapy of choice for isoimmunization in Rh-negative women and for other conditions to a group of nurses working at the women's health clinic. The nurse determines that additional teaching is needed when the group identifies which situation as an indication for RhoGAM?

sti

A pregnant woman has arrived to the office reporting vaginal bleeding. Which finding during the assessment would lead the nurse to suspect an inevitable abortion?

strong abdominal cramping

partial placenta previa ?

the internal os is partially covered by the placenta

marginal placenta previa

the placenta is at the margin or edge of the internal os;

; low-lying placenta previa

the placenta is implanted in the lower uterine segment and is near the internal os but does not reach it.

Slight vaginal bleeding early in pregnancy and a closed cervical os are associated with a

threatened abortion.

A nurse is assessing a client diagnosed with mild preeclampsia. The nurse suspects that the client has developed severe preeclampsia based on which finding?

urine output of less than 400 mL/24 hours

Misoprostol

used to stimulate uterine contractions and evacuate the uterus after an incomplete abortion to ensure passage of all the products of conception.

what is Placenta abruption or abruptio placentae

when the placenta becomes detached prematurely.

The client arrives in the office and reports that her feet and legs swelling. During a client evaluation, the nurse notes that she can elicit a 4-mm skin depression that disappears in 10 to 15 seconds. The nurse correctly documents this finding as:

2+ pitting edema

A pregnant woman has been admitted to the hospital due to severe preeclampsia. Which measure will be important for the nurse to include in the care plan?

Institute and maintain seizure precautions.

preeclampsia vision symptoms

blurred vision and blind spots

A serum magnesium level of 6.5 mEq/L would fall

within the therapeutic range of 4 to 7 mEq/L

pitting scale

1+ is a 2-mm depression that disappears rapidly; 2+ is a 4-mm depression that disappears in 10 to 15 seconds; 3+ is a 6-mm depression that lasts more than one minute; and 4+ is an 8-mm depression that lasts 2 to 3 minutes.

Proteinuria in severe preeclampsia is

500 mg per 24 hours.

the diagnosis of HELLP is

: low hematocrit, elevated LDH, elevated AST, elevated ALT, elevated BUN, elevated bilirubin level, elevated uric acid and creatinine levels, and low platelet coun

grade 3 (severe)

? absent to moderate bleeding (more than 1,500 mL), more than 50% separation, profound shock, dark vaginal bleeding, agonizing abdominal pain, decreased blood pressure, significant tachycardia, and development of disseminated intravascular coagulopathy.

Methotrexate

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

risk factors for placenta previa

advancing maternal age (more than 35 years), previous cesarean birth, multiparity, uterine insult or injury, cocaine use, prior placenta previa, infertility treatment, Asian ethnic background, multiple gestations, previous induced surgical abortion, smoking, previous myomectomy to remove fibroids, short interval between pregnancies, and hypertension or diabetes.

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?

diminshed reflexes

The three most common causes of hemorrhage during the first half of pregnancy are

e spontaneous abortion, ectopic pregnancy, and GTD

characterized by hypertension without proteinuria after 20 weeks of gestation resolving by 12 weeks postpartum

gestational hypertension

A pregnant 36-year-old woman has presented to the emergency department with vaginal bleeding. While reviewing the client's history, the nurse suspects placenta previa when which risk factors are found in her record? Select all that apply.

infertility treatment smoking advancing maternal age previous induced surgical abortion

A nurse is teaching a group of pregnant woman about bleeding that can occur early in pregnancy. The nurse determines that additional teaching is needed when the group identifies which condition as a common cause?

placenta previa

uterus it is soft and relaxed with,Bright red vaginal bleeding

placenta previa

A pregnant woman is diagnosed with abruptio placentae. When reviewing the woman's medical record, the nurse would expect which finding?

sudden dark vaginal bleeding

Rh (D) immunoglobulin is used to

suppress the immune response and prevent isoimmunization.

total placenta previa

the internal cervical os is completely covered by the placenta

Rh incompatibility can be prevented with the

use of RHogam

Oxytocin

used to stimulate uterine contractions and would be inappropriate for use with an ectopic pregnancy

During pregnancy a woman's blood volume increases to accommodate the growing fetus to the point that vital signs may remain within normal range without showing signs of shock until the woman has lost what percentage of her blood volume

40%

A nurse is conducting a presentation for a group of pregnant women about conditions that can occur during pregnancy and that place the woman at highrisk. When discussing blood incompatibilities, which measure would the nurse explain as most effective in preventing isoimmunization during pregnancy?

RHoGAM administration to Rh-negative women

A nurse is conducting a refresher program for a group of perinatal nurses. Part of the program involves a discussion of HELLP. The nurse determines that the group needs additional teaching when they identify which aspect as a part of HELLP?

elevated lipoproteins

A client has come to the office for a prenatal visit during her 22nd week of gestation. On examination, it is noted that her blood pressure has increased to 138/90 mm Hg. Her urine is negative for proteinuria. The nurse recognizes which factor as the potential cause?

gestational hypertension

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

A nurse is reviewing the medical record of a pregnant client diagnosed with placenta previa. The physical exam reveals that the placenta is implanted near the internal os but does not reach it. The nurse interprets this as which type of placenta previa?

low-lying

The nurse is preparing the plan of care for a woman hospitalized for hyperemesis gravidarum. Which interventions would the nurse most likely include? Select all that apply.

maintaining NPO status for the first day or two administering antiemetic agents obtaining baseline blood electrolyte levels monitoring intake and output

Severe preeclampsia

may develop suddenly and bring with it high blood pressure of more than 160/110 mm Hg, proteinuria of more than 5 g in 24 hours, oliguria of less than 400 mL in 24 hours, cerebral and visual symptoms, and rapid weight gain

grade 1 (mild)

? minimal bleeding (less than 500 mL), 10% to 20% separation, tender uterus, no coagulopathy, signs of shock or fetal distress;

just know this part 2

electrolyte replacement therapy as indicated. Once the nausea and vomiting subside, oral food and fluids are gradually reintroduced. Total parenteral nutrition or a feeding tube is used to prevent malnutrition only if the client does not improve with these interventions.

A pregnant woman is being evaluated for HELLP. The nursereviews the client's diagnostic test results. Which result would the nurse interpret as helping to confirm this diagnosis?

elevated LDH

; grade 2 (moderate)

? moderate bleeding (1,000 to 1,500 mL), 20% to 50% separation, continuous abdominal pain, mild shock, normal maternal blood pressure, maternal tachycardia;

Hemolysis

associated with ABO incompatibility is limited to mothers with type O blood and their fetuses with type A or B blood.

A high-risk pregnant client is determined to have gestational hypertension. The nurse suspects that the client has developed severe preeclampsia based on which finding?

blurred vision

severe preclampsia

characterized by a blood pressure of 160/110 mm Hg.

Gestational trophoblastic disease

comprises a spectrum of neoplastic disorders that originate in the placenta.

Promethazine and ondansetron are antiemetics that may be used to trea

hyperemesis gravidarum.

The woman with severe preeclampsia should be

in complete bed rest, in a dark and quiet room to avoid stimulation

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

n. With an inevitable abortion,

passage of the products of conception may occur.

Hydramnios occurs in approximately_____ of all pregnancies and is associated with fetal anomalies of development.

3%

Reducing physical activity, observing for signs of infection, and giving corticosteroids may be used for the woman with

PROM when the fetal lungs are immature.

PROM (premature rupture of membranes)

refers to a woman who is beyond 37 weeks' gestation, has presented with spontaneous rupture of the membranes, and is not in labor

When assessing a pregnant woman with vaginal bleeding, the nurse would suspect a threatened abortion based on which finding?

slight vaginal bleeding

Cerclage

treatment for cervical insufficiency.