Prep u
A RN is providing d/c teaching for a pregnant client with preeclampsia who will be managed at home on br. The nurse determines that the teaching was successful based on....
"I will drink about 8 glasses of water a day."
A pregnant client is admitted to a health care unit with/ D. I. C. Which prescription is the nurse most likely to receive regarding the therapy for such a client?
Administer cyroprecipate & platelets.
A 18 yr old preg client is hospitalized as she recovers from hyperemesis gravidarum. The client reveals she wanted to have an abortion but her cultural background forbids it. She is very unhappy about being pregnant & even expresses a wish for a miscarriage. Which action by the RN is most approp?
Contact the pcp to report the client's feelings.
A primipara @ 36 weeks' gestation is being monitored in the prenatal clinic for the risk of preeclampsia. Which s/sx should the RN prioritize?
dipstick value of 2+ for protein.
A woman at 10 weeks' gestation comes to the clinic for an eval. Which assessment finding should the nurse prioritize?
fundal ht measurement of 18cm.
A 25-year old client at 22 weeks' gestation is noted to have proteinuria & dependent edema on her routine prenatal visit. Which additional assessment should the nurse prioritize & convey to the RN or health care provider?
initial BP 100/70; current BP 140/90
What would be the physiologic basis for a placenta previa?
low placental implantation
A 24 yr old client presents in labor. The RN notes there is an order to administer RHO(D) immune globulin 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.
In Preeclampsia, auscultate lungs sounds every 2 hours to detect?
pulmonary edema
A woman has presented to the ER w/symptoms that suggest an ectopic pregnancy. Which finding would lead the RN to suspect that the fallopian tupe has ruptured?
referred shoulder pain
A student nurse asks the instructor what percentage of clinically recognized pregnancies end in miscarriage during the 1st trimester. Which response from the nurse is the most accurate?
15-20%
During pregnancy a woman's blood volume increases to accommodate the growing fetus to the point that vs may remain within normal range w/o showing signs of shock until the woman has lost what % of her blood volume?
40%
A 35-year old is seen for her 2 week postoperative appt after a suction curettage was performed to evaculate a hydatidiform mole. The nurse explains that the human chorionic gonadotropin (hcg) levels will be reviewed every 2 weeks & teaches about the need for contraception for the next 6 months to a year. The client states, "I'm 35 already. Why do I have to wait that long to get pregnant again?
A contraceptive is used so that a positive pregnancy test resulting from a new pregnancy will not be confused with the increased level of hcg that occurs with a developing malignancy.
The RN is teaching a client diagnosed with preeclampsia how to monitor her condition. The nurse determines the client needs more instruction....
If I have changes in my vision, I will lie down and rest
Difference between placenta eruption & placenta previa?
Placenta previa is an abnormally implanted placenta that is too close to the cervix and has painless bleeding.
The nurse is teaching a prenatal class on prenatal problems during pregnancy to a group of expectant parents. The risk factors for placenta adruption (abrupta plancentae) are discussed. Which comment validates accurate learning by the parents?
Placental abruption is quite painful and I will need to let the doctor know if i begin to have abd pain.
A RN is describing the use of Rho(D) immune globulin as the therapy of choice for isoimmunization in Rh-negative women and for other conditions to a group of nurses. The nurse determines additional teaching is needed when group identifies which situation as an indication of Rho(D)?
Sti's
A nurse is taking a history of a client at 5 weeks' gestation in the prenatal clinic, however, the client is reporting dark brown vaginal discharge, n/v. Which diagnosis should the nurse suspect?
gestational trophoblastic disease
A pregnant client has been admitted with reports of brownish vaginal bleeding. On examination, there is an elevated human chorionic gonadotropin (hcG) level, absent fetal heart sounds, and a discrepancy between the uterine size & the gestational age. The nurse interprets these findings to suggest which condition?
gestational trophoblastic disease
A pregnant client has been admitted w/reports of brownish vaginal bleeding. On exam. there is an elevated hcG level, absent fetal heart sounds, and a discrepency between the uterine size & the gestional age. The nurse interprets these findings to suggest which condition?
gestational trophoblastic disease/molar pregnancy
A client tells the RN in the doctor's office that her friend developed htn on her last preg. She is concerned that she will have the same prob. What is the standard of care for preeclampsia?
have her bp checked every prenatal visit.
A client in her 20th week of gestation develops HELLP syndrome. What are features of HELLP sydrome?
hemolysis elevated liver enzymes low plt count
A 24-year old woman presents with vague abd pains, n/v. 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 R lower guadrant?
immediate surgery
A woman who is 10 weeks' pregnant calls the physician's office reporting "morning sickness" but, when asked about it, tells the nurse that she is nauseated and vomiting all the time and has lost 5 pounds. What interventions would the nurse anticipate for this client?
lab work will be drawn to rule out acid-base imbalances.
A 28 yr old primigravida client with type 2 dm comes to the health care clinic for a routine 1st trimester visit reporting frequent blood glucose levels lower than normal, but glucose levels after meals being higher than normal. What should the nurse point out that these episodes are most likely related to?
normal response to pregnancy
A client at 25 weeks' gestation presents with a bp of 152/99, hr 78, no edema, & urine negative for protein. What would the nurse do next?
notify the health care provider (sign of gestational htn)
A pregnant client with preeclampsia w/ severe features has developed HELLP syndrome. In addition to the observations necessary for preeclampsia, what other nursing intervention is critical for this client?
observation for bleeding
A pregnant client with preeclampsia is to receive mag sulfate IV. Which assessment should the nurse prioritize before administering a new dose?
patellar reflex
During a routine prenatal visit, a client is found to have 1+ proteinuria & bp rise to 140/90 w/mild facial edema. The nurse recognizes that the client has which condition?
preeclampsia without severe features.
Some women experience a rupture of their membranes before going into labor. A RN recognizes that a client who presents w/preterm rupture of membranes (PROM) has completed how many weeks of gestation?
less than 37 weeks
A RN is reviewing the med record of a pregnant client. The physical exam reveals that the placenta is implanted near the internal os but does not reach it. The RN explains this happens in which condition?
low-lying placenta
A nurse is caring for a pregnant client admitted with mild preeclampsia. Which assessment finding should the nurse prioritize.
urine output <15ml/hr
A young woman presents at the emergency department reporting lower abd cramping & spotting @ 12 weeks' gestation. The primary care provider performs a pelvic examination & finds that the cervix is closed. What does the provider suspect is the cause of the cramps & spotting.
Threatened abortion
A client has been admitted to the hospital with a dx of preeclampsia w/severe features. What nursing intervention is priority?
strict BR in darkened room
The RN is caring for a woman at 32 weeks' gestation w/ severe preeclampsia. Which assessment finding should the nurse prioritize after the admin of hydralazine?
tachycardia
The nurse is required to assess a preg client who is reporting vaginal bleeding. Which nursing action is priority?
assessing the amount & color of bleeding
A preg client diagnosed with hyperemesis gravidarum is prescribed iv fluids for rehydration. When preparing to administer this therapy, which solution would the RN anticipate being described initially?
NS
A client with a hx of cervical insuffiency is seen for reports of pink-tinged discharge & pelvic pressure. The pcp decides to perform a cervical cericage. The RN teaches the client about the procedure. Which client response indicates that the teaching has been effective?
Purse-string sutures are placed in the cervix to prevent it from dilating.
A Rn is caring for a client undergoing tx for ectopic pregnancy. Which symptom is observed in a client if rupture or hemorrhaging occurs before the ectopic pregnancy is successfully treated?
phrenic nerve irritation
A nurse is assessing pregnant clients for the risk of placenta previa. What client faces the greatest risk for this condition?
a client who had a myomectomy to remove fibroids.
A nurse is caring for a client who just experienced a spontaneous abortion (miscarriage) in the 1st trimester. When asked by the client why this happened, which is the best response from the nurse?
abnormal fetal development
A nurse is caring for a client with hyperemesis gravidarum. Which nursing action is the priority for this client?
administer iv ns w/vitamins & electrolytes
A pregnant client with multiple gestation arrives at the maternity clinic for a regular antenatal check up. The nurse would be aware that client is at risk for which prenatal complication?
congenital anomalies
A nurse is caring for a young woman who is in her 10th week of gestation. She comes into the clinic reporting vaginal bleeding. Which assessment finding best correlates with a diagnosis of hydatidform mole?
dark red "clumpy" vaginal discharge
A RN is assessing a preg client for the possibility of preexisting conditions that could lead to complications during pregnancy. The nurse suspects that the woman is at risk for hydraminios based on which preexisting condition?
diabetes
A 28 year old client with a hx of endometriosis presents to the ER with severe abd pain & n/v. The client also reports her periods are irregular with the last one being 2 months ago. What is the possible cause?
ectopic pregnancy
A nurse understands the need to be aware of the potential of bleeding disorders in pregnant clients. Which disorder should she be aware of that occurs in the 2nd trimester?
placenta previa
What measure would the RN include in the plan of care for a woman w/prelabor rupture of membranes if her fetus' lungs are mature?
labor induction
Which measure should the nurse include in the plan of care for a woman with prelabor rupture of membranes if her fetus's lungs are mature?
labor induction
A client is experiencing a threatened abortion is concerned about losing the pregnancy & asks what she can do to help save her baby. What is the most approp. response from the RN?
restrict your physical activity to moderate BR.
A woman at 12 weeks' gestation comes to the clinic with vaginal bleeding. When assessing the woman further, the nurse would suspect a threatened abortion based on which finding?
slight vaginal bleeding
A woman in week 16 of her pregnancy calls her physician's office to report that she has experienced abdominal cramping, cervical dilation, vaginal spotting, and the passing of tissue. The nurse instructs the client to bring the passed tissue to the hospital with her. What is the correct rationale for this instruction? a) To determine the stage of development of the fetus b) To determine whether infection is present c) To determine whether gestational trophoblastic disease is present d) To determine whether the fetus is viable
to determine whether gestational trophoblastic disease is present.
A 17 yr old client comes to the clinic b/c of irregular menstrual bleeding & facial acne. The client is overweight, despite exercising daily, & has excessive hair growth on chin & abd. The nurse explain that blood will be drawn for which purpose?
to screen for insulin resistance to obtain fasting chol levels to measure androgen level
A client at 32 weeks' gestation is admitted with acute abdominal pain. She is diagnosed with placental abruption. Which intervention is priority?
transfuse blood