chapter 19 prep u

The nurse should prepare to administer RhoGAM after which diagnostic procedure?

Amniocentesis

When caring for a client with premature rupture of membranes (PROM), the nurse observes an increase in the client's pulse. What should the nurse do next?

Assess the client's temperature.

Severe preeclampsia

BP 160/100 or greater, proteinuria greater than 3+, oliguria, elevated serum creatinine- 1.2+, cerebral or visual disturbances (headache or blurred vision), hyperreflexia with ankle clonus, peripheral edema, hepatic dysfunction, RUQ pain, and thrombocytopenia

mild preeclampsia

Hypertension beginning after the 20th week of pregnancy with 1 to 2+ proteinuria and a weight gain of more than 2 kg per week in the second and third trimesters.

The nurse is caring for a client with preeclampsia and understands the need to auscultate this client's lung sounds every 2 hours. Why would the nurse do this?

Pulmonary edema

the nurse is caring for a multigravid who experienced a placental abruption 4 hours ago. For which potential situation will the nurse prioritize assessment?

Uterine atony

threatened abortion

Uterine bleeding at 18 weeks' gestation; no products expelled; cervical os closed.

inevitable abortion

Uterine bleeding at 18 weeks' gestation; no products expelled; membranes ruptured; cervical os open.

The risk of placenta previa is greatly increased when

a woman has had a previous cesarean delivery due to the scarring of the endometrial lining.

hallmark sign of ectopic pregnancy

abdominal pain with spotting within 6 to 8 weeks after missed menses

incomplete abortion

abortion without expulsion of all of the products of conception

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

complete abortion

all products of conception are expelled

The most commonly reported symptoms of ectopic pregnancy

are pelvic pain and/or vaginal spotting

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

Which assessment findings, experienced by the client at 36 weeks' gestation, would the nurse document as diagnostic signs of severe preeclampsia? Select all that apply.

blood pressure of 164/110 mm Hg elevated liver enzymes +1 proteinuria Elevated serum creatinine

first trimester spontaneous abortion

commonly due to fetal genetic abormalities

missed abortion

death of a fetus or embryo within the uterus that is not naturally expelled after death

The nurse is required to assess a client for HELLP syndrome. Which are the signs and symptoms of this condition?

epigastric pain upper right quadrant pain hyperbilirubinemia

The nurse is assessing a client at 12 weeks' gestation at a routine prenatal visit who reports something doesn't feel right. Which assessment findings should the nurse prioritize?

gestational hypertension, hyperemesis gravidarum, absence of FHR

Approximately 18% of all women with diabetes will develop

hydramnios during their pregnancy

uterine atony

inability of the uterus to contract effectively

When meconium is present in the amniotic fluid, it typically indicate

indicates fetal distress related to hypoxia.

preferred asthma therapy during pregnancy

inhaled corticosteroids

Pitting edema

leaves a small depression or pit after finger pressure is applied to a swollen area and can be measured

Dependent edema

may occur in clients who are both ambulatory and on bed rest.

Grade 1 (mild)

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

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

second trimester spontaneous abortion

more likely related to maternal conditons

a pregnant client with severe preeclampsia has developed HELLP syndrome. In addition to the observations necessary for preeclampsia, what other nursing intervention is critical for this client?

observation for bleeding

if magnesium toxicity occurs,

one sign in the client will be a decrease in the respiratory rate and a potential respiratory arrest.

The classic signs of abruptio placentae are

pain, dark red vaginal bleeding, a rigid, board-like abdomen, hypertonic labor, and fetal distress.

Placenta previa usually produces

painless bright red bleeding. Preterm labor contractions are more often described as cramping.

Reflex assessment

part of the standard assessment for clients on magnesium sulfate.

A 24-year-old client presents in labor. The nurse 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.

cerclage

purse string suture, is inserted into the cervix to prevent preterm cervical dilation (dilatation) and pregnancy loss

Premature separation of the placenta begins with

sharp fundal pain, usually followed by dark red vaginal bleeding.

habitual abortion

spontaneous abortion occurring in three or more consecutive pregnancies

The nurse instructs the client to bring the passed tissue to the hospital with her. What is the correct rationale for this instruction?

to determine whether gestational trophoblastic disease is present

The nurse knows that which factor is a known risk factor for ectopic pregnancy?

use of IUD for contraception

Gestational hypertension is caused by

vasospasms of the arteries.

In a partial molar pregnancy

two sperm penetrate the ovum, resulting in a total of 69 chromosomes