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A multiparous client with a history of gestational hypertension and previous history of abruption is in the transition phase of labor. The electronic fetal monitor shows fetal bradycardia, and a change is seen in the contour of the client's abdomen. What is the nurse's priority intervention?

Alerting others regarding the need for immediate cesarean delivery

A client who is in labor is admitted 30 hours after her membranes ruptured. Which condition is this client at increased risk for?

Chorioamnionitis

A client at 38 weeks' gestation is admitted to the high-risk prenatal unit with a diagnosis of severe preeclampsia. The nurse obtains the vital signs, performs a health history and physical assessment, and reviews the client's laboratory results. What is the priority nursing intervention at this time?

Correct2 Providing a dark private room

While reviewing laboratory results of clients seen at the maternity clinic, the nurse notes that one client's maternal serum alpha-fetoprotein level is lower than expected. What does the nurse recognizes that this may be associated with?

Down syndrome

A nurse in the prenatal clinic is caring for a client with heart disease who is in her second trimester. Which hemodynamic change of pregnancy is likely to affect the client at this time?

Heart rate acceleration in the last half of pregnancy

A pregnant client has a history of multiple preterm births followed by neonatal deaths. Which is the most significant impending sign of danger that the client must be taught to report

Pelvic pressure

A client at 28 weeks' gestation is scheduled for a sonogram. The results reveal a small-for-gestational age fetus and a low-lying placenta. Which complication should the nurse assess this client for during the last trimester of pregnancy?

Placenta previa

A pregnant client with type 1 diabetes is visiting the prenatal clinic for the first time. What is the primary long-term goal for this client?

Pregnancy will end with the birth of a healthy infan

A client at 28 weeks' gestation visits the clinic for a routine examination. Which finding is of greatest concern to the nurse?

Puffy fingers

The nurse is assessing her assignment of four postpartum clients. Which conditions increase the risk for postpartum hemorrhage? Select all that apply.

Twin birth Overdistended bladder Retained placental fragments

A primary healthcare provider prescribes carboprost to be administered to a postpartum client with intractable vaginal bleeding. Which prior condition noted in the client's history should alert the nurse to question this prescription?

asthma

Which nursing intervention is specific to clients in active labor who present with a history of cardiac disease?

Auscultating the lungs for crackles every 30 minutes

Which information in a postpartum client's health history should alert the nurse to monitor the client for signs of infection?

Blood loss of 850 mL after a vaginal birth normally 350 to 500 mL

The nurse is caring for a pregnant client with type 1 diabetes. Which complication is the result of type 1 diabetes?

Increased risk of hypertensive states

The nurse is caring for a patient who has just had an amniotomy performed by the primary healthcare provider. The fetal heart rate immediately decreases from 140 to 80 beats/min. What is the priority nursing action?

Inspecting the vagina

On her first visit to the prenatal clinic, a client with rheumatic heart disease asks the nurse whether she has any special nutritional needs. What supplements in addition to the regular pregnancy diet and prenatal vitamin and minerals will she need? Select all that apply.

Iron, Folic acid

During the second postpartum hour after a long labor and difficult birth, a nurse identifies that the client has heavy vaginal bleeding that does not diminish after fundal massage. The client reports, "I'm so thirsty. May I have some ginger ale?" How should the nurse reply?

"I know this is difficult; however, it's best for you to wait until the bleeding has subsided. I can give you a moisturizer for your lips to relieve the dryness.

A client with class I heart disease has reached 34 weeks' gestation. Which problem should the nurse anticipate now that the client is in her third trimester?

Dyspnea at rest

After a deep vein thrombosis developed in a postpartum client, an intravenous (IV) infusion of heparin therapy was instituted 2 days ago. The client's activated partial thromboplastin time (aPTT) is now 98 seconds. What should the nurse do next?

Interrupt the infusion and notify the primary healthcare provider of the aPTT result. The heparin should be withheld, because 98 seconds is almost three times the normal time it takes a fibrin clot to form (25 to 36 seconds), and prolonged bleeding may result; the therapeutic range for heparin is one-and-a-half to two times the normal range. The primary healthcare provider should be notified. The dosage of heparin must not be increased, because the client already has received too much. Documenting the result on the medical record and rechecking the aPTT in 4 hours is an unsafe option. Continuing the infusion could result in hemorrhage. The medication does not have to be changed; it should be stopped temporarily until the aPTT is within the therapeutic range.

A client with severe preeclampsia develops eclampsia. After the seizure, the client has a temperature of 102° F (38.9° C). What does the nurse suspect as the cause of the elevated temperature?

Irregularity in the cerebral thermal center

A client with a history of phenylketonuria (PKU) who was maintained on a low-phenylalanine diet until 9 years of age is pregnant. What is most important for the nurse to discuss with this client?

Reinstitution of the low-phenylalanine diet will protect her baby from the disorder.

A client at 30 weeks' gestation is being examined in the prenatal clinic. The nurse identifies a respiratory rate of 26 breaths/min, blood pressure of 100/60 mm Hg, and diaphragmatic tenderness. The client also reports increased urinary output. Which of these findings indicates that the client may be experiencing a complication?

Respiratory rate

A woman arrives for an appointment at an obstetrics clinic. During the visit the nurse records the following information. Which finding indicates a need for future intervention?

Rubella titer less than 1:8 (nonimmune)

A client's membranes rupture, and the nurse immediately detects the presence of a prolapsed umbilical cord. The nurse alerts another nurse, who calls the primary healthcare provider. Place the following nursing interventions in the order in which they should be performed

move cord trendelenburg give O2 check FHR

A client in active labor is admitted to the birthing unit. It is determined that the fetus is in the right sacrum anterior (RSA) position/presentation. Judging from the illustration, what is the point of maximal intensity for monitoring of fetal heart tones?

a

The nurse is caring for a client in active labor with a history of T5 spinal cord injury. Which of the following findings indicates to the nurse that the client is experiencing a complication of the labor process?

ncreased blood pressure A client with a spinal cord injury at T6 or higher is at risk for autonomic dysreflexia, marked by increased blood pressure and bradycardia. The nurse will need to carefully monitor this client throughout the labor process. An increased pulse rate may be a result of the adaptation of the labor process. Increased urine output would be expected, because clients are well hydrated in labor; this does not indicate a complication. Flaccidity is an expected assessment finding for a client with this history.

On her first visit to the prenatal clinic, a client with rheumatic heart disease asks the nurse whether she has any special nutritional needs. What supplements in addition to the regular pregnancy diet and prenatal vitamin and minerals will she need? Select all that apply.

On her first visit to the prenatal clinic, a client with rheumatic heart disease asks the nurse whether she has any special nutritional needs. What supplements in addition to the regular pregnancy diet and prenatal vitamin and minerals will she need? Select all that apply.

A client at 24 weeks' gestation arrives at the clinic for a routine examination. She tells the nurse, "I feel puffy all over." In light of this statement, what is the nurse's most important assessment?

Obtaining her blood pressure

A client at 40 weeks' gestation is admitted to the birthing unit in early active labor. During her intake assessment, she tells the nurse that her membranes ruptured 26 hours ago. Initial assessments of the fetal heart rate range between 168 and 174 beats/min. What is the priority nursing action?

Assessing maternal vital signs

Intravenous magnesium sulfate therapy is instituted for a client with severe preeclampsia who has a blood pressure of 170/110 mm Hg, a pulse of 108 beats/min, and a respiratory rate of 24 breaths/min. Eight hours later her blood pressure is 150/110 mm Hg, the pulse is 98 beats/min, the respiratory rate is 10 breaths/min, and the knee-jerk reflex is absent. What should the nurse do next?

Stop the infusion of magnesium sulfate and notify the primary healthcare provider.

A nurse is caring for a client with type 1 diabetes on her first postpartum day. While planning care for this client, what changes in insulin requirements does the nurse anticipate?

Suddenly decrease

A woman who is admitted to the labor suite has herpes simplex virus type 2 (HSV-2) with active lesions in the perineal area. What should the nurse's plan of care include?

Withholding oral fluid intake