Maternity Ch. 27 Hypertensive Disorders

The nurse is caring for a pregnant client with preeclampsia. The client reports severe and persistent epigastric pain. In reviewing the client's blood test, which result may indicate worsening liver function?

Increased liver transaminase levels

The nurse is caring for a client with preeclampsia who gave birth by cesarean delivery. The primary health care provider prescribes a nonsteroidal antiinflammatory drug (NSAID) to the client for pain. Which parameter would the nurse closely monitor in this client?

Blood pressure

A pregnant client with severe preeclampsia is being transported to a tertiary care center and needs to be administered a magnesium sulfate injection for seizure activity. Which actions would the nurse take when administering the drug? Select all that apply.

A local anesthetic is added to the solution The Z-track technique is used to inject the drug The injection site is massaged after the injection

A client with severe preeclampsia is receiving a magnesium sulfate infusion. Which assessment finding would be most concerning to the nurse?

A respiratory rate of 10 breaths/min

A woman with severe preeclampsia is being treated with an intravenous infusion of magnesium sulfate. When is this treatment considered successful?

If seizures do not occur

Which are the manifestations of HELLP syndrome? Select all that apply.

Hemolysis Low platelet count Elevated liver enzymes

An 8-month-pregnant client presents with preeclampsia. Which clinical findings in the client indicate that the disease has progressed to HELLP syndrome? Select all that apply.

Hepatic dysfunction Elevated liver enzymes Low platelet count

The nurse is caring for a hypertensive pregnant client who is on magnesium sulfate therapy. The nurse finds that the client has drowsiness, slurred speech, and depressed respiration. Which medication would the nurse anticipate the primary health care provider will prescribe to reverse these findings?

Intravenous calcium gluconate

Which nursing finding is appropriate to evaluate when a client in labor who is at 38 weeks of gestation is treated with nifedipine for hypertension?

Labor progress

The nurse is preparing to administer intravenous magnesium sulfate to a client with preeclampsia. Meanwhile, the student nurse positions the client in the supine position, monitors the fetal heart rate (FHR), checks for baseline variability, and monitors for the absence of late decelerations. Which action by the student nurse indicates the need for further teaching?

Placing the client in a supine position

The nurse is monitoring a client's deep tendon reflexes (DTRs) while receiving magnesium sulfate therapy for treatment of preeclampsia. Which assessment finding would indicate a cause for concern?

Positive clonus response elicited unilaterally

The nurse caring for a 37-week-gestation client with gestational hypertension determines that the client has very elevated blood pressure. Which is the best intervention to prevent complications in the client?

Prepare the client for induction of labor

Which system is a nursing priority after evaluating the information from the electronic health record for a client admitted with newly diagnosed preeclampsia?

Renal

Which condition in a pregnant client with severe preeclampsia is an indication for administering magnesium sulfate?

Seizure activity

The nurse is caring for a postpartum client with preeclampsia. Which statement would the nurse include in discharge teaching?

"Return to the hospital if you have epigastric pain."

Which initial nursing action is appropriate when caring for a client who has had an eclamptic seizure?

Administer oxygen

A client with severe preeclampsia has been receiving magnesium sulfate by intravenous infusion for 8 hours. The nurse assesses the client and documents the following findings: temperature 37.1° C, pulse rate 96 beats/min, respiratory rate 24 breaths/min, blood pressure 155/112 mm Hg, 3+ deep tendon reflexes, and no ankle clonus. The nurse calls the primary health care provider and anticipates a prescription for which medication?

Hydralazine

The nurse knows that which factor(s) is associated with HELLP syndrome?

It is characterized by hemolysis, elevated liver enzymes, and low platelet count

The nurse is monitoring a client's deep tendon reflexes (DTRs) while receiving magnesium sulfate therapy for treatment of preeclampsia. Which assessment finding would indicate a cause for concern?

Positive clonus response elivcited unliterally

The primary health care provider requests that the nurse test for proteinuria in a pregnant client. Which preliminary examinations would the nurse perform before testing for proteinuria to get accurate results? Select all that apply.

Presence of blood in the urine Presence of bacteria in the urine Presence of amniotic fluid in the urine

The nurse is assessing a pregnant client with preeclampsia on bed rest. Which region of the body would the nurse assess for edema in a client with preeclampsia?

Sacral region

Which conditions would the nurse remain alert for in a pregnant client with preeclampsia? Select all that apply.

Seizures Scotoma Cerebral edema

A client with gestational hypertension is prescribed labetalol hydrochloride therapy, which is continued postpartum. Which instruction would the nurse provide the client about breastfeeding?

"You may breastfeed the infant if you desire."

A client is prescribed a 4-g loading dose of magnesium sulfate to be infused over 20 minutes. The nurse has available magnesium sulfate 40 g in 500 mL of normal saline. How many mL/hr will the nurse set the infusion pump to deliver the loading dose? __________ mL/hr

150

A client with severe gestational hypertension is prescribed hydralazine. Which is the priority nursing intervention in this case?

Assess blood pressure frequently

The primary health care provider prescribes magnesium sulfate for a pregnant client who is being transported to the tertiary care center. Which actions would the nurse follow according to the protocol? Select all that apply.

Mix the drug with local anesthetic agent Administer 5 g to each buttock as a loading dose Administer 5 g as a maintenance dose alternately to each buttock

Which signs in a pregnant preeclamptic client would indicate the invasion stage of the tonic-clonic seizures? Select all that apply.

Fixed eyes Twitching of facial muscles

The nurse caring for a pregnant client knows that which situation is the most common medical complication of pregnancy?

Hypertension

The nurse is caring for a client with severe preeclampsia who is on an intravenous infusion of magnesium sulfate. Which assessment parameter indicates that the treatment is a success?

Seizures do not occur