Maternity Chpt. 20: Pregnancy at Risk, Health Conditions/Populations 5-8

Preparing for amniocentesis and fetal lung maturity assessment

A 17-year-old primigravida with type 1 diabetes is at 37 weeks' gestation comes to the clinic for an evaluation. The nurse notes her blood sugar has been poorly controlled and the health care provider is suspecting the fetus has macrosomia. The nurse predicts which step will be completed next? Allowing her to continue without plans for delivery. Scheduling the woman for induction of labor today. Preparing for amniocentesis and fetal lung maturity assessment Scheduling a cesarean delivery at 39 weeks.

Ask the client to decrease her intake of salicylates.

A client with rheumatoid arthritis (RA) is in week 38 of her pregnancy. Which intervention should the nurse make with this client? Ask the client to decrease her intake of salicylates. Urge the client to be on bed rest. Advise the client to continue her normal dosage of methotrexate. Perform the Snellen eye test.

in utero transmission

Cytomegalovirus infection can result in different congenital anomalies. It can also be transmitted via different routes. When discussing this infection with a pregnant woman, the nurse integrates understanding that permanent fetal disability can occur with which type of transmission of CMV? after birth transmission with any transmission in utero transmission during birth transmission

African heritage previous history of spontaneous abortion (miscarriage) maternal obesity with body mass index more than 35

During a routine prenatal checkup, the nurse interviews a pregnant client to identify possible risk factors for developing gestational diabetes. Which factor(s) will the nurse identify as increasing the woman's risk? Select all that apply. younger maternal age at pregnancy African heritage previous history of spontaneous abortion (miscarriage) previous birth of small-for-gestational-age neonate maternal obesity with body mass index more than 35

adhering to standard precautions

A pregnant woman who is HIV-positive comes to the labor and birth unit in labor. When developing the plan of care for this client, which intervention would be most important for the nurse to include? adhering to standard precautions educating her about family planning preparing the woman for cesarean birth helping her choose a newborn feeding method

Hematocrit of 32% or less

Many women develop iron-deficient anemia during pregnancy. What diagnostic criteria would the nurse monitor for to determine anemia in the pregnant woman? Hemoglobin of 13 g/dl (130 g/L) or lower Hematocrit of 32% or less Blood pressure of 100/68 mm Hg Heart rate of 84 beats/min

preterm labor preeclampsia postpartum hemorrhage

A nurse is conducting a teaching program for pregnant woman who are older than age 35. The nurse explains that although most women in their age group have healthy pregnancies and healthy newborns, they are at increased risk for possible complications. Which complications would the nurse include? Select all that apply. placental abruption (abruptio placentae) type 1 diabetes preterm labor preeclampsia postpartum hemorrhage

"Actually, having uncontrolled asthma is much riskier for your baby than the medication."

The nurse is assessing a pregnant client who has a long history of asthma. The client states, "I'm trying not to use my asthma medications because I certainly don't want my baby exposed to them." What is the nurse's best response? "In fact, most modern asthma medications are categorized as safe for use in pregnancy." "I'm glad to hear that you're focused on ensuring your baby's health." "Actually, having uncontrolled asthma is much riskier for your baby than the medication." "Your health care provider will likely agree with your decision."

preterm birth

Which should the nurse identify as a risk associated with anemia during pregnancy? newborn with heart problems newborn with an enlarged liver preterm birth fetal asphyxia

CMV

After conducting a refresher class on possible congenital infections with a group of perinatal nurses, the nurse recognizes the class was successful when the group identifies which congenital viral infection as the most common? HIV RSV HPV CMV

respiratory function

During the assessment of a laboring client, the nurse learns that the client has cardiovascular disease (CVD). Which assessment would be priority for the newborn? temperature respiratory function urine output heart rate

stage 1

Over the past 20 weeks, the following blood pressure readings are documented for a pregnant client with chronic hypertension: week 16 - 130/86 mm Hg; week 20 - 138/88 mm Hg; week 24 - 136/82 mm Hg; and week 28 - 138/88 mm Hg. The nurse interprets these findings as indicating which classification of her blood pressure? hypertensive crisis stage 1 elevated stage 2

Eat meat cooked to 160° F (71° C). Avoid cleaning the cat's litter box. Avoid outdoor activities such as gardening.

The nurse is caring for a pregnant client who indicates that she is fond of meat, works with children, and has a pet cat. Which instructions should the nurse give this client to prevent toxoplasmosis? Select all that apply. Eat meat cooked to 160° F (71° C). Avoid cleaning the cat's litter box. Keep the cat outdoors at all times. Avoid contact with children when they have a cold. Avoid outdoor activities such as gardening.

swelling of the face

The nurse is caring for a pregnant client who is in her 30th week of gestation and has congenital heart disease. Which finding should the nurse recognize as a symptom of cardiac decompensation with this client? swelling of the face dry, rasping cough slow, labored respiration elevated temperature

class III

A pregnant client with a history of heart disease has been admitted to a health care center reporting breathlessness. The client also reports shortness of breath and easy fatigue when doing ordinary activity. The client's condition is markedly compromised. The nurse would document the client's condition using the New York Heart Association (NYHA) classification system as which class? class I class II class III class IV

Administer rubella vaccine before discharge.

A postpartum mother has the following lab data recorded: a negative rubella titer. What is the appropriate nursing intervention? No action needed. Administer rubella vaccine before discharge. Assess the rubella titer of the baby. Notify the health care provider.

vagina rectum

A pregnant woman at 36 weeks' gestation comes to the care center for a follow-up visit. The woman is to be screened for group B streptococcus (GBS) infection. When describing this screening to the woman, the nurse would explain that a specimen will be taken from which area(s)? Select all that apply. throat nasal cavity vagina rectum conjunctiva

6 months

A client with systemic lupus erythematosus is interested in preconception counseling to discuss the desire to get pregnant. The nurse explains that it would be best if the client is symptom-free or in remission for how long before getting pregnant? 3 months 6 months 9 months 12 months

trichomoniasis

The nurse is assessing a primigravida woman who reports vaginal itching, a great deal of foamy yellow-green discharge, and pain during intercourse. The nurse suspects the woman has contracted which disorder? trichomoniasis simple yeast infection gonorrhea chlamydia

complex carbohydrates

When providing nutritional counseling to a pregnant woman with diabetes, the nurse would urge the client to obtain most of her calories from which source? complex carbohydrates protein unsaturated fats saturated fats

"You do not need to limit your physical activity unless you experience any problems such as fatigue, chest pain, or shortness of breath."

A nurse is caring for a 45-year-old pregnant client with a cardiac disorder who has been instructed by her primary care provider to follow class I functional activity recommendations. The nurse correctly instructs the client to follow which limitations? "You will need to be on bedrest for the remainder of your pregnancy." "It is important for you to rest after any physical activity in order to prevent any cardiac complications." "It will be beneficial if you plan rest periods throughout your day." "You do not need to limit your physical activity unless you experience any problems such as fatigue, chest pain, or shortness of breath."

small head circumference

A nurse is caring for a newborn with fetal alcohol spectrum disorder. What characteristic of the fetal alcohol spectrum disorder should the nurse assess for in the newborn? wide eyes decreased blood glucose level poor breathing pattern small head circumference

within 12 hours of birth

A pregnant client has tested positive for hepatitis B virus. When discussing the situation with the client, the nurse explains that her newborn will be vaccinated with an initial HBV vaccine dose at which time? within 12 hours of birth within 24 hours of birth within 36 hours of birth within 48 hours of birth

oral metronidazole

A pregnant client is reporting of a large amount of malodorous vaginal discharge that is foamy and yellow-green in color, vaginal itching and painful intercourse. When asked, she also reports that urination is somewhat painful. She is diagnosed with trichomoniasis. What treatment would the nurse anticipate the client receiving? ceftriaxone IM oral erythromycin benzathine penicillin G IM oral metronidazole

1500

A pregnant client with type 1 diabetes is in labor. The client's blood glucose levels are being monitored every hour and she has a prescription for an infusion of regular insulin as needed based on the client's blood glucose levels. Her levels are as follows: 1300: 105 mg/dL (5.83 mmol/L) 1400: 100 mg/dL (5.55 mmol/L) 1500: 120 mg/dL (6.66 mmol/L) 1600: 106 mg/dl (5.88 mmol/L) Based on the recorded blood glucose levels, at which time would the nurse likely administer the regular insulin infusion? 1300 1400 1500 1600

Notify the primary care provider if unable to eat because of nausea and vomiting.

A pregnant woman diagnosed with diabetes should be instructed to perform which action? Discontinue insulin injections until 15 weeks gestation. Ingest a smaller amount of food prior to sleep to prevent nocturnal hyperglycemia. Notify the primary care provider if unable to eat because of nausea and vomiting. Prepare foods with increased carbohydrates to provide needed calories.

chest x-ray sputum culture

A pregnant woman tests positive for tuberculosis (TB). The nurse explains to the woman that additional tests are needed to confirm the diagnosis. When describing these tests, which one(s) would the nurse likely include? Select all that apply. chest x-ray sputum culture whole-body CT scan spirometry abdominal ultrasound

labetalol

A pregnant woman with chronic hypertension comes to the clinic for evaluation. The last several blood pressure readings have been gradually increasing. On today's visit her blood pressure is 166/100 mm Hg. The health care provider prescribes an antihypertensive agent. The nurse anticipates which agent as likely to be prescribed? hydroxychloroquine labetalol albuterol ipratropium

Lie in a semi-recumbent position.

A woman with class II heart disease is experiencing an uneventful pregnancy and is now prescribed bed rest at 36 weeks' gestation by her health care provider. The nurse should point out that this is best accomplished with which position? Lie flat on her back. Stay in high Fowler position. Lie in a semi-recumbent position. Use pillows and wedges to stay in a fully recumbent position.

have been shown to be effective and safe in recent short term studies.

A woman with type 2 diabetes is considering becoming pregnant and asks the nurse whether she will be able to continue taking her current oral hypoglycemics. The nurse's response will point out which factor? can be used as long as they control serum glucose levels. can be taken until the degeneration of the placenta occurs. are usually suggested primarily for women who develop gestational diabetes. have been shown to be effective and safe in recent short term studies.

Use gloves when planting her vegetable garden. Hire someone to empty the litter box in the house. Make sure meats are cooked to 152ºF (66.7℃); do not eat raw or rare meats.

A client who is 10 weeks' pregnant reports during a social assessment interview that she has two indoor cats, lives alone, fixes her own meals and enjoys gardening. What precautions would the nurse recommend the woman take to prevent the possibility of contracting toxoplasmosis? Select all that apply. Use gloves when planting her vegetable garden. Wash all fruits and vegetables in hot, soapy water before eating. Hire someone to empty the litter box in the house. Make sure meats are cooked to 152ºF (66.7℃); do not eat raw or rare meats. Receive the vaccination as soon as possible to prevent contracting the disease.

Auscultate heart sounds for abnormalities. Assess for edema and note any pitting. Assess for a moist cough. Assess for shortness of breath.

A nurse is caring for a client with cardiovascular disease who has just given birth. What nursing interventions should the nurse perform when caring for this client? Select all that apply. Monitor the client's hemoglobin and hematocrit. Auscultate heart sounds for abnormalities. Assess for edema and note any pitting. Assess for a moist cough. Assess for shortness of breath.

fetal alcohol spectrum disorder

A nurse is conducting a presentation about prenatal care and preexisting maternal conditions. When discussing the various risks to the mother and infant, the nurse would include information about which condition as the leading cause of intellectual disability in the United States? genetic abnormalities fetal alcohol spectrum disorder maternal drug addiction pregnancy category X medications

"Peeling any raw vegetables is a good idea before eating them." "It is important to wear gardening gloves when digging in the soil." "Any cutting surface used for raw meats should be washed afterwards with hot, soapy water."

A nurse is conducting a class for a group of pregnant women about ways to minimize the risk of infection during pregnancy. One of the infections that the nurse is discussing is toxoplasmosis. The nurse determines that the class was successful when the group identifies which action(s) as helpful in preventing this infection. Select all that apply. "Peeling any raw vegetables is a good idea before eating them." "It is important to cook any meat that we will eat to at least a temperature of 145°F (62.8°C)." "A house cat should be kept outside to prevent bringing things inside the house." "It is important to wear gardening gloves when digging in the soil." "Any cutting surface used for raw meats should be washed afterwards with hot, soapy water."