21 prep u

A woman is going to have labor induced with oxytocin. Which statement reflects the induction technique the nurse anticipates the primary care provider will prescribe?

Administer oxytocin diluted as a "piggyback" infusion.

A pregnant patient is diagnosed with placenta previa. Which action should the nurse implement immediately for this patient?

Assess fetal heart sounds with an external monitor

A client's membranes have just ruptured. Her fetus is presenting breech. Which action should the nurse do immediately to rule out prolapse of the umbilical cord in this client?

Assess fetal heart sounds.

During a prenatal ultrasound, the client is discovered to have a placenta succenturiata. Following delivery of the fetus and placenta, which nursing assessment is most important?

Assessment for hemorrhage

(T/F) Tocolytic therapy will help to prevent preterm birth.

False

A pregnant patient is being admitted for severe preeclampsia. In which room location should the nurse place this patient? Near the nursery Across from the nurse's station Next to the elevator In the back private room

In the back private room

A pregnant client is admitted to a health care facility with a diagnosis of premature rupture of membranes (PROM). Which test would the nurse expect to be used to predict fetal lung maturity when the client goes into labor?

Lecithin/sphingomyelin ratio

A pregnant patient is prescribed to have labor induced with oxytocin. How should the nurse prepare to administer this medication?

Diluted as a "piggyback" infusion

A woman in labor suddenly reports sharp fundal pain accompanied by slight dark red vaginal bleeding. The nurse should prepare to assist with which situation? Premature separation of the placenta Possible fetal death or injury Placenta previa obstructing the cervix Preterm labor that was undiagnosed

Premature separation of the placenta

The following hourly assessments are obtained by the nurse on a client with preeclampsia receiving magnesium sulfate: 97.3oF (36.2oC), HR 88, RR 12 breaths/min, BP 148/110 mm Hg. What other priority physical assessments by the nurse should be implemented to assess for potential toxicity? Reflexes Oxygen saturation Magnesium sulfate level Lung sounds

Reflexes

A pregnant woman has arrived to the office reporting vaginal bleeding. Which finding during the assessment would lead the nurse to suspect an inevitable abortion? strong abdominal cramping closed cervical os slight vaginal bleeding no passage of fetal tissue

strong abdominal cramping

A pregnant woman at the emergency department informs staff that she is at least 2 weeks past her due date. The physician begins to perform several tests to determine fetal age. The nurse anticipates that the woman's amniotic fluid volume will be decreased. How would the nurse measure the amniotic fluid in this situation?

ultrasound

A nurse is teaching a woman diagnosed with gestational diabetes about meal planning and nutrition. The nurse determines that additional teaching is needed based on which client statement? "I need to avoid any fat with my meals." "I should get most of my calories from good complex carbs." "It's okay to eat small meals or snacks throughout the day." "Having a bedtime snack is good for me."

"I need to avoid any fat with my meals."

Which symptom may indicate a complication (not a common discomfort) in the second or third trimester of pregnancy? Lower extremity edema in the evening in the absence of proteinuria Braxton Hicks contractions at 38 weeks Backache after long periods of standing Dyspnea on exertion or while lying supine Pain underneath the ribs on the right side

Pain underneath the ribs on the right side

A patient who experiences premature rupture of membranes can expect to be put on pelvic rest. The nurse should explain to the patient that pelvic rest involves what?

placing nothing in the vagina

The nurse is monitoring a woman who is receiving IV oxytocin to assist with uterine irritability. Which action should the nurse prioritize if the woman's contractions are determined to be 80 seconds in length after 1 hour of administration of the oxytocin? Slow the infusion to under 10 gtts per minute. Increase the flow rate of the main line infusion. Continue to monitor contraction duration every 2 hours. Discontinue the oxytocin infusion.

Discontinue the oxytocin infusion.

A client at 25 weeks' gestation presents with a blood pressure of 152/99 mm Hg, pulse 78 beats/min, no edema, and urine negative for protein. What would the nurse do next? Assess the client for ketonuria Provide health education Notify the health care provider Document the client's blood pressure

Notify the health care provider

After a regular prenatal visit, a pregnant client asks the nurse to describe the differences between placental abruption (abruptio placentae) and placenta previa. Which statement will the nurse include in the teaching?

Placenta previa is an abnormally implanted placenta that is too close to the cervix.

During a routine prenatal visit, a client is found to have proteinuria and a blood pressure rise to 140/90 mm Hg. The nurse recognizes that the client has which condition? severe preeclampsia eclampsia gestational hypertension mild preeclampsia

mild preeclampsia

A nurse is reviewing a client's history and physical examination findings. Which information would the nurse identify as contributing to the client's risk for an ectopic pregnancy? recurrent pelvic infections use of oral contraceptives for 5 years heavy, irregular menses ovarian cyst 2 years ago

recurrent pelvic infections

The nurse is reviewing the physical examination findings for a client who is to undergo labor induction. Which finding would indicate to the nurse that a woman's cervix is ripe in preparation for labor induction?

shortened

An infant was born at term but has intrauterine growth restriction (IUGR). What findings in the infant's history would contribute to this problem? Select all that apply. Maternal heartburn Maternal smoking Parents small in stature Daily maternal exercise Intrauterine infection of the fetus

Maternal smoking Intrauterine infection of the fetus

A pregnant client has tested positive for cytomegalovirus. What can this cause in the newborn? clubbed fingers and toes bicuspid valve stenosis microcephaly hypertension

microcephaly

The nurse in a busy L & D unit is caring for a woman beginning induction via oxytocin drip. Which prescription should the nurse question with regard to titrating the infusion upward for adequate contractions? Discontinue infusion if contractions are every 2 minutes lasting 60 to 90 seconds each. Begin infusion at 10 milliunits (mu)/min and titrate every 15 minutes upward by 5 mu/min. Start oxytocin drip, piggyback to main IV line to port closest to client. After one hour, titrate the infusion upward by 1 to 2 mu/min until contractions are adequate.

Begin infusion at 10 milliunits (mu)/min and titrate every 15 minutes upward by 5 mu/min.

A patient with diabetes is in the first trimester of pregnancy and is currently having difficulty keeping blood glucose levels within normal limits. The patient explains that she has been "eating for two" so the baby is healthy. How should the nurse respond to the patient? "Elevated blood glucose levels cause low birth weights in infants." "Elevated blood glucose levels hasten the development of the fetus in utero." "Elevated blood glucose levels in the first trimester have been linked to congenital anomalies." "Elevated blood glucose levels ensure the baby has mature lungs at birth."

"Elevated blood glucose levels in the first trimester have been linked to congenital anomalies."

The nurse provides education to a postterm pregnant client. information will the nurse include to assist in early identification of potential problems? "Monitor your bowel movements for constipation." "Increase your fluid intake to prevent dehydration." "Be sure to measure 24-hour urine output daily." "Continue to monitor fetal movements daily."

"Continue to monitor fetal movements daily."

A nurse is teaching a pregnant woman with preterm prelabor rupture of membranes about caring for herself after she is discharged home (which is to occur later this day). Which statement by the woman indicates a need for additional teaching? "It's okay for my husband and me to have sexual intercourse." "I can shower, but I shouldn't take a tub bath." "I need to call my doctor if my temperature increases." "I need to keep a close eye on how active my baby is each day."

"It's okay for my husband and me to have sexual intercourse."

The client is anxious about her prolonged pregnancy. She informs the nurse she has been doing research on the Internet and has read about certain herbs that can help to induce labor. Which response from the nurse would be appropriate? "There is no scientific evidence they work. You will just complicate your situation more." "Why would you do something as stupid as that?" "Personally, I would use them, but I cannot tell you to." "Please talk to your primary care provider first to ensure it is safe."

"Please talk to your primary care provider first to ensure it is safe."

A client in her first trimester arrives at the emergency room with reports of severe cramping and vaginal spotting. On examination, the health care provider informs her that no fetal heart sounds are evident and orders a dilatation and curettage. The client looks frightened and confused and states that she does not believe in abortion. Which statement by the nurse is best? "The choice is up to you but the health care provider is recommending an abortion." "I know that it is sad but the pregnancy must be terminated to save your life." "You have experienced an incomplete miscarriage and must have the placenta and any other tissues cleaned out." "Unfortunately, the pregnancy is already lost. The procedure is to clear the uterus to prevent further complications."

"Unfortunately, the pregnancy is already lost. The procedure is to clear the uterus to prevent further complications."

The nurse is providing care to several pregnant women who may be scheduled for labor induction. The nurse identifies the woman with which Bishop score as having the best chance for a successful induction and vaginal birth?

>8

The client appears at the clinic stating that she is 8 months pregnant and has had no prenatal care due to a lack of health insurance. She states not feeling well with blurred vision and a terrible headache. The client's blood pressure is 190/100 and edema is present in her lower extremities. Which diagnostic test will provide additional pertinent data? A blood culture to note any infection of the blood An ultrasound to determine fetal age A urine culture to rule out a urinary tract infection A urine dipstick test to check for protein

A urine dipstick test to check for protein

A client at 36 weeks' gestation presents to the OB unit reporting continuous, heavy vaginal discharge and pelvic pressure. Assessment reveals no signs of labor and positive Nitrazine test. The nurse prepares for which nursing intervention after admitting the client?

Administering erythromycin IV

A patient in her late twenties visits the clinic to begin the process of in vitro fertilization (IVF). Her husband in his late fifties asks if there are any tests to check for any irregularities. What tests should the nurse discuss with this couple? Examination of egg and sperm PPD amniocentesis CVS

Examination of egg and sperm

A client in preterm labor is receiving magnesium sulfate IV and appears to be responding well. Which finding on assessment should the nurse prioritize?

Depressed deep tendon reflexes

A client with a high-risk pregnancy has been prescribed inpatient bed rest. When assessing the client each morning, which risk factor of is common with this treatment plan? Diarrhea Muscle rigidity Weight loss Depression

Depression

A pregnant patient receiving intravenous oxytocin for 1 hour has contractions lasting 80 seconds. What should the nurse do first for this patient?

Discontinue the oxytocin infusion.

A 25-year-old client at 22 weeks' gestation is noted to have proteinuria and dependent edema on her routine prenatal visit. Which additional assessment should the nurse prioritize and alert the RN or health care provider? Initial BP 100/70 mm Hg; current BP 140/90 mm Hg Initial BP 120/80mm Hg; current BP 130/88 mm Hg Initial BP 140/85 mm Hg; current BP 130/80 mm Hg Initial BP 110/60 mm Hg; current BP 112/86 mm Hg

Initial BP 100/70 mm Hg; current BP 140/90 mm Hg

A nurse is reviewing the medical record of a pregnant client. The physical exam reveals that the placenta is implanted near the internal os but does not reach it. The nurse interprets this as which condition?

Low-lying placenta

A 32-year-old gravida 3 para 2 at 36 weeks' gestation comes to the obstetric department reporting abdominal pain. Her blood pressure is 164/90 mm Hg, her pulse is 100 beats per minute, and her respirations are 24 per minute. She is restless and slightly diaphoretic with a small amount of dark red vaginal bleeding. What assessment should the nurse make next? Check deep tendon reflexes. Palpate the fundus and check fetal heart rate. Measure fundal height. Obtain a voided urine specimen and determine blood type.

Palpate the fundus and check fetal heart rate.

A client at 27 weeks' gestation is admitted to the obstetric unit after reporting headaches and edema of her hands. Review of the prenatal notes reveals blood pressure consistently above 136/90 mm Hg. The nurse anticipates the health care provider will prescribe magnesium sulfate to accomplish which primary goal? Prevent maternal seizures Reverse edema Decrease protein in urine Decrease blood pressure

Prevent maternal seizures

A woman who had preterm labor and preterm PROM successfully halted has reached week 36 of pregnancy and is doing well on home care. Which of the following nursing diagnoses should the nurse prioritize for this client?

Risk for fetal infection related to early rupture of membranes

A pregnant woman at term is in the obstetrics unit for induction in the morning. Her membranes rupture, and the external fetal monitor shows deep variable decelerations. For what should the nurse immediately check the patient?

Umbilical cord prolapse

A nurse working with a woman in preterm labor receives a telephone report for the fetal fibronectin test done 10 hours ago. The report indicates an absence of the protein, which the nurse knows indicates:

birth is unlikely within the 2 next weeks.

Before calling the health care provider to report a slow progression or an arrest of labor, several assessments need to be made. What other maternal assessment does the nurse need to make prior to calling the health care provider?

check for full bladderr

A pregnant woman comes to the birthing center, stating she is in labor and does not know far along her pregnancy is because she has not had prenatal care. A primary care provider performs an ultrasound that indicates oligohydramnios. When the client's membranes rupture, meconium is in the amniotic fluid. What does the nurse suspect may be occurring with this client?

complications of a postterm pregnancy

Which assessment finding will alert the nurse to be on the lookout for possible placental abruption (abruptio placentae) during labor?

gestational hypertension

A nurse is describing the risks associated with post-term pregnancies as part of an inservice presentation. The nurse determines that more teaching is needed when the group identifies which factor as an underlying reason for problems in the fetus?

increased amniotic fluid volume

A nurse is conducting a review course on tocolytic therapy for perinatal nurses. After teaching the group, the nurse determines that the teaching was successful when they identify which drugs as being used for tocolysis? Select all that apply. indomethacin nifedipine misoprostol dinoprostone magnesium sulfate

nifedipine magnesium sulfate indomethacin

A patient who is at 7 months' gestation presents to the emergency department with reports of a large gush and continuous leaking of fluid from her vagina. She does have some slight pelvic pressure but denies any contractions. This patient is showing clinical signs of what?

premature rupture of membranes

A nurse is assessing the following antenatal clients. Which client is at highest risk for having a multiple gestation? the 27-year-old client who gave birth to twins two years ago the 19-year-old client diagnosed with polycystic ovarian syndrome the 41-year-old client who conceived by in vitro fertilization the 38-year-old client whose spouse is a triplet

the 41-year-old client who conceived by in vitro fertilization

A young woman experiencing contractions arrives at the emergency department. After examining her, the nurse learns that the client is at 33 weeks' gestation. What treatment can the nurse expect this client to be prescribed?

tocolytic therapy

A nurse is reviewing an article about preterm prelabor rupture of membranes. Which factors would the nurse expect to find placing a woman at high risk for this condition? Select all that apply. high body mass index low socioeconomic status smoking single gestations urinary tract infection

urinary tract infection low socioeconomic status smoking

A nurse is preparing an in-service program about labor and the hormones involved with the initiation of labor. Which information would the nurse include as believing to play a role in the onset of labor? suppression of prostaglandin release decrease in fetal cortisol levels withdrawal of progesterone suppression of oxytocin

withdrawal of progesterone

A 35-year-old client is seen for her 2-week postoperative appointment after a suction curettage was performed to evacuate a hydatidiform mole. The nurse explains that the human chorionic gonadotropin (hCG) levels will be reviewed every 2 weeks and teaches about the need for reliable 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?" What is the nurse's best response? "After a curettage procedure, it is recommended that you give your body some time to build up its stores." "You may need chemotherapy, so we don't want to risk pregnancy." "Since you are at the end of your reproductive years, it is suggested that you don't try to have any more pregnancies." "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."

"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."

A client is admitted to the unit in preterm labor. In preparing the client for tocolytic drug therapy, the nurse anticipates that the client's pregnancy may be prolonged for how long when this therapy is used?

2 to 7 days

A primary care provider prescribes intravenous tocolytic therapy for a woman in preterm labor. Which agent would the nurse expect to administer?

magnesium sulfate

A client presents to the emergency department reporting regular uterine contractions. Examination reveals that her cervix is beginning to efface. The client is in her 36th week of gestation. The nurse interprets the findings as suggesting which condition is occurring?

preterm labor