Chapter 19: Nursing management of the pregnancy at risk:

The nurse suspects preeclampsia based on which finding?

- B/P of 140/90 mm Hg on two occasions 6 hours apart

A high risk pregnant client is determined to have gestational hypertension. The nurse suspects that the client has developed severe preeclampsia based on which finding?

- BLURRED VISION RATIONALE: Visual symptoms and blind spots suggest severe preeclampsia and preteinuria in severe preeclampsia is greater than 500mg

The nurse suspects that the woman is at risk for HYDRAMNIOS based on which preexisting condition?

- Diabetes

Which measure would the nurse include in the plan of care for a woman with premature rupture of membranes if her fetus's lungs are mature?

- Induction of labor

Which medication would the nurse prepare to administer if prescribed as treatment for an unruptured ectopic pregnancy?

- Methotrexate used to treat ectopic pregnancy.

Symptoms that suggest an ectopic pregnancy. Which finding would lead the nurse to suspect that the Fallopian tube has ruptured?

- Referred shoulder pain rationale: referred pain to the shoulder area indicates bleeding into the abdomen when a tubal pregnancy ruptures.

A nurse recognizes that a woman who presents with PPROM has completed how many weeks of gestation?

- less than 37 weeks rationale: PPROM is defined as the rupture of the membranes prior to the onset of labor in a woman who is less than 37 weeks. PROM is beyond 37 weeks gestation. and is not in labor.

Three most common causes of hemorrhage during the 1st half of pregnancy ?

- spontaneous abortion, ectopic pregnancy, and GESTATION TROPHBLASTIC DISEASE NOT PLACENTA PREVIA

Risk factors for Placenta Previa:

-Advancing maternal age, -Previous induced surgical abortion -smoking -Infertility treatment

Therapeutic magnesium level:

4-7 mEq/L

Classificiation of abruptio placentae:

Grade 1: mild minimal bleeding (less than 500ml), 10-20% separation, tender uterus, no coagulopathy. Grade 2: Moderate bleeding (1000-1500), 20-50% separation, continuous abdominal pain, mild shock, NORMAL BP, tachycardia. More than 50% separation =. profound shock

Pitting Edema Scale

+1- is a 2mm depression that disappears rapidly; +2- is a 4-mm depression that disappears in 10-15 seconds +3 is a 6-mm depression that last more than 1 minute +4 is an 8mm depression that last 2-3 mins

A nurse is providing care to a client who has been diagnosed with a common benign form of gestation trophoblastic disease ?

-Hydatidiform mole

The physical exam reveals that the placenta is implanted near the internal os but does not reach it. The nurse interprets this as which type of placenta previa ?

-Low-lying - in low-lying placenta previa- the placenta is implanted in the lower uterine segment and is near the internal os but does NOT reach it.

The multiparous client has a history of cesarean births. The nurse anticipates the need to closely monitor the client for which condition?

-Placenta accreta rationale: Placenta accreta is a condition where the placenta attaches its self too deeply into the wall of the uterus. The risk increases with cesarean births.

A pregnant woman is diagnosed with abrupt placentae. When reviewing the woman's medical record the nurse would expect which finding?

-Sudden dark vaginal bleeding- rationale: the uterus is firm to rigid to the touch with abruptio placentae. bleeding associated with abrupt placentae occurs suddenly and is usually dark in color

HELLP syndrome

hemolysis, elevated liver enzymes, low platelets -The diagnosis is base on laboratory test results, including : low hemtocrit, elevated LDH, Elevated AST, elevated AST, Elevated ALT, elevated BUN and low platelets.