lippincott: preexisting conditions
A 40-year-old client at 8 weeks' gestation has a 3-year-old child with Down syndrome. The nurse is discussing amniocentesis and chorionic villus sampling as genetic screening methods for the expected baby. The nurse is confident that the teaching has been understood when the client makes which statement? "Amniocentesis is a more dangerous procedure for the fetus." "Chorionic villus sampling can be performed earlier in pregnancy." "Each test identifies a different part of the infant's genetic makeup." "The test results take the same length of time to be completed."
"Chorionic villus sampling can be performed earlier in pregnancy."
After instruction of a primigravid client at 8 weeks' gestation diagnosed with class I heart disease about self-care during pregnancy, which client statement would indicate the need for additional teaching? "I should reduce my intake of protein in my diet." "I should limit my salt intake at meals." "I may be given antibiotics during my pregnancy." "I should avoid being near people who have a cold."
"I should reduce my intake of protein in my diet.
A primigravid client who was successfully treated for preterm labor at 30 weeks' gestation had a history of mild hyperthyroidism before becoming pregnant. What instructions should the nurse include in the plan of care? Contact the health care provider (HCP) if bradycardia occurs. Discontinue taking the methimazole until after the birth of the neonate. Continue taking low-dose oral propylthiouracil as ordered. Consider breastfeeding the neonate after the birth.
Continue taking low-dose oral propylthiouracil as ordered.
A nurse is reviewing a client's prenatal history. Which finding indicates a genetic risk factor? The client has a history of preterm labor at 32 weeks' gestation. The client is 25 years old. The client was exposed to rubella at 36 weeks' gestation. The client has a child with cystic fibrosis.
The client has a child with cystic fibrosis.
A client who is 24 weeks pregnant has sickle cell anemia. When preparing the care plan, the nurse should identify which factor as a potential trigger for a sickle cell crisis during pregnancy? dehydration tachycardia sedative use hypertension
dehydration
While caring for a primigravid client with class II heart disease at 28 weeks' gestation, the nurse would instruct the client to contact her primary health care provider (HCP) immediately if the client experiences which symptom? dyspnea at rest emotional stress on the job mild ankle edema weight gain of 1 lb (0.45 kg) in 1 week
dyspnea at rest
Which medication is considered safe during pregnancy? magnesium hydroxide oral antidiabetic agents aspirin insulin
insulin
A pregnant client with diabetes mellitus is at risk for having a large-for-gestational-age neonate because: excess sugar causes reduced placental functioning. the mother follows a high-calorie diet. excess insulin reduces placental functioning. insulin acts as a growth hormone on the fetus.
insulin acts as a growth hormone on the fetus.
When developing the plan of care for a multigravid client with class III heart disease, the nurse should expect to assess the client frequently for which problem? nausea and vomiting iron-deficiency anemia dehydration tachycardia
tachycardia
When explaining the risk for having a child with cystic fibrosis to a husband and wife, the nurse should tell them: the gene is carried on the X chromosome and there is little risk. the disease will only occur if the child is a male. the disease does not have a genetic basis. the risk is greatest when both clients have the recessive gene.
the risk is greatest when both clients have the recessive gene.
the nurse explains the complications of pregnancy that occur with diabetes to a primigravid client at 10 weeks' gestation who has a 5-year history of insulin-dependent diabetes. Which complication, if stated by the client, indicates the need for additional teaching? Candida albicans infection twin-to-twin transfer polyhydramnios preeclampsia
twin-to-twin transfer
A client at 36 weeks' gestation with type 1 diabetes is scheduled for a contraction stress test. After explaining the purpose of the test, the nurse determines that the client understands the instruction when she states that the test is done to detect which problem? cardiac anomalies kidney anomalies amniotic fluid volume uteroplacental sufficiency
uteroplacental sufficiency
A nurse is caring for a client at 30 weeks' gestation who has tested positive for the human immunodeficiency virus (HIV). What should the nurse tell the client when the client says that she wants to breast-feed her neonate? Encourage breast-feeding to facilitate bonding. Encourage breast-feeding because it's healthier for the neonate. Discourage breast-feeding because HIV can be transmitted through breast milk. Encourage breast-feeding so that the client can get her rest and get healthier.
Discourage breast-feeding because HIV can be transmitted through breast milk.
A primigravid client with class II heart disease who is visiting the clinic at 8 weeks' gestation tells the nurse that she has been maintaining a low-sodium, 1,800-calorie diet. Which instruction should the nurse give the client? Take iron supplements with milk to enhance absorption. Increase caloric intake to 2,200 calories daily to promote fetal growth. Severely restrict sodium intake throughout the pregnancy. Avoid folic acid supplements to prevent megaloblastic anemia.
Increase caloric intake to 2,200 calories daily to promote fetal growth.
When developing a teaching plan for a primigravid client with insulin-dependent diabetes about monitoring blood glucose control and insulin dosages at home, the nurse would expect to include which desired target range for blood glucose levels? 140 to 160 mg/dL (7.8 to 8.9 mmol/L) 1 hour after meals 110 to 140 mg/dL (6.2 to 7.8 mmol/L) before meals and bedtime snacks 60 to 100 mg/dl (3.3 to 5.6 mmol/L) before meals and bedtime snacks 40 to 60 mg/dL (2.2 to 3.3 mmol/L) between 14:00 and 16:00 hours
60 to 100 mg/dl (3.3 to 5.6 mmol/L) before meals and bedtime snacks
